By Iptisam Abdallah, Kakamega
Daylight struck the skies flooding an orangish tinge into the horizon as I trotted along Maraba road.
As I was walking, a rusty metallic door of a roadside house creaked open and a boy of about 17 years came out with a damp mattress reeking of urine. A raspy feminine voice scolded at him “ Anika haraka na uoshe hayo makojoo. Kijana mkubwa unaniaibisha”
He shamefully leaned it on a wall facing the sun and hurriedly disappeared in the house slamming the door shut.
Curiosity gnawed my conscience as I tried to think of reasons of bed wetting at such a big age . It then dawned on me that it could be an issue of Urology.
Paving my way through mukombero and mandazi sellers along Kakamega road, I hurriedly walked towards the magnificent Golf hotel where Urology doctors had a conference.
I met two resident urologists from Kenyatta National Hospital, who after warm handshakes and a little chit- chat agreed to spill knowledge about Urology right into my absorbing brain.
Donning smiles, we sat inside a gazebo, Dr. Abdalla mwadzingo , Dr. Luwi Wekesa and I, eyes on each other ready for a fruitful question answer session.
‘‘Urology also known as genitourinary surgery is a branch of medicine that focuses on surgical and medical diseases of the urinary tract system and reproductive organs.
A Urologist is a medical doctor specializing in conditions that affect the urinary tract in men, women and children. This system constitutes the bladder, kidneys, ureters and urethra which are responsible for keeping the body clean. A Urologist also treats conditions involving reproductive organs and adrenal glands.’’ explained Dr. Abdalla .
‘Urologists treat an entire spectrum, including patients of all ages, gender and socio-economic status.’’ He added.
The Genitourinary system
Whilst wondering what such a difficult medical term meant, the two doctors warmly smiled and took turns explaining to me in the simplest way possible.
‘’The genitourinary system are the organs of the reproductive system and urinary system that urologists treat. They are grouped together due to their proximity to each other, their common embryological origin and the use of common pathways.
The urinary tract is the system that creates , stores and removes urine from the body.
It is composed of kidneys which are the organs that filter waste out of the blood to produce urine, ureters which are tubes through which urine flows from kidneys to the bladder, bladder which is the hollow sac that stores urine, urethra which is the tube through which urine travels from the bladder out of the body and adrenal glands which are the glands located on top of each kidney that release hormones.’’ said Dr. Abdalla.
Taking his turn to explain, Dr. Luwi continued;
‘The male reproductive organs are inclusive in the genitourinary system. This organs include the penis which is an organ that releases urine and carries sperm out of the body, prostate which is the gland underneath the bladder that adds fluid to sperm to produce semen and testicles which are two oval organs inside the scrotum that make hormone testosterone and produce sperm,’’
Conditions that Urologists treat
‘’Urologists treat a wide variety of conditions that affect the urinary system. In men, urologists commonly treat cancers of the bladder, kidneys, penis, adrenal and prostate glands, prostate gland enlargement known as benign prostatic hyperplasia, erectile dysfunction, male infertility, interstitial cystisis and other bladder disorders, kidney diseases and kidney stones, prostatitis which is inflammation of the prostate gland, urinary tract infection, varioceles or enlarged veins in the scrotum and urethral stricture.
In women, Urologists often treat urinary incontinence, bladder prolapse which is the dropping of the bladder in the vagina, cancers of the bladder, kidneys and adrenal glands, bladder conditions such as interstitial cystisis and overactive bladder, kidney and ureteral stones as well as ureteral infections.
In children, urologists commonly treat congenital diseases that cause urinary blockage, infections or difficulties urinating, bladder dysfunction that can be a cause of bed-wetting, circumcision revision, kidney conditions such as duplex kidney and kidney dysplasia ’’ Explained Dr. luwi.
When to consult a Urologist
‘’A Urologist should be consulted on occasions where one experiences changes in urination patterns to frequent, trouble in urinating ranging from a strong flow of urine, cloudy urine, blood stained urine to pain during urination, trouble getting or keeping an erection in men, infertility, vaginal heaviness or a feeling of something falling into it in females, pelvic pain and unwanted urination at night , when sneezing laughing or exercising.’’ Said Dr. Luwi.
Sub-specialties of Urology
‘’Urology is referred to as a surgical sub-specialty requiring four years of under-graduate education, four years of medical school and an additional five to six years of residency. After residency urologists can pursue advanced coursework and training in areas of urology of their interest that are referred to sub-specialties.
Sub-specialties of Urology include, urological oncology,laparascopy, pedriatic urology, andrology, endourology, female urology, reconstructive urology, and neurorology, ‘’
Confused of the constituents of the sub-specialties mentioned, Dr. Luwi smiled and further explained,
‘’The subspecialties involve; Urological oncology that is a medical specialty with surgeons who focus on the treatment of cancer in the urinary tract and male reproductive organs. Laparascopy, on the other hand consists of surgeons who perform minimally invasive surgeries using laparascopes which are cameras that see through the abdomen as an alternative to convectional open surgery. Pedriatic urology
has specialized surgeons who can diagnose, treat and manage childrens urinary and genital problems.’’
Taking a short pause, he continued, ‘’Andrology is aspecialist area of medicine involving male health issues such as fertility problems and sexual dysfunction. Endourology/ Calculi is a minimally invasive technique used to treat kidney stones and involves the stones being extracted or fragmented using tiny instruments through natural body channels such as the urethra , the bladder and ureter. Female urology is a sub-specialty that focuses on conditions of a woman’s reproductive and urinary tract. Reconstructive urology is a sub-specialty of urology that focuses on restoring both structure and function to the genitourinary tract. Lastly, Neurourology focuses on the nervous systems control of genitourinary organs.
Urological tests and treatments
‘’Before treatment, urologists have to run tests on patients to properly diagnose a disease for effective treatment procedures. The tests include; A variety of blood and urinary tests, studies of the bladder and lower urinary system called urodynamics to assess function of these structures, cystoscopy using a thin endoscope called a cytoscope to see inside the urethra and the bladder, imaging such as CT scan, MRI scan, PET scan, or ultrasound and contrast studies of the bladder or kidneys.’’ said Dr. Abdalla.
Taking his turn, Dr. Luwi guided me into the treatment procedures.
‘’Urological doctors use surgery as a treatment procedure. The surgeries involve endoscopic removal of the prostate, a kidney transplant, which involves replacing a diseased kidney with a healthy one, robotic surgery to remove bladder, kidney or prostate to treat cancer, extracorporeal shock-wave lithotripsy which is kidney stone removal or laser fragmentation of kidney and uteretic stones, cystoscopy, formation of a stoma to divert urine into a bag , scrotal surgery, a sling procedure which involves using strips of mesh to support the urethra and keep it closed to treat urinary incontinence and vasectomy which involve cutting and tying the vas deferens.’’
Contented with the loads of information I got about urology, I thanked the doctors and exchanging nice-to-meet –you handshakes, I left a happy soul.


Advanced Gunshot Wounds Course
1005 Cobb Place Blvd. Kennesaw
The Advanced First Aid for Gunshot Wounds is an in depth course for the participant to learn how to recognize, evaluate and treat the 3 most likely causes of preventable death due to penetrating trauma – 1) massive bleeding, 2) airway obstruction, and 3) chest injuries resulting in tension pneumothorax.
The 6 hour course is a mixture of lecture, skill sessions, and scenario training. Participants will progress through various stations and scenarios at a “crawl, walk, run” pace which allows for skill development and learning.
The objective of the class is not to offer instruction on basic first aid, but to teach the principles of Tactical Combat Casualty Care and Tactical Emergency Casualty Care so that participants are able to effectively assume the role of a “Bystander First Responder” and render effective aid during the critical first minutes following a life threatening injury, before professional help arrives. CPR and first aid principles are not taught during this course.
No prior medical training is necessary to participate. All necessary training materials will be provided as this is a “hands on” course of instruction.
- Patient assessment
- Patient movement
- Massive bleeding and hemorrhage control
- Improvised tourniquets
- Methods of applying a trauma dressing
- Airway obstruction and maintaining an open airway
- Evaluation and treatment of sucking chest wounds and tension pneumothorax
- Management of abdominal injuries
- Methods of treating hypothermia
- Items to include in a trauma kit


