Major Factors Affecting the Increase in Population Growth

†¢ Review of related Literature As can be seen in Figure 1, the worlds population grew very slowly until about 1750. There was a long period of stationary growth (no growth) until 1000 B.C.E., when the worlds population was approximately 300 million; this was followed by a period of slow growth from 1000 B.C.E. to approximately 1750, at which time global population was an estimated 800 million. Until this time, the worlds population was kept in check by high death rates, which were due to the combined effects of plagues, famines, unsanitary living conditions, and general poverty. After 1750, the worlds population grew substantially; by 1950 it had tripled to around 2.5 billion. In this 200-year period, the doubling time was 122†¦show more content†¦As a result, the world witnessed unprecedented rapid population growth between 1950 and 1985, owing, in large part, to third world increases. FIGURE 2 Further, the phenomenal increase in human numbers over the past 250 years is largely the consequence of mortality declines—not fertility increases. The first deaths to be reduced were those due to infectious diseases, the victims of which were most often children. The old killers of the past were to be replaced by chronic and degenerative diseases; the primary victims shifted from the young to the old. The rate of global population growth has declined significantly from its 1970s highs (see Figure 2). Current estimates anticipate a continued decline to about 0.5 percent in 2050. This corresponds to a doubling time of 140 years, a rate that has fostered concern about how the world will cope with 18 billion people in 2190. It is in the less developed countries that the continued growth in population will occur in the twenty-first century. Even though mortality is much higher in less developed countries (e.g., life expectancy at birth in 2000 was 75 years in the more developed countries and 62 to 64 years in the less developed countries), fertility remains even higher, thus accounting for relatively high growth in the third world. However, projections are not guarantees. Population may grow more slowly if, optimistically, fertility declines more quickly than expertsShow MoreRelatedPopulation Growth And Urban Road Emissions1738 Words   |  7 PagesPOPULATION GROWTH AND URBAN ROAD EMISSIONS Toh Xinyi Cindi1 1Undergraduate Student, Faculty of Agricultural and Environmental Sciences, McGill University, 817 Sherbrooke St. W., xinyi.toh@mail.mcgill.ca Abstract This paper describes how world population growth is the most challenging factor in affecting urban road emissions. 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The National Academy of Sciences of the USA includes salinization of soils and waters as one of the leading processes contributing to a possible worldwide catastrophe (Francois and Maas, 1994). The increasing world population, especially in arid and semi-arid regions, food shortages, and land scarcity are compelling the use of lands not utilized because of salinity and other soil stresses. Salinity and sodicity problems are characterized by an excess of inorganic saltsRead MorePopulation Growth Of Sweden : Sweden1536 Words   |  7 PagesPOPULATION GROWTH OF SWEDEN Forty years ago, Sweden was very different country to what it is today; the freedom to chose a school for your child was only open to a few privileged families, the age of majority reduced from 20 to 18, the introduction of the parental benefit scheme and Europe was divided between the West and communist East, or otherwise known as the Cold War. The memory of those times seem like a distant memory because Sweden has experienced major changes, particularly with respect

How Does What We Eat Affect Our Brains - 1449 Words

How does what we eat affect our brains? The brain is one of the most complex organs in the human body. A vast number of factors can lead to huge changes in the functionality of the human brain, in a multitude of unexpected and intriguing ways. Despite the, much needed, increase in related research over the past few decades, the exact mechanism of action of many dietary nutrients still remains unknown or unexplained, the subject of concern to many. Effects are caused by excesses or deficiencies in certain chemicals, and can manifest themselves in various ways - current understanding suggests a myriad of ways in which dietary chemicals affect the brain. Many have the potential to alter the presence of various chemical signalling agents, and†¦show more content†¦This contains near toxic vitamin A levels, which can induce huge effects upon the brain and body alike. The negative effects caused by vitamin A are known as hypervitaminosis A. Vitamin A has effects ranging from altered metabolism of other vitamins, changing their absorption and processing by the body, to causing blurry vision. With these, huge effects on the brain are also ushered in. A common symptom of excessive vitamin A is increased pressure inside the skull. This then results in numerous consequences for the brain, including swollen optic nerves which affect vision. This can also lead to seizures. Part of the reason for the relatively high intensity and long lasting brain effects of vitamin A is the fact it is, unlike many other vitamins, fat soluble, meaning it will not dissolve in water. This means that it does not leave the body in urine, as with many other toxins. Instead, the liver takes the role of removing it from the body. This is often slower than removal via the kidneys, and can result in issues if excessive quantities are consumed along with other toxins such as alcohols. There are a wide range of chemicals related to vitamin A, known as retinoids, which are also found naturally in the body, being produced by metabolism - the biochemical reactions necessary for life. The levels of these products can be increased via ingesting excessive amounts of vitamin A. The exact

Organic And Conventional Are Safety, Price, And Production

5 The nutrients we receive from food is something we cannot live without. The question is what is the process to get this to our plates to our stores in and our homes? What a typical family goes to a store to buy the weekly groceries they choose fruits vegetables some form of meat protein. Often times in many stores around the country there is an option for organic food as well as what is known as conventional. Depending on the economic situation a family may choose conventional over organic depending on the budget of the household. There?s an argument that could be made organic is healthier and a better option for the long-term benefits of the household. The issues that make up the debate concerning organic versus conventional are safety, price, and production. Organic food promotes a healthy way to live along with improving one?s overall health. This commitment in changing lifestyle has an alternative name known as alternative farming. This movement began to improve the lives of rule farming communities. To eventually conserve natural resources such as soil and water in that area. The term organic farming tries to follow the practices of not using pesticides to begin the process to transfer conventional fields into organic it takes approximately three years. There is a common myth that organic food is healthier and lacks the toxicity of conventional foods. All there is no proof regardless of higher cost many prefer organic due to better tastingShow MoreRelatedHow Organic Food Is Healthier For You1524 Words   |  7 PagesOrganic food consists of any crops or animal product produced without the use of pesticides, man-made fertilizers, additives, or growth regulators. ‘In 2002 the USDA created national organic standards, overri ding any state regulators and creating a labeling system.’ (Griswold 2015) The Labels include different levels such as â€Å"100 percent organic† which means the product must be made from only organic products, â€Å"organic† products that have at least 95 percent organic ingredients, and products, â€Å"containingRead MoreNutritional Benefits Of Organic Foods1218 Words   |  5 Pagesof healthy alternatives, the organic food industry is quickly expanding. The U.S. organic foods market has rapidly grown from $3.5 billion in 1996 to $28.6 billion in 2010 according to the clinical report of Organic Foods: Health and Environmental Advantages and Disadvantages written by Joel Forman and Janet Silverstein. But should we purchase and consume more organically grown produce, meats, dairy products, and grains than conventionally grown foods? As the organic food section in local food supermarketsRead MoreOrganic Foods And Organic Food Essay1066 Words   |  5 PagesOrg anic food is one of the fast growing markets in the world. Only in the U.S., retail sales of organic foods were $6.2 billion in 2015: California made up the biggest part of the country’s organic food market, with $2.436 billion of total sales; Colorado was on the ninth place with $155 million of total sales (â€Å"2015 Certified Organic Survey† 9). Today, organic products are available in almost every conventional grocery store and often have a higher price over conventional products. In fact, theRead MoreOrganic vs. Conventional Farming Essay1625 Words   |  7 PagesOrganic farming is becoming an increasingly popular market throughout the world. (Adam, 2004, p. 666). The aims of organic farming are, to decrease pollution, maintain soil fertility and biodiversity, be more sustainable, and have increased nutritional benefits than conventionally grown foods (Yaping et. al., 