What does it entail?
In Vitro Fertilization is the technique most commonly used in assisted reproduction centres. It is a more complex procedure than intrauterine insemination and consists of fertilising eggs with sperm in the laboratory with the aim of generating an embryo. The embryos are cultivated for a few days and then transferred to the woman’s uterus so that they can continue their natural development.
Fertilization can be performed using two techniques:
- a technique called ICSI (Intracytoplasmic Sperm Injection). In this way, our embryologists select the best sperm and inject them one by one directly into each egg. This is an extremely accurate technique that increases the chances of fertilization of the eggs.
- a technique called IVFET (In Vitro Fertilisation and Embryo Transfer). The oocytes collected are placed in a culture plate along with prepared partner/donor sperm to achieve fertilization. After about 20 hours the development of the zygotes is ascertained (pre-embryonic phase).
In addition, depending on where the sperm come from, in vitro fertilization can be:
- IVFET with sperm from the couple (homologous IVFET). The sperm comes from a sample provided by the patient’s partner.
- IVFET-D with donor sperm (heterologous IVFET). The sperm comes from a gamete bank.
Who is it indicated for?
IVFET is recommended in the following cases:
- Lesion or absence of the Fallopian tube
- Severe alterations in sperm quality
- Use of sperm of testicular origin (TESE and MicroTESE)
- Multiple failures of previous treatments
- Hereditary genetic disease
- Need for Preimplantation Genetic Diagnosis (PGT-A, PGT-M)
- Use of vitrified oocytes after oocyte cryopreservation treatment
Control of follicular development
Oocyte collection (Pick-up)
Egg collection is a very simple procedure performed in the operating room, using a thin needle. The operation is performed by transvaginal ultrasound for aspiration of the follicles. The process does not take more than 15/20 minutes and is carried out under sedation for the comfort and well-being of the patient.
It does not require hospitalization, only a few hours rest in our clinic room is advised. Once this time has elapsed, the patient can resume her usual activities.
Preparation of the sperm sample
The sperm sample needs to be prepared so as to be able to fertilize the egg and to obtain an optimal concentration of motile sperm.
The sperm sample is obtained from the man by masturbation, in our centre, on the same day of the oocyte collection or it can be previously cryopreserved. In cases where the use of donor sperm is recommended, it too will be cryopreserved. In both cases, our biologists will treat it in the lab with a process known as sperm capacitation, in order to select sperm with the best motility.
Fertilisation and culture of the embryo
Our embryologists carry out the fertilization by means of a technique called IVFET (In Vitro Fertilization and Embryo Transfer), in which the oocytes collected are placed in a culture plate together with the sperm of the partner/donor prepared to achieve fertilization. After about 20 hours the development of the zygotes is ascertained (pre-embryonic phase). The zygotes destined for transfer to the uterus are left in culture to become actual embryos/blastocysts over the next few days.
Our embryologists carry out fertilization by means of a technique called ICSI (Intracytoplasmic Sperm Injection), which consists of selecting a single sperm for each egg and then microinjecting it into the egg. It is a very accurate method which facilitates the fusion of the nuclei of the male gamete with the female gamete. The fertilized zygotes must be kept in culture for the next few days, becoming actual embryos/blastocysts in the following days.
During embryo transfer the embryo is placed inside the uterine cavity; this can be done with a “fresh” or “thawed” embryo.
The transferred embryo is at the embryo/blastocyst stage (approximately 3-5 days of embryonic life).
It is defined as “fresh” when the embryo/blastocyst obtained during the same cycle of ovarian stimulation and follicle collection is used. Thawing is defined as transferring a previously cryopreserved embryo/blastocyst from an earlier treatment.
A “thawed” embryo is transferred when: a) there is a risk of “Ovarian Hyperstimulation Syndrome”, b) endometrial conditions are not suitable for embryo implantation, c) embryonic genetic diagnosis techniques (screening and pre-implantation diagnosis) are necessary, d) there is some reason that does not recommend gestation in the same cycle as IVFET/ICSI.
In both cases, the transfer is done with a thin transfer catheter. It is a completely painless procedure and requires no hospitalization.
After the “beta wait” period (9-14 days after embryo transfer), a blood pregnancy test will be conducted. This tests for presence of the hormone β-hCG (Human Chorionic Gonadotropin), which is the hormone that the embryo produces after its implantation in the endometrium.
If the beta result is positive, we will perform an ultrasound scan in the following weeks to confirm the presence of the “gestational sac” inside the uterus and observe the heartbeat of the future baby.


CoEd All Levels Athletic Training
2015-2016 VHSL Physical Form
Physicals must be on the March 2013 VHSL form and completely filled out in order for students to try-out/participate in a sport. Physicals have to be done ON or AFTER May 1, 2015. If you have any questions, please contact Ms Pittelkau (Athletic Trainer at WSHS) at 703-497-8032 or firstname.lastname@example.org
Student Accident Insurance
Athletes at WSHS are required to have health insurance either through their parent/guardian or they can purchase it. Please click on the link for more information.
VHSL Skin Lesion Form
This form is to be filled out by a physician in the even that an athlete has a skin infection (boil, impetigo, ring worm, scabies, head lice, conjunctivitis, and others). There are guidelines on this form as to when an athlete could potentially return to play if they are diagnosed with a skin infection. It is IMPERATIVE that the athlete and/or parent communicate with their athlete's coach AND athletic trainer. Skin infections can spread rapidly. We would like to avoid this as much as possible.
National Athletic Trainers' Association
The NATA is a non-profit organization made up of athletic trainers. This website has helpful information about athletic trainers, what we do, what we are trained in, our education, and other great information.


Our Bountiful Location
We love Bountiful! The stunning mountains and incredible view of the Great Salt Lake make this city one of the best in Utah. The community in Bountiful is full of wonderful folks that we feel deserve the best dental care available. We’re committed to providing that care here at Alpenglow!
Our Bountiful office is conveniently located near Lakeview Hospital at 425 Medical Dr. Ste 211.
Let us provide your dental care in Bountiful! Give us a call today to schedule an appointment: 801-397-5220.
Our Bountiful Team
The warm, friendly staff at our Bountiful office is dedicated to making your dental experience great. We know your time is valuable, so we’ll work with you to accommodate your schedule and ensure that you’re seen quickly when you arrive.
Dr. Benzon and Dr. Curtis work in our Bountiful office to address all your dental needs:
Dr. Benzon is a Utah native who loves Bountiful for the great rock climbing opportunities found in the beautiful mountains above the city. Bountiful Peak and Skyline Crag are just two of the many stunning viewpoints to enjoy here. He also enjoys interacting with Spanish-speaking patients; he’s a fluent Spanish speaker. Read more about Dr. Benzon here.
Dr. Curtis was born here in Utah and is an alumnus of the University of Utah. He went off to Las Vegas for his dental school education, but luckily for us, he came back to Bountiful! When he’s not providing excellent dental care in our office, he’s enjoying the numerous family-friendly recreational opportunities in Bountiful with his kids. Read more about Dr. Curtis here.
Personalized Care and Service
Dr. Curtis and Dr. Benzon want to ensure that you have a great experience in our Bountiful office. They will thoroughly review every procedure with you so that you’re fully informed and comfortable during your visit. Our four popular services in Bountiful include:
Accidents happen and dental emergencies don’t always occur during office hours. We know how stressful a painful tooth can be, and we’re here to help. Our extended emergency hours are from 8:00 am- 9:00 pm Monday through Saturday.
We want to help your avoid those pesky dental emergencies and encourage you to stop by for a visit every 6 months. Keep those teeth healthy with regular exams and cleanings!
Our Bountiful dentists provide cosmetic services including ClearCorrect braces and teeth whitening. No matter what your age, we can help you get the look you’re looking for.
Missing a tooth? Need a crown? We’re here to help! Come in for a consultation; Dr. Benzon or Dr. Curtis are ready to work with you to create the perfect dental plan.
5 Reasons We Love Bountiful:
There are so many reasons to love the beautiful city of Bountiful. Here are five of our favorites:
- Our rich heritage. Bountiful was founded in 1847!
- It’s a great place to raise a family.
- We have some of the best restaurants in the state!
- The annual Handcart Days celebration brings our community together.
- Bountiful is a truly beautiful place.


Chief Development Officer
Anne-Marie Li-Kwai-Cheung joined Wave in February 2022 as Senior Vice President, Regulatory Affairs, Compliance and Policy and was promoted to Chief Development Officer in September 2022. In her current role, Anne-Marie oversees all preclinical and clinical drug development activities at Wave.
Anne-Marie was previously at Roche (Basel, Switzerland), where she started in Global Regulatory Affairs and went on to hold leadership positions of increasing responsibility in global drug development and global program leadership within the neurology and rare disease therapeutic areas. She served as Life Cycle Leader for tominersen in Huntington’s disease, guiding the Phase 3 program and other late-stage development activities, including responsibility for commercial activity, reimbursement, medical affairs, development and manufacturing and supply. In addition, she led the filing and development team at Roche through the global launch of Ocrevus for multiple sclerosis. Her career also reflects her keen interest in personalized medicines, as she led a team focused on the development of novel digital outcome measures for neurological diseases, and software as a medical device (SaMD) to enable physicians and patients to better understand and manage disease progression. Prior to her work at Roche, Anne-Marie worked for Genzyme, leading regulatory teams in regulatory filings and a filing team for an advanced therapy during a period of significant legislative changes. With more than 20 years’ experience across major pharmaceutical companies, including GlaxoSmithKline and Wyeth, Anne-Marie has broad experience with the execution of strategic development and regulatory plans that deliver timely and meaningful therapies for patients.
Anne-Marie earned a master’s degree in medicinal chemistry from the University of Salford and is a member of RAPS (Regulatory Affairs Professionals Society) and TOPRA (The Organisation for Professionals in Regulatory Affairs).


In addition to nicotine, Juul pods include a mixture of glycerol, propylene glycol, benzoic acid and flavoring agents, the long-term health effects of which have but to be determined, she said. Critics of e-cigarettes concern that vaping will get children hooked on nicotine and that they’re going to “graduate” to cigarettes when they want a much bigger kick, Warner says. “My reading of the evidence is that it is fairly convincing that e-cigarettes are serving to some people give up smoking.” The FDA regulates e-liquids offered in stores, but not ones you purchase on the street. But nicotine, which is thought to be addictive, is the most typical active ingredient. Two of them — diacetyl and formaldehyde — are linked to lung disease and cancer.
E-cigarettes could be particularly harmful for young folks because nicotine impacts them in several ways than adults. Youth who use e-cigarettes are additionally more prone to try cigarettes. In 2017, a couple of in six New York City highschool students reported utilizing e-cigarettes. That means more than thrice as many high school students use e-cigarettes than smoke cigarettes. While e-cigarettes have the potential to learn some individuals and hurt others, scientists nonetheless have lots to find out about whether or not e-cigarettes are effective for quitting smoking.
This Is Quitting
Get The Information About Vaping
Meanwhile, there are lots of of several types of e-cigarettes on the market, and nearly all of them include nicotine. Sometimes, they even contain THC, the chemical present in marijuana that makes customers really feel “high.” As of Dec. 20, 2019, the new authorized age limit is 21 years old for buying cigarettes, cigars, or any other tobacco merchandise in the U.S. “Juul made it cool, and younger individuals who had never smoked cigarettes have gotten hooked on nicotine,” said Erika R. Cheng, a public health epidemiologist at Indiana University School of Medicine.
FDA wish to thank all State Departments of Health for his or her ongoing efforts, collaboration and communications on the recent respiratory diseases related to e-cigarettes and vaping merchandise. THC use has been associated with a variety of well being effects, particularly with extended frequent use. The finest way to keep away from potentially dangerous effects is to not use THC-containing e-cigarette, or vaping, products.
Researchers are trying at the well being results of different e-juice components. CDC will conduct aerosol emissions testing of e-cigarette, or vaping, products. FDA is analyzing e-liquids for the presence of a broad range of chemical substances. Analysis of each aerosol emissions and e-liquids will complement each other, and together will assist enhance our understanding of exposures among case sufferers associated with the lung injury outbreak. CDC and FDA are working collectively to coordinate evaluation of e-cigarette, or vaping, merchandise to offer perception into the nature of the chemical publicity contributing to the lung injury outbreak.
- Dr. Friedman mentioned that quite than outright bans that can have unanticipated prices, she favors higher regulations.
- Still, she and other experts are very concerned about the explosive uptake of vaping by young individuals.
- So, a completely new era of persons are turning into hooked on nicotine.
- What’s extra, vaping is attracting teenagers and younger adults who would not in any other case smoke.
- Even though some scientists imagine they are less dangerous than traditional cigarettes, they’re nonetheless not a healthy, or secure various.
Knowledge about opposed experiences might help the FDA determine health or quality problems beyond these usually associated with tobacco product use. Talk together with your health care provider about sources and techniques that can assist you cope with nicotine withdrawal. Many medical health insurance plans, together with Medicaid, cover services that can assist you quit vaping. The CDC, FDA and state and native well being departments are investigating a multi-state outbreak of e-cigarette, or vaping, product use associated lung injury. While the investigation is ongoing, we urge New Yorkers to share data with their communities.
CDC, FDA, and state health authorities have made progress in identifying substances of concern in e-cigarette, or vaping, product use-related lung harm , and in characterizing the outbreak. If you could have skilled undesired well being or quality problems with a specific tobacco product, you’ll be able to report a problem with any tobacco product, including vapes, to the FDA.