2003, p. 298). While the aim of conventional farming is to provide safe, proficient supplies of food, in abundance and at low prices (Trewavas, 2001, p.409). Since 1996, the amount of landRead MoreOrganic Vs. Conventional Farming1364 Words   |  6 PagesOrganic farming, a new and upcoming industry is booming, however people are beginning to scrutinize the price of organic and naturally grown food and the validity of it’s value to health. Consumers paying the lofty price for their organic food contend it is saving them trips to the doctor and protecting them from the countless stacks of future hospital bills with regard to poor health. Consequently, to all the other people still buying into the cancer causing products produced by conventional farmingRead MoreOrganic Food Industry And Marketing Strategies1110 Words   |  5 Pagesfifteen years, organic food industries and companies have grown up tremendously around for its production and marketing strategies. According to the Organic Trade Association’s 2016 Industry Survey, the total organic products sales in 2015 have increased 11% percent from the previous year’s record level hitting a new benchmark of $43.3 billion, and conventional food products accounted for $3.6 billion. The industry saw its largest annual of all the food sold in the U.S in 2015 was organic was Near toRead MorePolicy Paper : Gmos Are The Problem !1493 Words   |  6 Pagesgrocery shopping, we are faced with the question, â€Å" Do we choose organic or the conventional products?† For some people, this may be an easy question depending on how much you want to spend, or if you choose organic products regardless of the price. However, no matter what an individual chooses, we will always be skeptical of the quality difference in grocery produce. Is organic milk that much different? Is it healthier than the conventional milk in the isle? Will it protect you from pathogens? TheseRead MoreDifference Between Organic and Conventional Foods and Farming1466 Words   |  6 PagesOrganic foods have become more a nd more popular over the years, and consumers may or may not be knowledgeable when shopping for organic and/or conventional foods. This report will help define the difference between organic and conventional foods and farming, including the health benefits and risks. The demand for organic foods will also be discussed briefly. The purpose of this research is to describe and identify the advantages and issues that are involved with organic and inorganic foods. OrganicRead MoreFood Inc, opinion paper1518 Words   |  7 Pagesmessages that suggest a more organic flow of food products relate to the realities of 21st-century marketing channels for food? The American Marketing Association defines marketing as â€Å"the activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large† (https://www.ama.org/AboutAMA/Pages/Definition-of-Marketing.aspx). The marketing mix consists of product, price, place, promotion, whichRead MoreWhole Foods Pestle1012 Words   |  5 PagesAnalysis Political Factors â€Å"A Healthier You† Government Strategy Reporting of organic prices. Safety Inspections Services. Evaluation: POSITIVE impact Economic Factors GDP: ↑ 3.9% in the 3rd qtr Real Personal Consumption expenditures ↑3.0% in 3rd qtr Disposable Personal Income ↑ 6.1 % in the 3rd qtr US Business Cycle: At â€Å"slump†/ Wages/Labour European Markets: Weak dollar against Euro, Surging Energy Prices, Increasing Interest Rates Evaluation: MODERATE impact PESTLE Analysis Socio-cultural

An Ideal Legal System For A Digital Device - 2156 Words

An ideal legal system can be compared to a digital device. An example would be Microsoft s Windows program. When the first version of Windows emerged, people were delighted and untroubled. But as the evolution in technology expands, new versions and updates became available to as time passes. They ranged from Windows 3.0, 97, 2003, and now the newest version is Windows XP. This relates to the legal system because laws need to update to fit the time and lifestyle of the consumers, in this case the citizens of a country. Another example can be that Canada would be the IPhone 6 while France in the flip-phone, both phones but one is more likely to suit the people s needs in the revolutionized lifestyle. In 1791 the Declaration of the†¦show more content†¦Both France and the Canada have a Bill of Rights. Both documents list rights of the citizen. Both countries and the U.N. Universal Declaration of Human Rights all share one set purpose (Humphrey, 1948). They all were created in the best interest of the citizens to ensure freedom and equality throughout a nation. For over 200 years, the rights and freedoms has served as the cornerstone of the Nation s democracy for both French citizens and Canadian citizens. It has guaranteed freedom in