Mold spores are all around us. They are as constantly present as the air we breathe. However, some species are far from benign when you encounter them in higher concentrations or over an extended period. There are various symptoms you could have from breathing in, touching, or even ingesting mold that you should be aware of. To not understand these symptoms could mean you suffer needlessly when mold removal could make a huge difference in your life.
The least common ailments are those from touching or ingesting mold because this rarely happens accidentally. As long as you wash up well after touching mold and don’t eat spoiled food, you are unlikely to encounter skin rashes, diarrhea, dehydration, stomach cramps, nausea, vomiting, or a loss of appetite that can result.
Breathing mold spores is another matter altogether. If your home’s indoor air quality is being undermined by mold spores, there are several diseases and symptoms you could realize. Allergies are one typical ailment with symptoms, including nasal congestion, runny nose, sneezing, and itchy eyes. In some cases, the allergic reaction can cause lung airway inflammation, sinusitis, and asthma symptoms.
More serious symptoms to watch for include fatigue, flu-like symptoms, shortness of breath, general weakness, coughing up blood or dirty-looking mucus, frequent headaches, nosebleeds, painful joints and muscles, frequent ear infections, memory loss, and sexual dysfunction.
If you or someone in your family is experiencing any of these symptoms, we urge you to call us at TMS Property Solutions for mold removal. Even if you do not see mold, it could be growing in hidden places. Our mold removal services take care of any type of mold safely, including black mold, so that your family can start on the road to good health again.


Going to the doctor can be overwhelming and time consuming. But it doesn’t have to be. Taking a few simple steps before your appointment can help ensure that you get the most out of your visit with your doctor. With these tips you can make sure that you and your Doctor are on the same page and that your time is well spent.
Preparing for your appointment
Preparing for your doctor’s appointments can help ensure that you make the most of your time with your healthcare provider. Start by gathering any relevant information such as medical records, test results, and a list of current medications. Next, write down any questions or concerns you have so that you don’t forget to address them during your visit. Consider bringing a trusted friend or family member with you for support or to help you remember important details. Finally, take some time to mentally prepare yourself and prioritize what you want to discuss with your doctor.
Making a list of questions and concerns
One of the most important steps to getting the most out of your doctor visit is to make a list of all your questions and concerns. This will help you stay focused during the appointment and ensure that you don’t forget anything important. Write down any symptoms you’ve been experiencing, any changes in your health, or any questions you have about your treatment plan. Don’t be afraid to ask your doctor’s appointments for more information if you don’t understand something or if you need clarification. Remember, the more informed you are, the better decisions you can make about your health.
Bringing important documents and records
One of the key ways to get the most out of your doctor visit is to bring along any important documents and records related to your medical history. This may include past test results, lab reports, and imaging scans. By having these documents on hand, you can provide your doctor with a comprehensive overview of your health and any previous treatments or procedures. This can help your doctor make more informed decisions and provide more targeted care. Additionally, having these records with you can help prevent any potential delays or confusion during your appointment.
Taking notes during the appointment
Taking notes during your doctor’s appointment can be a valuable way to keep track of the conversation and ensure that you don’t forget any important details. Jotting down notes can also help you to remember any instructions your doctor gives you. Consider bringing a pen and notebook or using the notes app on your phone. If you’re having trouble keeping up with the conversation, consider asking your doctor if it’s okay to record the appointment so you can listen back to it later. Don’t be afraid to ask your doctor to repeat any important information or clarify any confusing instructions.
Asking for clarification
One of the most important things you can do during your doctor’s appointments is to ask for clarification if you don’t understand something. Medical jargon can be confusing, and it’s crucial that you fully grasp what your doctor is telling you. Don’t hesitate to ask questions if you need more information or if something doesn’t make sense. Your doctor is there to help you, and they want you to understand your condition and treatment plan. By asking for clarification, you can ensure that you are fully informed and can make the best decisions for your health.
Discussing treatment options
Once your doctor has thoroughly assessed your condition and made a diagnosis, it’s time to discuss treatment options. This is a crucial part of your visit, as it allows you to actively participate in your healthcare decisions. Ask your doctor about the different treatment options available to you, including potential risks and benefits of each. Consider asking about alternative treatments or complementary therapies as well. Don’t hesitate to share your preferences and concerns, as open communication with your doctor can lead to a more personalized and effective treatment plan. Remember, you are an important member of your healthcare team, so be an advocate for yourself during this discussion.
Advocating for yourself
It’s important to remember that you are your own best advocate when it comes to your health. Don’t be afraid to speak up and ask questions, or to share any concerns or symptoms you may be experiencing. If you feel like your doctor is not taking you seriously or dismissing your concerns, don’t hesitate to seek a second opinion. Remember that you have the right to be an active participant in your healthcare and to receive the best possible treatment. Don’t be afraid to advocate for yourself and your health needs.


In the years 80, when my brother and I were young, we loved to go to Long John Silver's [a chain of American fast food specializing in seafood]. But it wasn't about the fish. It was the vinegar. The malt. We used to uncover the bottle that was on the table and drink that delicious and pungent nectar of the gods. Do you feel repulsion? Probably. Were we anticipating to our time? Apparently.
Some online media and search engines want us to believe that drinking vinegar is the cure for everything. Our friends and colleagues tell us stories about the healing powers of vinegar for any problems we have mentioned in the conversation. "Do you have back pain for mowing the lawn? Vinegar. " Those last kilos you need to get rid of? The vinegar will get out of them. " "Syphilis again? You know that, vinegar. "
As a practicing family doctor and medical teacher, people ask me all the time about the benefits of drinking apple cider vinegar. And the question would be equally valid for any type of vinegar because, explains Manuel Moñino, member of the Spanish Academy of Nutrition and Dietetics, given the amount used for this product as a condiment, no matter if it is Apple, sherry, cider, Modena or Rice. I really enjoy those moments, because we can talk about the (long) history of vinegar and then distill the conversation towards the possible benefits.
A cure for colds, plague and obesity?
Historically, vinegar has been used for many ailments. The Greek doctor Hippocrates used to recommend vinegar treatments for cough and colds, and his Italian namesake Tommaso Del Garbo washed his hands, face and mouth with this food during the plague outbreak of 1348 in the hope of being able to prevent infection .
From the Times of Roman soldiers to modern athletes, a drink made from the mixture of vinegar and water has been used to quench the thirst. Around the world, ancient and modern cultures have found good uses for this "sour wine."
Despite having historical testimonies and anecdotes about the virtues of vinegar, what does medical research have to say about its relationship with health?
The most reliable evidence about the health benefits of vinegar comes from some studies done with people. One of them showed that, after a meal, vinegar can improve the blood glucose levels of those insulin-resistant people. In a group of 11 "prediabetic" participants, an intake of 20 milliliters — a little more than one tablespoon — of vinegar reduced blood sugar levels more than the placebo within 30 to 60 minutes after eating. A good data, but only tested in 11 people.
Another research carried out with obese adults showed a significant decrease in weight, body fat and triglycerides. Scientists selected 155 obese Japanese to Ingirieran well 15 milliliters — around one tablespoon — or 30 milliliters — a little more than two tablespoons — of vinegar daily or a placebo drink, and monitored their weight, body fat, and Triglycerides. In the group of 15 milliliters and in the 30 milliliters, the experts observed a reduction in the three markers. Although it is necessary to confirm these results with more extensive studies, the data are promising.
Work done with animals, especially rats, show how vinegar can potentially reduce the blood pressure and fat cells of the abdominals. This helps build the case for upcoming human studies, but basing benefits on animal outcomes alone is premature.
In general, the benefits of vinegar have to be confirmed by larger studies carried out in humans, something that will occur as researchers test in people already tested in animals.
Currently, "there is no health statement authorized by the European Food Safety Authority (EFSA) of which it has been requested (the name of the sender of the consultation is not known): It eliminates toxins, which is good for vascular health, The skin, helps in weight control, improves intestinal health, etcetera, "says Moñino.
Is there something wrong?
Is there any evidence that vinegar is bad for your health? not really. Unless you're drinking excessive amounts [Moñino clarifies that "vinegar is not intended to be drunk and less if you think that it is going to lose weight"], and "unless you have reflux or other problems of dyspepsia", point from the Spanish Academy of Nutric Ion and Dietetics. Or, of course, unless you take a vinegar with a high acetic acid content, like the one that is distilled and used for cleaning — the acetic acid content of the vinegar consumable is only 4% to 8% — you rub it in your eyes , or hot in a pot of lead like the Romans did. In such cases, it is not healthy. In general, do not heat any food in lead cookware. It's always bad.
So you can take your fish and chips [or the lentil plate] with vinegar. It's not going to hurt you. You may not be reporting all the benefits you would like, and it certainly does not serve as a cure for everything, but it is something that people from all over the world will be enjoying with you. So lift that glass of malt vinegar with me and wet our lips for our health.
* Author: Gabriel Neal, family physician, member of the American Academy of Family Physicians and professor at Texas A & M University. This article is an original publication of The conversation. Read the article in English here.


Minnesota United is hosting a community cleanup event beginning at 10:00 a.m. on Saturday, April 17. Fans, MNUFC staff and community members will gather together in the Midway community to pick up winter trash and debris that has emerged this spring with the snow melt.
Participants will park in Lot A on the eastern side of Allianz Field for check in from 9:00-10:00 a.m., where staff will be handing out sanitary gloves, disinfectant wipes and bags. There will also be snacks and water available. The group will be split up and given designated areas to clean up. Once a bag is full, participants will bring the bags back to Allianz Field for disposal.
Use the form below to register, but first be sure to look over the Participant Waiver and Release.
COVID-19 Health Promise
In order to help mitigate the risk of transmission of the novel coronavirus SARS-CoV-2 and any resulting disease (together with any mutation, adaptation, or variation thereof, “COVID-19”) and other contagious illnesses, Holder agrees to the following:
Stay-at-home: Holder agrees that neither Holder, nor anyone in Holder’s party, will attend any Event if any one or more of the following is true on the day of such Event:
- Within the 14 days prior to the Event, Holder has (or any person in Holder’s party or with whom Holder has had close contact has) tested positive for, or been exposed to someone who has tested positive for, COVID-19;
- Within the 48 hours prior to the Event, Holder has (or any person in Holder’s party or with whom Holder has close contact has) experienced symptoms of COVID-19 (i.e., a fever of 100.4⁰F or higher, cough, shortness of breath or difficulty breathing, chills, repeated shaking, muscle pain/achiness, headache, sore throat, loss of taste or smell, nasal congestion, runny nose, vomiting, diarrhea, fatigue or any other symptoms associated with COVID-19 identified by the Centers for Disease Control and Prevention or Health Canada, as applicable);
- Within the 14 days prior to the Event, Holder has (or any person in Holder’s party or with whom Holder has had close contact has) traveled to any state or international territory identified by federal or applicable local governments as being subject to travel or quarantine advisories due to COVID-19.


Laser Hair Removal in Toronto
For perfect, smooth skin with no more razors or waxing, Julian Anthony's provides exceptional hair removal services.
Our team of fully trained professionals uses state-of-the-art equipment and a meticulous approach to each client.
Julian Anthony's is proud to offer a warm, comfortable facility in the heart of downtown Toronto. Our clients appreciate the relaxed atmosphere and amazingly effective results.
Best of all, we provide our laser hair removal services at competitive rates!
If you have any questions or would like further information on laser hair removal, or any of our other services, contact Julian Anthony's. One of our associates would be glad to assist you!
What is Laser Hair Removal?
Laser hair removal is a revolutionary procedure which uses laser technology to safely remove unwanted hair.
A device emitting a beam of concentrated light which is absorbed into the skin’s pigment (melanin). The light energy is then concerted into heat, which damages the tube-shaped hair follicles within the skin. As a result, future hair growth in the area is prevented or delayed.
While very effective in the long-term, laser hair removal is not fully permanent. We will treat your skin with multiple treatments to prevent hair regrowth.
Laser hair removal includes a variety of treatment locations, including legs, armpits, upper lip, chin, and the bikini line. It is safe for use everywhere on the body except the eyelids.
Julian Anthony's would be happy to answer any questions you have pertaining to our laser hair removal treatment!
Preparing for Laser Hair Removal
Prior to your hair removal appointment, you will be scheduled for a consultation. Your specialist will go over your medical history, including skin conditions or scarring and any medication use.
For up to six weeks before the procedure, it is recommended you stay out of the sun. Be sure to wear broad-spectrum sunscreen if you’re going to be exposed to the sun.
As plucking, waxing, and electrolysis can damage hair follicles and affect the results of laser hair removal, these methods for hair removal should be avoided for four weeks before your appointment.
During the Treatment
You will be scheduled for two to six treatments depending on your treatment locations and objectives. The frequency of the treatments depends on the location of hair removal—from 4-8 weeks for areas of fast hair growth, to 12-16 weeks for areas with slower hair growth.
During the procedure, you will wear special sunglasses for protection against the laser light. A hand-held laser device will be held to your skin, against the area in question. Either a cooling device or a gel will be used to provide coolness and relief. Some clients feel a very slight warm sensation or mild discomfort, while many feel nothing at all.
The length of the procedure varies from a few minutes to over an hour, depending on treatment areas.
Laser Hair Removal Results
For the first several hours after the treatment, slight skin redness and swelling is common. You may apply ice to the treated area to reduce any irritation.
Hair will not immediately fall out, but will be shed over several days to weeks. After that, hair will be removed for several months to years, depending on the client.
To learn if laser hair removal is right for you, contact Julian Anthony's today!


Aquatic Therapy Pools for your Health
Swimming is an excellent source of exercise and rehabilitation. Swimming is a low impact sport that helps people get in shape and stay in shape. Overcoming an injury to upper and lower extremities can be accomplished with the aid of a therapy pool. Consult an expert physical therapist or aquatic trainer before using a therapy pool.
Animals are very much like humans and swimming with the aid of a therapy pool can help animals that are in need of rehabilitation.
Riverflow Pumps can be easily utilized in varying sizes of swimming pools and water vessels making water current available to a variety of applications, especially therapy pools. The ability to control the power of water current gives qualified personnel the necessary tools for the user’s specific needs.


This month we will discuss two common eyelid bumps. Styes and chalazia are common reasons for seeking a consultation with an eye doctor.
What are styes and chalazia?
Styes and chalazia are bumps of the eyelid. A stye is a localized infection of a hair follicle, usually on the outside of the eyelid. A chalazion is localized inflammation from the blockage of an oil gland of the eyelid. These start from the inside of the eyelid. As the gland becomes more blocked, the oils cannot escape, which creates the bump of the eyelid.
What are the symptoms?
Both bumps can present with soreness and redness of the eyelid. They may cause some symptoms of dry eye syndrome including the feeling of something in the eye. Crusting of the eyelids may occur with some styes. Chalazia may become larger with time and cause mild blurry vision.
What do styes and chalazia look like?
A stye often looks like a small pimple at the base of an eyelash. The photo here shows a stye.
A chalazion is a small smooth bump of the eyelid. When the eyelid is flipped, the doctor can see a white spot indicating which gland is blocked. The photo here shows a chalazion.
What are the treatments?
Warm compresses: These are a good conservative method for relieving styes and chalazia. The warmth of the compress will open any blockages. One can warm a washcloth with very warm water. Another option is to put a small amount of uncooked rice in a bowl and microwave it for 10-20 seconds until it is warm. The rice can be put in a washcloth and held on the eyelid. There are also eye masks sold in stores that contain beads which heat up in the microwave. The most important thing is to ensure that the cloth is not too hot as the eyelid skin is thin and can burn. It is most useful to apply the warm compresses several times a day for 5-10 minutes.
Lid scrubs: It is important to keep the eyelids clean from debris and dirt that collects in the lashes. This can be done by taking a small amount of baby shampoo and gently rubbing the eyelids with clean fingers. Wash with warm water. Another option is to purchase a cloth scrub that contains a soap.
Lubricating drops: These are eye drops that are like your own tears. These may be used throughout the day if there are any dry eye symptoms.
Prescription medications: Doctors may prescribe antibiotic or steroid eye drops to help relieve the bumps. Some also use oral antibiotics for chalazia that are especially good for inflammation.
Omega 3 vitamins: Studies have shown that these vitamins can help with inflammation and dryness.
Incision and drainage: This is an option if the bump has not resolved on its own. It is done in the office using local anesthesia.
Other tips: Avoid wearing contact lenses and eye makeup if you have a stye or chalazion. Many of these treatments are conservative and can be continued after a stye or chalazion has resolved to prevent reoccurrence.
Return next month for a discussion on a new topic!
- Images courtesy of Wikimedia Commons [return]


CEO neuroloop GmbH
Michael Lauk is a serial start-up entrepreneur in the healthcare field, focused on medical devices. He has more than 25 years of experience in business as well as research in the healthcare field in Germany and the USA. Most recently he co-founded neuroloop GmbH, a Start-up designing an active implantable device to lower blood-pressure. Besides neuroloop, he co-founded the start-ups SpinDiag GmbH, Tomes GmbH, inSleep Health LLC, resp(EQ) Inc., TNI medical AG and seleon GmbH, where he worked in different management and board positions.
Michael earned his PhD in physics in Freiburg and Boston. He is a data scientist and an early mover in the Digital Health arena, and seasoned in designing healthcare products and marketing strategies. He has executed more than 50 medical device projects, and initiated several co-operations between companies, hospitals, and universities.
Michael is holding honorary positions as a board member of bwcon e.V., the German-American-Institute, he is chairman of the board of an organization managing foundations for the University of Freiburg to support students, and chairman of the board of trustees at the Freiburg Material Research Center.


Oxivir® Tb Wipes
Oxivir TB Wipes is a broad-spectrum virucidal hard surface disinfectant that is expected to inactivate SARS-CoV-2 (the virus that causes COVID-19).
Registered One-Step Hospital Grade Disinfectant Cleaner
Ready-to-use Oxivir® Tb Wipes are intended for the cleaning and disinfecting of healthcare environmental surfaces. Based on proprietary AHP® technology to deliver fast, effective cleaning and disinfection.
• inactivates SARS-CoV-2 (the virus that causes COVID-19)
• Kills bacteria and viruses in just 1 minute
• Virucidal, Bactericidal, Fungicidal, and Tuberculocidal
• Active ingredient breaks down to oxygen and water.
• Meets Health Canada's standard for cleaning & decontaminating blood & body fluids
Active chemicals: Benzyl alcohol, Hydrogen peroxide
Sheet size: 6″ x 7″ sheets, 160 sheets per canister
Shelf Life: 3 years
Color: Purity White
Quantity: 1 pack x 160 wipes
Construction: canister for easy dispensing
Origin: United States
We have heard from many concerned people regarding increased pricing. We share your frustration. Unfortunately, our entire supply chain has been affected by a global supply shortage and the difficulties of navigating many logistical challenges during COVID-19. This is a market reality driven by the worldwide spike in demand for hand sanitizer.
NO RETURN POLICY
Please note that due necessary health and safety reasons, once shipped, it cannot be returned for refund. These items are non-refundable and non-returnable.
Earn up to 14 Lab Points


Exposed tooth roots are the result of gum recession. There are many causes of gum recession including periodontal disease, aggressive brushing, anatomic susceptibility, and tooth position. If recession progresses without treatment, it can lead to esthetic compromises, tooth sensitivity, tooth decay on roots, or even tooth loss. Recession does not always need to be treated. Therefore, it is important that an examination be completed to identify the potential risks for future progression. Soft tissue grafting is the most common treatment for recession. During this procedure, Dr. O'Neal will move healthy gum tissue from the roof of the mouth (palate), and restore the tissue in the area of recession.