the decision making process and equality in lives of the people. Although both Bills share same purpose, they also share small differences that make a great impact in the overview. The French Declaration of the Rights of Man s first difference from the Canadian s Charter of Rights and Freedoms is the reason to why it was created. To ensure freedom and justice to the public is the main reason for both countries but further research show The French document was written by a French assembly of representatives aimed at showing the problems of their government. The Canadian Bill of Rights was aimed at changing the government to avoid the mistakes Britain made and to keep the government in check to avoid a trampling of these rights (Goldman, 2008). Another similarity is that both documents pointed out the flaws that can cause social corruption. Beside the reason of the creation of both documents, other differences up rise knowing

Waves On Pregnant Women Health And Social Care Essay Free Essays

Waves have been applied to many of import processs presents. In this article I am traveling to look into the application of moving ridges on pregnant adult females. One of the really of import subjects is the application of echography in antenatal medical examination ; therefore I would concentrate on this subject and discourse its rule and advantages among other different methods of antenatal medical examination. We will write a custom essay sample on Waves On Pregnant Women Health And Social Care Essay or any similar topic only for you Order Now However moving ridges do non merely conveying benefits to pregnant adult females, but besides injury. There are some electromagnetic moving ridges ( or EM moving ridges ) which may be harmful to both the female parents and the foetuss, such as X ray. Yet, will pregnant adult females truly have an increased hazard of abortion after holding an X-ray? Recently there are besides concerns about the consequence of wireless moving ridges and microwaves on gestation. In this article I am traveling to look into them one by one. Obstetric Ultrasonography Ultrasonography refers to the usage of ultrasound. Ultrasound is longitudinal moving ridge, it has the same velocity as hearable sound moving ridge in air, which is 340ms-1. The chief difference between hearable sound moving ridge and ultrasound is that ultrasound has a frequence beyond hearable scope of homo, which is around 20 Hertz ( 20 Hz ) to 20 kHzs ( 20 kilohertz or 20,000 Hz ) . Normally the frequence of ultrasound used in antenatal medical examination is ranged from 1.6 to 10 MHz ( MHz ) , depending on what constructions of the foetuss are being examined. Ultrasound with lower frequence can perforate deeper into organic structure tissues, because the higher the frequence, the more supersonic moving ridges are being absorbed alternatively of reflected, therefore while analyzing deeper tissues like the liver and kidney, ultrasound with lower frequence ( around 1.6-6MHz ) is used. In the echography, ultrasound moving ridges are emitted by a device called transducer. Actually the term transducer refers to a device which converts one signifier of energy into another, so there are tonss of types of transducer. In the echography, an electroacoustic transducer is used to change over electricity to breathe and have ultrasound ; therefore to be more exact, the device used is besides called an ultrasound transceiver. The transducer is placed on the venters of the pregnant adult female, the ultrasound emitted penetrates the tegument and so reaches the fetus and other internal variety meats of the female parent. The moving ridges are so reflected back to the transceiver, the transceiver senses the moving ridges and converts them into images. An ultrasound transceiver: hypertext transfer protocol: //l.b5z.net/i/u/6062479/i/transducer_tn.jpg beginning: hypertext transfer protocol: //www.chesapeakeultrasound.com/ultrasound_products An echography: hypertext transfer protocol: //gulfcoastmri.files.wordpress.com/2010/06/sonogram-human-foetal-fetal-ultrasound-scan-at-22-weeks-mono-1-anon.jpg Beginning: hypertext transfer protocol: //gulfcoastmri.wordpress.com/2010/06/07/obstetric-ultrasonography/ In instance that the pregnant adult female is in early gestation or corpulent, she can undergo transvaginal echography, which a investigation is placed in the adult female ‘s vagina. Sometimes the trial is besides carried out if the pregnant adult female has got unnatural vaginal hemorrhage or pelvic hurting. This type of echography has the similar rule as the echography mentioned above. Some female parents may desire to see the pulse of their babes, they can transport out the Doppler echography. It has fundamentally the same rule as the echography except the ultrasound is farther