Sonus Complete Reviews: is a revolutionary supplement that helps alleviate tinnitus symptoms. The formula contains essential ingredients like and that boost the immune system and reduce inflammation. The combination of and promotes healthy nerve function and regeneration. With , Sonus Complete is a safe and effective solution for those suffering from tinnitus. It not only reduces the symptoms of tinnitus but also overall ear health. The supplement a long-term solution and has been proven to work for thousands of individuals. Sonus Complete is a for those who want to regain their peace of mind and enjoy a better quality of life.
What is Sonus Complete?
Sonus Complete is a dietary supplement designed to help relieve tinnitus symptoms. It is formulated with natural ingredients that promote ear health and reduce inflammation. The supplement is available in capsule form and can be taken daily.
How does Sonus Complete work?
Sonus Complete works by targeting the root cause of tinnitus, which is often linked to inflammation and damage in the auditory system. The supplement contains ingredients that help reduce inflammation and protect the nerves in the ear. It also supports brain function and promotes overall ear health.
What are the ingredients in Sonus Complete?
Sonus Complete contains a blend of natural ingredients, including hibiscus, hawthorn berry, olive leaves, vitamin B3 and B12, garlic, green tea, juniper berries, and uva ursi. Each ingredient is chosen for its ability to support ear health and reduce inflammation.
Is Sonus Complete safe?
Sonus Complete is made with natural ingredients and is generally considered safe for use. However, it is important to consult with a healthcare professional before taking any new supplement, especially if you have a pre-existing medical condition or are taking medication.
How do I take Sonus Complete?
Sonus Complete is taken orally, with two capsules recommended daily. It is recommended to take the supplement with a meal and a full glass of water. It is important to follow the recommended dosage and not exceed it.
Is Sonus Complete effective?
Sonus Complete has been reported to be effective in reducing tinnitus symptoms for many individuals. However, it may not work for everyone. It is important to remember that dietary supplements are not a substitute for medical treatment and should be used in conjunction with other treatments recommended by a healthcare professional.
Can Sonus Complete cure tinnitus?
Sonus Complete is not a cure for tinnitus, but it may help relieve symptoms and promote ear health. It is important to consult with a healthcare professional for proper diagnosis and treatment of tinnitus.
Is Sonus Complete FDA approved?
Dietary supplements like Sonus Complete are not regulated by the FDA for safety and effectiveness. However, the supplement is manufactured in a FDA registered facility that follows Good Manufacturing Practices (GMP).
Can Sonus Complete be taken with other medications?
It is important to consult with a healthcare professional before taking Sonus Complete with other medications. Certain medications may interact with the ingredients in the supplement, and it is important to ensure that it is safe to take together.
Where can I buy Sonus Complete?
Sonus Complete can be purchased online through the official website. It is important to only purchase from a reputable source to ensure the quality and safety of the supplement.
What is the price of Sonus Complete?
The price of Sonus Complete may vary depending on the package and quantity purchased. It is important to check the official website for current pricing and promotions.
Is there a money-back guarantee for Sonus Complete?
Yes, Sonus Complete comes with a 60-day money-back guarantee. If you are not satisfied with the supplement, you can return it for a full refund.
What are the side effects of Sonus Complete?
There are no known side effects of Sonus Complete. However, it is important to follow the recommended dosage and not exceed it. If you experience any adverse reactions, discontinue use and consult with a healthcare professional.
How long does it take for Sonus Complete to work?
The time it takes for Sonus Complete to work may vary depending on the individual and the severity of their tinnitus symptoms. It is recommended to take the supplement for at least two to three months to see the full benefits.
Can Sonus Complete be used by everyone?
Sonus Complete is formulated for adults and is not recommended for children. It is important to consult with a healthcare professional before taking the supplement, especially if you have a pre-existing medical condition or are pregnant or breastfeeding.
Is there a recommended diet while taking Sonus Complete?
While there is no specific diet recommended while taking Sonus Complete, it is important to follow a balanced and healthy diet for overall ear health. This includes consuming plenty of fruits and vegetables, lean protein, and whole grains.
What should I do if I miss a dose of Sonus Complete?
If you miss a dose of Sonus Complete, take it as soon as you remember. However, if it is close to the time of your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
Can I stop taking Sonus Complete once my tinnitus symptoms improve?
It is important to continue taking Sonus Complete as directed, even if your tinnitus symptoms improve. This will help maintain ear health and reduce the risk of symptoms returning.
How long should I take Sonus Complete?
The length of time you should take Sonus Complete may vary depending on your individual needs and symptoms. It is recommended to take the supplement for at least two to three months to see the full benefits. It is important to consult with a healthcare professional for personalized advice.
|Sonus Complete is a natural supplement for tinnitus relief.|
|It contains ingredients like hibiscus and olive leaves.|
|The supplement helps improve cognitive function.|
|Sonus Complete is safe for long-term use.|
|It helps reduce the ringing in the ears.|
- Sonus Complete is a non-invasive solution for tinnitus.
- The supplement is made from natural ingredients.
- It helps improve overall ear health.
- Sonus Complete is easy to take and has no side effects.
- It comes with a 60-day money-back guarantee.


The Complete Guide to Fats and Oils in Health and Nutrition
Healing fats are required, together with other nutrients, to prevent and reverse so-called "incurable" degenerative diseases: heart disease, cancer, and Type II diabetes. Healing fats also help reverse arthritis, obesity, PMS, allergies, asthma, skin conditions, fatigue, yeast and fungal infections, addictions, certain types of mental illness, and many other conditions.
# Publisher: Alive Pr Ltd
# Language English
# ISBN-10: 0920470165
# ISBN-13: 978-0920470169
# Product Dimensions: 21.6 x 14 x 1.8 cm


Health and Fitness
We all know that technology has come a long way in personal care: heart monitors, blood pressure monitors, air monitors, and more. DigitalGiftStore.com has scouted around for the absolute imperatives in the broad spectrum of personal care products to bring you the most recent, unique, and functional results from Oregon Scientific, Panasonic, Norelco, and Lifeline First Aid. Let us know if you see other products on the market that blend with our goal of offering high-quality, cutting-edge items at the most affordable prices. We would love to hear from you!


Railway Staff Nurse Vacancy 2024: In 2024, the railway industry is looking to hire staff nurses to provide medical care for passengers and employees. These positions are vital for ensuring the health and safety of everyone on board trains and at railway stations. The railway staff nurse vacancy offers an opportunity for qualified healthcare professionals to contribute to the well-being of the traveling public and support the smooth operation of the railway system.
|Railway staff nurse vacancy
|Railway Recruitment Board
|Nursing Degree Or Diploma
|For More Vacancy
Railway Staff Nurse Vacancy Eligibility
To be eligible for a railway staff nurse position, candidates typically need to meet certain requirements. These may include having a nursing degree or diploma from a recognized institution, along with a valid nursing license. Previous experience in a healthcare setting, especially in emergency care or general medicine, could also be beneficial. Additionally, candidates might need to demonstrate proficiency in basic medical procedures and possess excellent communication skills to effectively interact with passengers and colleagues. Meeting these eligibility criteria ensures that staff nurses are well-equipped to provide quality care within the railway environment.
Railway Staff Nurse Exam Pattern
The Railway Recruitment Board (RRB) conducts the RRB Staff Nurse Exam to recruit eligible candidates for the post of staff nurse in various zones of Indian Railways. The RRB Staff Nurse Exam Pattern consists of two stages: a computer-based test (CBT) and a document verification (DV).
The CBT is the first and main stage of the RRB Staff Nurse Exam. It is an online exam that tests the candidates’ knowledge and skills in professional and general subjects.
- The duration of the exam is 90 minutes (1 hour and 30 minutes).
- The exam is objective type, with multiple-choice questions.
- The total number of questions can vary, but generally, it ranges from 100 to 150 questions.
- The exam is divided into two sections: Professional Knowledge and General Aptitude.
- The Professional Knowledge section covers topics related to nursing, such as anatomy, physiology, nutrition, biochemistry, nursing foundations, psychology, microbiology, sociology, pharmacology, pathology, genetics, medical-surgical nursing, etc.
- The General Aptitude section covers topics related to general intelligence and reasoning, general science, general arithmetic, and general awareness.
- Each question carries one mark, and there is a negative marking of 1/3 mark for every wrong answer.
The candidates who qualify the CBT are called for the DV, which is the final stage of the RRB Staff Nurse Exam. In this stage, the candidates have to produce their original documents and certificates for verification. The documents include educational qualifications, age proof, identity proof, caste certificate, disability certificate, etc. The candidates who clear the DV are selected for the RRB Staff Nurse post, subject to the availability of vacancies and medical fitness.
The RRB Staff Nurse Exam Pattern is designed to assess the candidates’ suitability for the job of staff nurse in Indian Railways. The candidates who aspire to appear for this exam should prepare according to the syllabus and exam pattern prescribed by the RRB. They should also practice mock tests and previous year papers to improve their speed and accuracy. By following a systematic and smart strategy, the candidates can crack the RRB Staff Nurse Exam and secure their dream job.
Railway Staff Nurse Salary Details
The RRB Staff Nurse salary is one of the attractive aspects of this job. The staff nurses are entitled to receive a basic pay of Rs. 44,900/- in the pay level-7 of the 7th Central Pay Commission. This corresponds to the grade pay of Rs. 4600/- and the pay scale of Rs. 9300-34800/-. The basic pay is the starting salary of the staff nurses and it increases with time and experience.
In addition to the basic pay, the staff nurses also get various allowances and benefits that enhance their monthly income. Some of the allowances are:
- Dearness Allowance (DA): This is a cost of living adjustment that is calculated as a percentage of the basic pay. The current DA rate for RRB Staff Nurses is 23.12% of the basic pay.
- House Rent Allowance (HRA): This is a compensation for the rent paid by the staff nurses who do not avail the railway quarters. The HRA rate depends on the city of posting and it is 24% of the basic pay for RRB Staff Nurses.
- Transport Allowance (TA): This is a reimbursement for the expenses incurred by the staff nurses
Frequently Asked Questions
1.What is the RRb staff nurse vacancy, and how can I apply for it?
Answer: The RRb staff nurse vacancy refers to job openings for staff nurse positions within the Railway Recruitment Board (RRB). To apply, candidates typically need to monitor RRB notifications for staff nurse vacancies, then submit an online application through the official RRB website during the specified application period. Detailed eligibility criteria and application instructions are provided in the official notification.
2.What qualifications are required to apply for the RRb staff nurse vacancy?
Answer: Candidates applying for the RRb staff nurse vacancy typically need to possess a nursing degree or diploma from a recognized institution and hold a valid nursing license. Previous experience in healthcare settings, especially in areas relevant to railway medical services, can be advantageous. Specific eligibility criteria may vary depending on the RRB region and the nature of the vacancy.
3.Are there any age restrictions for applying to RRb staff nurse vacancies?
Answer: Yes, there are usually age restrictions imposed for RRb staff nurse vacancies, as per the guidelines provided in the official notification. Generally, candidates must be within a certain age range, typically between 20 and 40 years, although this can vary based on factors such as reservation categories and specific job requirements. Age relaxation may be applicable for candidates belonging to certain categories, as per government norms.
4.What is the selection process for RRb staff nurse vacancies?
Answer: The selection process for RRb staff nurse vacancies typically involves a series of stages, including a written examination, skill test, and/or interview. The exact process may vary depending on the RRB region and the nature of the vacancy. Candidates are advised to refer to the official notification for detailed information regarding the selection process, examination pattern, syllabus, and other relevant details.


About our Clinic
Center For Functional Weight Loss P.C. is a professional weight loss center in Valparaiso, Indiana offering a proven medically engineered method for weight loss and weight maintenance. We enhance this method with valuable education, professional coaching and emotional support. With years of experience, knowledge and success, founder Michelle Regan RN MBA aims to help clients discover a healthier lifestyle through dietary changes and education.
At Center For Functional Weight Loss P.C. clients are held accountable through weekly visits, which include weight checks, body measurements, body composition analysis, blood pressure readings, diet journal reviews and lifestyle discussions. Clients are engaged in discussions about balanced nutritional diets, processed foods and poor eating habits, so to prepare them for weight maintenance. We help to identify triggers, stresses or obstacles that may cause weight gain and overeating and together plan alternative options. We review weekly client activities, exercise habits, hobbies and meal planning, and even offer cooking instructions that will benefit an entire family. When needed, Center For Functional Weight Loss P.C., communicates and collaborates with client physicians and other health care professionals in order to provide a comprehensive and team approach to health and weight management.
At Center For Functional Weight Loss P.C., as committed medical professionals, we are aware of the growing trends in obesity and obesity related illness. During weekly visits at the center, clients are assisted in understanding and identifying health benefits which may be gained from weight loss and lifestyle changes. Education covers numerous topics such as metabolic syndrome, insulin resistance, understanding processed foods and sugars, reading nutritional labels and benefits of dietary fiber.
Serving Northwest Indiana, Center For Functional Weight Loss P.C., strives to change not only waist lines, but improve health and increase knowledge, self esteem and overall quality of life.
Center for Functional Weight Loss P.C is Authorized to Use the Ideal Protein Weight Loss Protocol and Products. The testimonials on this website are those of the individual that is identified, you should not necessarily expect to receive these results. Typical results vary from person to person and individual to individual when the Ideal Protein Weight Loss Protocol is followed properly. You should consult your physician or other health care professional before starting this or any other diet program to determine if it is right for your needs.
2503 Chicago St. Suite F Valparaiso, IN 46383 – Phone: (219) 462-0410
Copyright © 2017 Ideal Protein All rights reserved.


Novelix Pharmaceuticals, Inc. (Novelix), is a private, La Jolla based, biotechnology company committed to developing innovative, proprietary, dermatology products with large market potential to treat serious skin diseases. The company's main focus is the development of NVX-207, a novel, topical drug candidate with the potential to revolutionize how actinic keratosis (AK) is being treated in the absence of inflammation. AK is a pre-cancerous skin condition resulting from prolonged sun exposure and is one of the the skin diseases most frequently diagnosed by US dermatologists, affecting more than 60 million Americans. In Australia, for instance, AK affects about half the population over age 50. While the overall AK market is estimated at over $2 billion in the US alone, topical therapy is used in only about 25% of patients due to limited activity (complete clearance of lesions in only about half the patients) and often severe side effects of available topical products. In spite of these deficiencies, the AK market for topical products in the US alone exceeded $450 million in 2009 growing at 22% per annum. NVX-207's patent position is strong, development timelines to human proof of concept in AK patients are short and interest in the opportunity at the proof of concept level is clear. A recent transaction demonstrates the interest in new therapies in AK markets - LEO Pharma of Denmark acquired Peplin for $287.5 million in cash to gain access to PEP005, a natural product, without composition of matter patent protection and average to low activity, in late stage development for AK. NVX-207's potential in additional large-market dermatology opportunities including genital warts, a second small molecule NCE program and a full pipeline complement the Novelix product portfolio.


Day 1 – 4
These four days were like a short recovery period post-chemotherapy. Those awful side effects that were making me sick were more or less gone and I did not feel physically weak as before. However, the nurses warned me of the upcoming mucositis and sore throat which most patients experience a few days after Day 0. FYI, mucositis results in painful ulcers and inflammations on the mucous membranes of the entire gastrointestinal tract. As a result, I was told to follow the saline and caphosol gargle schedule strictly.
Besides preparing myself mentally for the incoming second (and hopefully the last) wave of side effect, it was also time to load up with lots of food to compensate for all the vomiting and poor appetite during chemo and after mucositis sets in. My responsibility for those few days was to eat as much as I could!!! Thanks to Marcus, the dietitian, I knew how much I was consuming and how much more I had to take in terms of the milk supplements. And even greater thanks to SSN Eunice who taught me that by freezing the packet of Ensure for about 3.5 hours, I would get a ‘dessert’ close to ice-cream!
Meanwhile, my white blood cells, platelets and haemoglobin levels were dropping fast, which was expected.
The back of my throat was already red and today I felt a small pain when swallowing my own saliva. Also experienced a short pain every time I pee. To make things worse, I had a strong urge to pee like every 20 minutes. At times the urine looked red as if there was blood, though a simple dip test showed negative. Laboratory test showed no signs of urinary tract infection as well.
White blood cell count was dead low and fever sets in now and then. Was quickly given antibiotics to treat the fever. Magnitude of sore throat worsen.
The pain along the throat was hard to swallow. I was forced to switch to liquid diet which consisted of Ensure, Ensure Plus and Resource 2.0. Even so, I had to force the viscous milk down, each time taking at least half an hour to complete a pack of about 200ml. Drinking the milk seemed to increase mucous production and I had to swallow my saliva more often, increasing the pain. At last, I requested for morphine, hoping it would ease the pain. But, no it did not help, not even with an increased dose. The pain aggravated as predicted by Dr Linn, I stopped talking and regularly spat out my saliva instead of swallowing it. I was given the option to have tube feeding but I rejected the idea as the nutrients absorption is poor. I took the pain so my body could gain, afterall, no pain no gain!
The orange flavoured morphine syrup was probably the best tasting medicine among all, but it caused drowsiness, hallucinations, nausea and bad dreams. I hardly get a decent sleep at night, I was either choking on my saliva or waking up from nightmares.
Day 11 – 18
Requested to stop morphine and switch to Fentanyl patch because I disliked the dopey effect from morphine. However, the patch did not ease the pain either. Day 13+, my wbc showed a significant jump to 0.92 (from 0.32). Most importantly, my platelets showed an increment from 31k to 45k – a sign that engraftment has taken place. But engraftment could only be confirmed if the increment is stable.
Day 14+, platelets went up further to 68k, that’s engraftment for sure! Mucositis improved gradually as the blood counts improved and I could include soft food in my diet. A pity, the chemo seemed to have disconnected my taste buds from me, I could not taste what I was eating. SEN Giam told me usually patients’ taste would only improve around Day +40. ZOMG!
Day 16+, doctor ordered a change of IV Cyclosporine to oral form and stopped my hydration drip! If my counts are stable, I could go home soon. That was definitely music to the ears. The doctors kept me under observation for another two days and I finally got discharged on Day +18.
Cyclosprine is also known as the “smelly drug”. I can’t describe how bad it smells but it’s bad enough to induce vomitting.
The entire stay of 26 days was much lesser than the estimated 6-8weeks! In the last week of stay, Dr Teh commented on my determination to recover as the nurses reported that I took over an hour to complete my meals. I really wanted my cells to have the daily required nutrition so that I could get well soon. My effort paid off!
Very thankful for Ward 77 nurses who came over to visit me and give me their support after work, and the many friends who texted me to check how was I doing.
Confirmation about my discharge was given in a short notice. Appreciate mum and brother’s effort in doing a quick spring cleaning the day before I return. I am also grateful that Keong came to fetch me home as my family went to pay respect to my late father and grandparents. It’s good to be home, always, with your loved ones.