enhanced by Doppler Effect. Generally the foetus ‘s pulse can be detected after 7 hebdomads of gestation, therefore the blood flow of the foetus can be detected every bit good. The blood flows in a circulation in the organic structure of the foetus, the Doppler echography can therefore observe the alteration in waies of blood flow by Doppler consequence and see if the circulation is normal or no n. This can be done by mensurating the alteration in the frequence received in the transceiver. In fact there are a few more types of prenatal medical examination, such as amniocentesis and chronic villus trying. However, the echography is the safest manner for diagnosing. The echography merely involves a transducer puting outside the female parent ‘s venters, while amniocentesis and chronic villus trying necessitate mechanical incursion and trying inside the female parent ‘s womb or venters, this increases the hazard of abortion during the trials. Despite this fact, echography can merely give an early diagnosing of the female parents and foetuss, it can non handle anomalousnesss or familial diseases. Harmonizing to the trial conducted by RADIUS survey group in 1993, research workers found that obtaining echography has no significantly negative consequence on cut downing perinatal morbidity or mortality among the foetuss or the female parents. Furthermore, the sensing of anomalousnesss really did non change the result of newborn babes. Therefore it is of import to a dmit that echography is merely a trial whether the foetuss are healthy, but non a intervention to anomalousnesss. Harmful consequence of X ray X ray is an electromagnetic moving ridge with a wavelength ranged from 0.01 to 10 nanometres ( 0.01-10 x10-9m ) . It has a velocity of 3Ãâ€"108 ms-1 in vacuity. In fact, X ray is normally used in medical interventions, such as radiation therapy of malignant neoplastic disease and medical imagination engineering. X ray is produced in an X-ray tubing. In the X-ray tubing, negatrons are accelerated by using a high electromotive force. Electrons so collide with a metal, and the sudden slowing of negatrons consequences in the emanation of X ray. An X-ray tubing: hypertext transfer protocol: //hyperphysics.phy-astr.gsu.edu/hbase/quantum/imgqua/xtube.gif Beginning: hypertext transfer protocol: //hyperphysics.phy-astr.gsu.edu/hbase/quantum/xtube.html X ray has high ionising power, therefore there are many people worrying about the harmful effects of holding an X-ray diagnosing, particularly pregnant adult females. It is true that a really high dosage of radiation from X ray may ensue in radiation illness. Prolonged and uninterrupted exposure to X-ray besides increases the hazard of malignant neoplastic disease development, and in pregnant adult females, there may besides be a hazard for the foetus to develop childhood malignant neoplastic disease or even abortion. However, it seems that the harmful effects of exposing to X ray are exaggerated. The serious harmful effects mentioned above are merely the consequences of high dose in a short period of clip. There are different sorts of X raies, one type is used in scanning or diagnosing, one type is used in handling malignant neoplastic disease. The energy stored in different types of X raies is different. For normal X-ray scanning, the dose is highly little. The captive dosage of X ray is measured in rad, which 1 rad = 10Ãâ€"10-3 J kg-1 = 10-2 J kg-1. If a pregnant adult female is holding a chest X ray, the estimated fetal dosage is about 60 millirads, the dosage is about 290 millirads for an abdominal X ray. This is rather a low value, as the dosage from the radiation from outer infinite is around 90-100 millirads. In fact, the hazard of the foetus holding oculus abnormalcies or mental deceleration additions merely when the dose exceeds 10 rads, therefore it is really rare that pregnant adult females suffer from harmful effects by the X-ray radiation. Harmonizing to the American Academy of Family Physicians, by and large X raies are safe even for pregnant adult females, and harmonizi ng to radiotherapists, no individual diagnostic X ray has a radiation dosage important plenty to do inauspicious effects in a underdeveloped embryo or foetus. Normally physicians will non inquire pregnant adult females to undergo an X-ray scanning, unless when it is pressing and necessary. It is besides suggested that pregnant adult females should state the radiotherapists about the gestation, so that radiotherapists can set the radiation degree to better protect the female parents and the foetuss. To reason, many people are afraid of holding X-ray scanning when they are pregnant, but in fact the hazard is non that high if we compare the dose to the exposure to outer infinite radiation. An X-ray movie demoing gestation: hypertext transfer protocol: //www.neurobodyfit.com/wp-content/uploads/2012/03/xray-pregnancy.jpg Beginning: hypertext transfer protocol: //www.neurobodyfit.com/x-rays-are-safe-during-pregnancy/ Concerns of wireless moving ridges and microwaves Besides X-ray, some people are refering about the consequence of wireless moving ridges and microwaves on gestation. In fact the consequence of these two types of EM moving ridges is even less than X ray. There has been a survey look intoing the relationship between exposure of wireless moving ridges and microwaves of female physical therapists, and the ratio of abortion. Due to occupational usage, physical therapists are really frequently exposed to medical equipment breathing microwaves diathermy and wireless moving ridges. Harmonizing to the survey, research workers compared the uneven ratios between those pregnant physical therapists and other pregnant adult females. The consequences showed that the hazard of abortion was non associated with reported usage of diathermy equipment, therefore people need non worry excessively much about this issue. A microwave diathermy: hypertext transfer protocol: //image.ec21.com/image/medicm/oimg_GC04993002_CA04993086/Microwave_Diathermy_HM-801C.jpg Beginning: hypertext transfer protocol: //medicm.en.ec21.com/Microwave_Diathermy_HM_801C — 4993002_4993086.html Decision Waves have been widely used in medical equipment, and there are several applications of moving ridges on gestation. Ultrasonography is the most common and the safest method of antenatal medical examination. Though it can be used in diagnosing, it is unable to handle diseases in foetus. Many people concern about the side effects of utilizing X-ray, microwaves and wireless moving ridges, nevertheless it is in fact really safe because the dose of radiation is highly little. Therefore people need non worry excessively much about the hazard of abortion caused by exposure to these moving ridges. How to cite Waves On Pregnant Women Health And Social Care Essay, Essay examples

Case Study of Mr XZ-Free-Samples for Students-Myassignmenthelp

Question: Discuss about the Case Study of Mr XZ. Answer: Introduction The paper deals with the case study of Mr XZ, a 43-year-old man diagnosed with central diabetes insipidus. In the previous 3 months, he was complaining of polyuria, polydipsia, and nocturia. The water deprivation test confirms the illness and eliminates diabetes mellitus. In response to the case study, the paper discusses the aetiology and pathophysiology of the diabetes insipidus. The difference between the central and nephrogenic diabetes insipidus is discussed along with the diagnostic tool available. The paper also highlights the physiological functions of endogenous hormone vasopressin, and agents available for the treatmentof DI, with reference to the pharmacological basis for their therapeutic effects. Lastly, the reasonable management strategies for XZ are proposed. Physiological functions of endogenous hormone vasopressin Hypothalamus synthesises vasopressin and is then transferred to the posterior pituitary as the neurosecretory vesicles. The hormone is released into the circulation that is maintained by the plasma osmolality. The function of the hormone is to concentrate the urine in the distal renal tubules. The deficiency of the hormone leads to failure of urine concentration in the renal tubules. This contributed to the passage of the copious volume of dilute urine, which can be more than 3 litres of urine in 24 hours and with low osmolality (Hagiwara et al. 2014). In healthy people, ADH is released when the bodily fluids are depleted. The hormone released from the pituitary gland prevents the excretion of fluids from the body in the form of urine. The hormone increases the water permeability of the distal convoluted tubule and in the collecting duct of the kidney. The hormone functions to activate the transmembrane protein channels called aquaporins to open and allow water into the collecting ducts. The collecting ducts are the tubules receiving the diluted urine by nephrons, the functional unit of the Kidney. Vasopressin induces the translocation of the aquaporin CD water channels to increase the permeability of the collecting ducts. Thus, the blood absorbs more water and urine volume is reduced and is concentrated. This functioning is hampered during deficiency of hormone. In short, the main functions of this hormone are to constrict the blood vessels and to retain the water in the body (Qureshi et al. 2014). Vasopressin also increases arterial blood pressure by enhancing the peripheral vascular resistance. By regulating the blood glucose, water and salts, it maintains the homeostasis. Sometimes, vasopressin stored in the posterior pituitary is directly released into the brain and