The U.S. Food and Drug Administration (FDA) unveiled a new set of guidelines on August 15, 2023, concerning informed consent, building upon their 2014 draft. The release is a testament to the FDA’s dedication to refining the procedures around clinical trials. In this post, we’re spotlighting the major takeaways from these updates.
Key Themes in the Final Guidance
- Modernizing informed consent. The emphasis is on utilizing technology, streamlining the consent form approval process, and ensuring patients clearly understand what they’re agreeing to.
- Electronic methods over paper. The FDA acknowledges the evolution of informed consent, especially in scenarios like contagious disease outbreaks. For instance, a photographed signed consent form, paired with an authenticity statement, can now replace traditional methods. However, solely verbal consents over phone calls don’t make the cut.
- Consent form approval made easier. The final guidance simplifies the process by stating that institutional review boards (IRBs) no longer need to scrutinize nonessential changes or translated versions of consent forms. Only substantial updates should undergo IRB review, while minor changes can be updated directly.
- Clear communication with patients. The goal is to bolster patient comprehension by implementing communication aids and making sure patients understand all of the information relevant to their participation in the study. Along these lines, the FDA includes the following suggestions:
- Visual aids. Using visual tools such as diagrams, videos, and other aids can help explain complex concepts to patients. Customizing the content to cater to specific audiences, like using enlarged font sizes or audio recordings, is also encouraged.
- Updates and new findings. It’s paramount to update patients about major discoveries, especially those affecting their decision to participate. While trivial updates need not be communicated, pivotal information, including study-related risks and other crucial changes, must be shared transparently.
- Defining roles in the informed consent process. The final guidance aims to clarify the roles each person plays in the informed consent process by providing instructions relating to (1) the person obtaining the consent, (2) the translator (if applicable), and (3) the witness in cases of a short form consent process.
- Acknowledging sponsor practices. The changes acknowledge the existence of sponsor practices that are common in clinical investigations. Specifically, the FDA addresses the use of template consent forms and the involvement of sponsor personnel in study activities.
- Changes in the legal and regulatory landscape. The guidance addresses recent changes in the legal and regulatory landscape, particularly in the following areas:
- Conflicts of interest, like an investigator having a stake in the product under study or owning part of the sponsoring company.
- Subject withdrawal from the trial and how to treat their data post-withdrawal.
- Undue influence, which can be context-specific, like when consent for extra tissue samples for research is sought just before a surgical procedure.
- Circumstances in which the FDA may not strictly enforce informed consent rules, such as for previously gathered human specimens used in FDA-regulated diagnostic device studies, as long as the specimens cannot be traced back to individuals.
- Addressing special scenarios. The FDA also touches on unique circumstances that might arise in the research process. These scenarios include:
- Special circumstances in which one person co-enrolling in more than one study simultaneously may be acceptable, although it is generally discouraged.
- Indirect costs of which participants should be made aware, such as time off work or child care.
- Risks and benefits in the standard of care.
- Unapproved uses of an FDA-approved drug or device when such use is considered standard of care.
The final guidance contains updates, clarifications, and additional details aimed at modernizing and streamlining the informed consent process for all parties involved while simultaneously increasing transparency and understanding for study participants. The FDA intends for the guidance to assist IRBs, clinical investigators, and sponsors in complying with FDA’s existing informed consent regulations for clinical investigations. Institutions are advised to familiarize themselves with the guidance and review their internal informed consent processes, policies, and forms to ensure alignment with the final guidance. For additional information, please see our article on the topic.


The Importance of Water and Human Health
"I'm dying of thirst!"
Well, you just might. It sounds so simple. H20. Two parts hydrogen, one part oxygen. But this substance better known as water is the most essential element, next to air, to our survival. Water truly is everywhere; still most take it for granted.
Water makes up more than two thirds of the weight of the human body, and without it, we would die in a few days. The human brain is made up of 95% water; blood is 82% and lungs 90%. A mere 2% drop in our body's water supply can trigger signs of dehydration: fuzzy short-term memory, trouble with basic math, and difficulty focusing on smaller print, such as a computer screen. (Are you having trouble reading this? Drink up!) Mild dehydration is also one of the most common causes of daytime fatigue. An estimated seventy-five percent of Americans have mild, chronic dehydration. This is a scary statistic for a developed country where water is readily available through the tap or bottle.
Water is important to the mechanics of the human body. The body cannot work without it, just as a car cannot run without gas and oil. In fact, all the cell and organ functions made up in our entire anatomy and physiology depend on water for their functioning.
• Water serves as a lubricant
• Water forms the base for saliva
• Water forms the fluids that surround the joints.
• Water regulates the body temperature, as the cooling and heating is distributed through perspiration.
• Water helps to alleviate constipation by moving food through the intestinal tract and thereby eliminating waste- the best detoxification agent.
• Regulates metabolism
In addition to the daily maintenance of our bodies, water also plays a key role in the prevention of disease. Drinking eight glasses of water daily can decrease the risk of colon cancer by 45%, bladder cancer by 50% and it can potentially even reduce the risk of breast cancer. And those are just a few examples!
In a nutshell, drink more water!
Drink water on empty stomach technique.
It is popular in Japan today to drink water immediately after waking up every morning. Furthermore, scientific tests have proven its value. For old and serious diseases as well as modern illnesses, the water treatment had been found successful by a Japanese medical society as a 100% cure for the following diseases:
Headache, body ache, heart system, arthritis, fast heart beat, epilepsy, excess fatness, bronchitis asthma, TB, Meningitis, Kidney and Urine diseases, vomiting, gastritis, diarrhea, piles, diabetes, constipation, all eye diseases, womb, cancer and menstrual disorders, ear nose and throat diseases.
Method of treatment
1. As you wake up in the morning before brushing teeth, drink 4x160ml glasses of water
2. Brush and clean the mouth but do not eat or drink anything for 45 minutes
3. After 45 minutes you may eat and drink as normal.
4. After 15 minutes of breakfast, lunch and dinner do not eat or drink anything for 2 hours
5. Those that are old or sick and are unable to drink 4 glasses of water at the beginning may commence by taking little water and gradually increase it to 4 glasses per day
6. The above method of treatment will cure diseases of the sick and others can enjoy a healthy life.
The following list gives the number of days of treatment required to cure or control main diseases:
1. High Blood Pressure - 30 days
2. Gastric - 10 days
3. Diabetes - 30 days
4. Constipation - 10 days
5. Cancer - 180 days
6. TB - 90 days
Arthritis patients should follow the above treatment for only 3 days in the first week to be followed by daily treatment from second week onwards. This treatment method has no side effects, however at the commencement of treatment you may have to urinate a few times.
Although this technique not scientifically proven, there is no harm in drinking more water (commonly recommended adult intake is 1.5 to 3.0 litres a day depending on body mass, diet, exercise habits and environment). As mentioned above, an estimated seventy-five percent of Americans have mild, chronic dehydration. It’s worth a try and Good Health....


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Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging
Autho(rs): Catherine Yang1; Henrique Simão Trad2; Silvana Machado Mendonça3; Clovis Simão Trad4
Keywords: Inferior vena cava; Congenital abnormalities; Venous thrombosis.
Congenital anomalies of the inferior vena cava (IVC) are uncommon, occurring in up to 8.7% of the population, as anomalies of the left renal vein are considered(1).
With a complex embryonic development, originated from multiple embryonic structures, several anatomic variations of the venous return from the abdomen and lower limbs may occur(1–6). Some of these anomalies have significant clinical implications associated with other congenital anomalies, history of lower limb venous thrombosis and hematuria, sometimes determining changes in surgical planning(3,7–10).
With the availability of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) volumetric techniques, the demonstration of IVC anomalies became easier(4–6,11). However, it is not uncommon for such findings not being described on radiological reports, a fact that may negatively impact the approach to patients. In the present study, a simplified review of IVC embryology is made, demonstrating the main congenital anomalies, with evaluation, presentation, and discussion of ten cases.
Computed tomography (CT) and MRI studies performed between 2008 and 2010 in ten patients with IVC anomalies were retrospectively reviewed.
All the CT images were acquired in a 16-row multidetector equipment, with volumetric acquisition of 1.25 mm-thick slices without spacing, after intravenous injection of 100 ml iodinated contrast agent. The MRI studies were performed in 1.5 tesla high-field equipment, with acquisition of T1-and T2-weighted images acquisition, MRI angiography and contrast-enhanced volumetric gradient-echo, delayed phase sequences.
Among the ten patients, five were men and five were women, with ages ranging from 6 to 77 years (median of 42.5 years). Three patients had a history of deep venous thrombosis (DVT) of lower limbs, with ages of 25, 29 and 47 years (median of 29 years), and were submitted to the exams in order to clarify their condition. The remaining patients were submitted to the exams for other reasons, such as abdominal pain, hematuria and tumor staging.
Among the seven patients with no DVT history two presented agenesis of the IVC intrahepatic portion, three presented double IVC, one presented transposition of the IVC and another presented retrocaval ureter. The median age of such patients was 43 years, revealing that the anomalies without relevant clinical implications have a tendency to be incidentally found during investigations performed for other reasons. In such a group, one 30-year old patient had agenesis of the intrahepatic portion of the IVC associated with polysplenia, intestinal malrotation and pancreatic malformation.
Among the three patients with a history of DVT, one presented agenesis of the infrarenal portion only, another presented agenesis of the whole IVC and preserved intrahepatic portion only; and the third patient presented agenesis of the renal and suprarenal portions of the IVC. In the three cases, multiple, small retroperitoneal collateral vessels could be visualized. Further details on such findings are described on Table 1 and on Figures 2 thru 8.
Figure 1. Three-dimensional reconstruction with volume rendering. The anatomic segments of the IVC are separately colored, with highlighted embryonic origins.
Figure 2. Intrahepatic IVC agenesis associated with polysplenia and intestinal malrotation. a: Dilated azygos vein on the axial section (arrow) and polysplenia (arrowhead). b: Sagittal MIP – IVC continuation with retrocrural, calibrous azygos vein (arrow); c: Coronal MIP – intestinal malrotation (arrow indicates small bowel loops; arrowhead indicates the colon). d: 3D coronal view – short pancreas (arrowhead) with splenic vein in inferior pathway (arrow).
Figure 3. Persistent left IVC. Case 1 (a) – Left IVC draining into the left renal vein (arrow); small vessel anastomosis between the common iliac veins (arrowhead); Case 2 (b) – Left IVC draining into the left renal vein (arrow); branches from the left internal iliac joining the right IVC (arrowhead). Case 3 (c) – Left IVC with superior retroaortic pathway (white arrow) in continuation with the azygos vein (white arrowhead); left renal vein draining into the left IVC (black arrow) and there is a retroaortic communication between the inferior venae cavae, on the topography of retroaortic left renal vein (black arrowhead).
Figure 4. IVC transposition Coronal MIP (a) and 3D coronal image (b) demonstrate left IVC (arrows) draining into the left renal vein (arrowhead), anteriorly to the aorta. Absent right infrarenal IVC. The IVC is normally positioned at right of the renal, suprarenal and intrahepatic portions.
Figure 5. Retrocaval ureter. Right proximal ureter with posterior pathway to the IVC, crossing between the IVC and the middle third of the abdominal aorta.
Figure 6. Agenesis of infrarenal IVC. MRI angiography MIP reconstruction of abdomen – Agenesis of infrarenal IVC (arrow on a); dilated retroperitoneal veins and markedly calibrous left gonadal vein (arrow and arrowhead on b); magnification of the IVC occlusion area in the renal/infrarenal transition (c); pelvic varices (arrows in d) and varices on the lower abdominal wall (arrowheads on e).
Figure 7. Agenesis of suprarenal, renal and infrarenal IVC. Coronal MIP (a,b) – presence of extensive, calibrous collaterals in the retroperitoneum (arrows); thrombosed iliac veins (arrowheads). Axial MIP (c,d) – presence of calibrous collaterals in the retroperitoneum with increased caliber of the lumbar veins (arrows on c); thrombosed common iliac veins (arrowheads on d). 3D reconstruction – lumbar and retroperitoneal collaterals.
Figure 8. Agenesis of suprarenal and renal IVC. Coronal MIP (a,b,c) – infrarenal IVC (arrows) visible up to the renal hilum, with ill-defined suprarenal portion, and multiple calibrous vessels in the retroperitoneum (arrowheads). 3D reconstruction – calibrous, lumbar and retroperitoneal vessels, with increased caliber of the azygos and hemiazygos veins (arrows) pelvic varices (arrowheads).
At later phases of its embryonic development, the IVC may be divided into four segments: hepatic, suprarenal, renal and infrarenal, originating from different embryonic structures. In a simplified way, the IVC originates from three pairs of veins, namely, postcardinal veins, subcardinal veins and supracardinal veins, which are dominant in the fourth, sixth and eighth gestational weeks, respectively. From the beginning through the end of the ontogenesis of the IVC, the pairs of embryonic veins present partial regression and anastomosis, contributing to the development of retroperitoneal vascular structures of the adult (Table 2 and Figure 1).
Intrahepatic IVC agenesis with azygos/hemiazygos continuation
Embryonically, there is a developmental failure of the subcardinal-hepatic anastomosis between the suprarenal and hepatocardiac segments(1,6). Consequently, blood is deviated to the retrocrural azygos vein which is dilated up to the arch, which joins the superior vena cava in the right paratracheal space. The posthepatic segment drains the suprahepatic veins directly into the right atrium.
Such an anomaly was classically described as being associated with polysplenia/asplenia and heterotaxy syndromes, with congenital cardiopathies and intestinal malrotation (Figure 2)(1,4,6,8). In such syndromes, the set of findings is variable from patient to patient, with reports of incidental findings, like in the case of the patient on Figure 2. With increasing utilization of imaging methods, such anomaly is found in asymptomatic patients with no other associated anomaly.
Persistent left IVC
It results from the persistence of right and left supracardinal veins, with two venae cavae around the infrarenal aorta(1,4,6). Typically, the left IVC ends at the left renal vein, which anteriorly crosses the aorta to join the IVC (Figure3). Variations may occur, as in the case presented at Figure 3c, with retroaortic left renal vein and left IVC continuation with the azygos vein. The left ICV continues with the iliac veins, with variations in the anastomosis with the internal and external common iliac veins(2).
Transposition of the IVC
It results from the regression of the right supracardinal vein and persistence of the left supracardinal vein. Typically, the left IVC ends at the left renal vein, which anteriorly crosses the aorta and forms a supra-renal IVC at right (Figure 4)(1).
Retroaortic/circumaortic left renal vein
The left renal vein derives from the intersubcardinal anastomosis, which courses anteriorly to the aorta. Retroaortic left renal vein (1.7% to 3.4% of the individuals) occurs by regression of the intersubcardinal anastomosis and renal drainage through retroaortic intersupracardinal anastomosis(1,3). The persistence of the two anastomoses results in a renal vein coursing anteriorly and another posteriorly to the aorta (prevalence of 2.4% to 8.7%), with the retroaortic vein caudal in relation to the pre-aortic vein(1) (Figure 3c).
It occurs exclusively in the right ureter and is one of the few IVC anomalies that may be symptomatic(1,4). Along the development of the infrarenal IVC there is regression of the right supracardinal vein, which courses posteriorly and medially to the ureter, originating from the right posterior cardinal vein, which, by its turn, is anteriorly located in relation to the ureter, which is medially displaced (Figure 5). The ureter is fixed between the IVC and the aorta, with the possibility of ureteral stenosis, upstream hydronephrosis and recurrent urinary infections.
Subhepatic IVC agenesis
Agenesis of subhepatic segments of the inferior vena cava may occur, involving the suprarenal, renal and infrarenal segments(1,4,7). In the present series, the three cases with history of lower limbs venous thrombosis, the findings were agenesis of subhepatic segments, without definition of single calibrous retroperitoneal vessel which would assist in venous return. Multiple calibrous venous collaterals were visualized in the retroperitoneum, including gonadal veins, lumbar and pelvic varices, with increased caliber of the azygos/ hemiazygos system (Figures 6 thru 8).
IVC ANOMALIES AND CLINICOSURGICAL IMPLICATIONS
Left-sided IVC may cause misdiagnosis with para-aortic lymph node enlargement, and may cause difficulties in the transjugular approach for IVC filter implantation. Also, it should be suspected whenever there is recurrent pulmonary thromboembolism in patients with implanted IVC filter.
Anomalies of (retroaortic and circumaortic) left renal vein have clinical relevance mainly in surgical planning and in renal vein catheterization. On rare occasions the compression of the retroaortic renal vein may result in periureteral varices, venous hypertension and hematuria.
Anomalies of the IVC were recognized as a possible risk factor for lower limb thrombosis, particularly in young adults. In some cases, the inappropriate venous return increases the pressure, leading to blood stasis in lower extremities and development of varices. Thrombosis occurs bilaterally in 50% of cases. An exuberant network of collaterals is generally identified, with prominent azygos and hemiazygos veins, ascending lumbar veins, internal paravertebral venous plexus and anterior abdominal wall veins. Markedly dilated lumbar veins may cause lumbar pain.
The evaluation of the retroperitoneum and its vessels is of extreme importance in the investigation of the abdomen. In spite of being uncommon, congenital IVC anomalies may cause difficulties in the interpretation of axial images. A basic knowledge of embryology and on the main congenital IVC anomalies is required for the correct interpretation and description by the radiologist, with special emphasis on alterations with possible clinical and surgical implications.
1. Kellman GM, Alpern MB, Sandler MA, et al. Computed tomography of vena caval anomalies with embryologic correlation. Radiographics. 1988;8:533–56.
2. Morita S, Higuchi M, Saito N, et al. Pelvic venous variations in patients with congenital inferior vena cava anomalies: classification with computed tomography. Acta Radiol. 2007;48:974–9.
3. Royal SA, Callen PW. CT evaluation of anomalies of the inferior vena cava and left renal vein. AJR Am J Roentgenol. 1979;132:759–63.
4. Kandpal H, Sharma R, Gamangatti S, et al. Imaging the inferior vena cava: a road less traveled. Radiographics. 2008;28:669–89.
5. Fernandez-Cuadrado J, Alonso-Torres A, Baudraxler F, et al. Three-dimensional contrast-enhanced magnetic resonance angiography of congenital inferior vena cava anomalies. Semin Pediatr Surg. 2005;14:226–32.
6. Bass JE, Redwine MD, Kramer LA, et al. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radio-graphics. 2000;20:639–52.
7. Gayer G, Luboshitz J, Hertz M, et al. Congenital anomalies of the inferior vena cava revealed on CT in patients with deep vein thrombosis. AJR Am J Roentgenol. 2003;180:729–32.
8. Fulcher AS, Turner MA. Abdominal manifestations of situs anomalies in adults. Radiographics. 2002;22:1439–56.
9. Saad WE, Saad N. Computer tomography for venous thromboembolic disease. Radiol Clin North Am. 2007;45:423–45, vii.
10. Applegate KE, Goske MJ, Pierce G, et al. Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 1999;19:837–54.
11. Sheth S, Fishman EK. Imaging of the inferior vena cava with MDCT. AJR Am J Roentgenol. 2007;189:1243–51.
1. Specialist in Radiology and Imaging Diagnosis, Fellow PhD degree, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRPUSP), Radiologist at CEDIRP – Central de Diagnóstico Ribeirão Preto, Ribeirão Preto, SP, Brazil
2. Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Radiologist at CEDIRP – Central de Diagnóstico Ribeirão Preto, Physician Assistant at Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HC-FMRPUSP), Ribeirão Preto, SP, Brazil
3. Specialist in Radiology and Imaging Diagnosis, Radiologist at CDPI – Clínica de Diagnóstico Por Imagem, Rio de Janeiro, RJ, Brasil
4. PhD, Titular Member of Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Radiologist and Responsible Technician at CEDIRP – Central de Diagnóstico Ribeirão Preto, Ribeirão Preto, SP, Brazil
Dr. Henrique Simão Trad
Rua Maestro Vila Lobos, 515, Jardim São Luiz
Ribeirão Preto, SP, Brazil, 14020-440
Received August 5, 2012.
Accepted after revision January 4, 2013.
* Study developed at CEDIRP – Central de Diagnóstico Ribeirão Preto, Ribeirão Preto, SP, Brazil.


As an employed physician, are you tired of seeing half your paycheck go to taxes? Employed physicians face a lack of tax-sheltered savings space compared to their business-owning counterparts.
After you max out your 401k/403b, there are few options for tax-deferred savings. There is an option offered by some hospitals and health systems, the 457(b) plan.
On the surface, the 457(b) plan appears to be just what employed physicians need, more tax-deferred savings space!


|Item type||Location||Collection||Call number||Status||Date due|
CASTLETON FREE LIBRARYNew Materials Shelf
|Non-Fiction - Adult||612 BRY||Checked out||03/30/2020|
Includes bibliographical references (pages 416-424) and index.
How to build a human -- The outside : skin and hair -- Microbial you -- The brain -- The head -- Down the hatch : the mouth and throat -- The heart and blood -- The chemistry department -- In the dissecting room : the skeleton -- On the move : bipedalism and exercise -- Equilibrium -- The immune system -- Deep breath : the lungs and breathing -- Food, glorious food -- The guts -- Sleep -- Into the nether regions -- In the beginning : conception and birth -- Nerves and pain -- When things go wrong : diseases -- When things go very wrong : cancer -- Medicine good and bad -- The end.
"[A] head-to-toe tour of the marvel that is the human body ... a must-read owner's manual for everybody. Bill Bryson once again proves himself to be an incomparable companion as he guides us through the human body--how it functions, its remarkable ability to heal itself, and (unfortunately) the ways it can fail"--Provided by publisher.