regulates social behaviour, pair bonding, stress response and sexual motivation (Juul et al. 2014). Aetiology and pathophysiology of Diabetes Insipidus According to Kalra et al. (2016), the abnormalities in the vasopressin gene present on chromosome 20 are responsible for the autosomal dominant form of the primary version of this disease. Even in the cases of genetic abnormalities, many cases are idiopathic. In rare cases, the disease can occur due to the genetic abnormality. The disease can also be secondary or acquired due to various lesions that may include cranial injuries, hypophysectomy, Langerhans cell histiocytosis, suprasellar and intrasellar tumours, lymphocytic hypophysitis, vascular lesions, granulomas, and infections. The primary central diabetes insipidus is marked by the profound decrease in the hypothalamic nuclei of the neurohypophyseal system (Oiso et al. 2013). As per Bockenhauer and Bichet (2015), hypothalamic pituitary disorder contributes to central diabetes insipidus. It is characterised by the large volume of dilute urine that is less than 300mOsm/kg. The primary storage site and release of vasopressin is the posterior lobe of pituitary gland. However, the hypothalamus is the synthesis site of vasopressin. Until the hypothalamic nuclei and the neurohypophyseal tract are functional or intact, the newly synthesised hormone can be released into the circulation. In order to avoid this condition, the intact nature of the 10% of neurosecretory neurons is enough. Hence, the pathology of central diabetes insipidus always involve supraoptic, and paraventricular nuclei of the hypothalamus or at least a major part of the pituitary tract should be intact. A complete central diabetes insipidus is indicated by the absence ofvasopressin, or it may be partial when the body has an insufficient level of ADH (Rutishauser et al. 2016). Polyuria, polydipsia, nocturia is the predominant clinical manifestations of the disease. In mammals, including humans, central or nephrogenic diabetes insipidus is caused by a deficiency in any part of this endocrine system and are manifested as polyuria and dilute urine. The same has been observed in the case of the patient MR. XZ. The previous three months of the patient showed these manifestations. The production of the very dilute urine or Polyuria is caused by the poor level or lack of anti-diuretic hormone or ADH, also known as vasopressin (De Fost et al. 2015). The low volume of ADH fails to function, activate the aquaporins, and subsequently allow the water into the collecting duct. Thus, blood cannot reabsorb the water, increasing the urine volume and decreasing its concentration. Polyuria is followed by polydipsia, a condition of excessive thirst to prevent the circulatory collapse. With the greater loss of body fluid, a patient feels dehydrated, with more urge to drink water. With polyuria and polydipsia, a person has to suffer from nocturia, a condition characterised by waking up at night frequently for voiding (Kalra et al. 2016). Differentiating central and nephrogenic DI and the diagnostic tools available The central diabetes insipidus is characterised by the decrease in secretion of ADH. The nephrogenic diabetes insipidus is impairment in the urine concentration process, caused by the resistance to ADH function in the Kidney. The diagnosis by the water deprivation test show poor ability to concentrate urine maximally. The causes of the central diabetes insipidus differ from the nephrogenic form. The principal causes of the central diabetes insipidus are the idiopathic, malignant tumours, head trauma, and crania surgery (Kalra et al. 2016). Water deprivation test distinguishes the central form of insipidus to the nephrogenic form as in later the injection of vasopressin does not reverse the existing symptoms. The low vasopressin levels are diagnostic but are difficult to measure. Moreover, these tests are not routinely available. Nocturia is diagnosed by taking the patient's nocturnal urine volume. It excludes the last void before sleeping but includes the first in the morning (Abbas et al. 2016). Prior to water deprivation test, the urine is tested for sugar to rule out diabetes mellitus. In addition to high sodium level, many electrolytes are found to be abnormally high. In addition to the water deprivation tests, another form of diagnosis of central diabetes insipidus is urinalysis and magnetic resonance imaging (MRI). Urinalysis is the physical and the chemical examination of urine. In central diabetes, inispdius urine is less concentrated if the water is high in comparison to the other excreted substances(Robertson 2016). MRI is the non-invasive technique where the magnetic field and radio waves are used to get the detailed view of the brain tissues and detect any abnormalities (Cull et al. 2014). In the idiopathic cases, destruction of the hypothalamus cells is more common. With the advancement of the imaging techniques, and identification of the antibodies against secreting cells, the idiopathic cases have decreased. However, this leads diagnostic confusion as these antibodies are also found on the people with Langerhans cell histiocytosis. Thus, Serial contrast-enhanced brain MRIs (every 3-6 months for the first 2 years) is mandatory for diagnosis. Craniopharyngioma and other primary tumours are the common manifestations of the central diabetes insipidus. Central diabetes insipidus is also the common manifestation of subarachnoid haemorrhage (Kreutz et al. 2017). In 10% of the cases, this disease is familial and may be under diagnosed. The autosomal dominant inheritance and result from a defect in theAVP-NP2gene on chromosome 20p13. Genetic testings are recommended to determine the specific aetiology and answer the recurrence risk questions (Bernal et al. 2016). Additional causes can be cancer, cardiac arrest, granulomatous disease and vascular lesions. CT and MRIs are successful brain imaging techniques to identify any abnormal findings On the other hand, the nephrogenic diabetes insipidus is caused by the metabolic factors such as high blood sugar, calcium and low potassium. In adults, this condition mostly develops due to hypocalcaemia or lithium toxicity. In 20% of the cases, where the patient is taking lithium, experiences impairment in urine concentration. The contributing factor of this condition is the dysregulation of the aquaporin systemin the collecting duct having principal cells. The urine concentrating ability is also declined by the prolonged elevation of the serum calcium level that is more than 11 mg/dL (Bockenhauer and Bichet 2015). In addition to Lithium, there are other drugs that reduce the concentration of the urine in the distal renal tubule. It may include Amphotericin B, Orlistat, cidofovir, Demeclocycline, and Ofloxacin. The other causes of the nephrogenic diabetes insipidus include transient pregnancy, Hypokalemia, renal disease (amyloidosis, sickle cell anaemia), and hyperglycemia (Bockenhauer and Bichet 2015). The hereditary factors responsible for this form of the disease are rare. When occurs, it is attributed to the mutations in the AVP receptor 2 genes (AVPR2) on chromosome Xq28. The resistance to the ADH is caused by the defects in the AVP receptor. It is an X-linked disorder, hence, mostly males are affected by this disease. In case of females, this disease is reported occasionally due to skewed X inactivation (Moeller et al. 2013). The familial nephrogenic DI casesare contributed by the mutation in AQP2, aquaporin 2. This gene is present on chromosome 12q13, that expresses water channel in the collecting ducts of Kidneys. In nephrogenic diabetes insipidus, both Autosomal recessive and autosomal dominant forms are reported (Bockenhauer and Bichet 2015). The central diabetes insipidus is commonly diagnosed by water deprivation test to examine the blood electrolyte levels, urine production, and weight for 12 hours. After dehydration, the patients cannot maximally concentrate urinebut can do so after receiving exogenous ADH. In this test, the patient is not allowed to take fluid for stipulated time say 8-12 hours. If the morning void is not concentrated, then it can be diagnosed as central diabetes insipidus (Robertson 2016). It is also confirmed by the decrease in blood pressure, loss of more than 5% body weight and increase in heart rate. By injecting vasopressin, these effects are reversed (Kalra et al. 2016). Treatment The primary treatment goals include rectification of water deficit that is persisting and reduction of the ongoing excessive urinary water losses. The treatment depends on the speed of the onset of the symptoms. In case, the patient has the presence of any associated hypernatremia (Valenti and Tamma 2016). To promote rehydration, the level of dehydration in Mr XZ must be assessed and ongoing losses. Accordingly, the rehydration therapy can be commenced. In case the serum sodium is greater than 150mmol/L, rehydration therapy is immediately needed and the symptoms may improve within 48 hours. Desmopressin as pharmacology therapy treats central diabetes insipidus. This agent is the longer acting form (synthetic analogue) of vasopressin. This physiologic replacement is effective for the hormonal deficiency. It can be taken as the tablet, or nasal spray and dose can be adjusted as per the bodys requirement to maintain water balance and urine output. Both vasopressin and desmopressin when taken in excess amount lead to complications such as swelling, fluid retention and other problems. Injections of vasopressin are given to people undergoing surgery. For outpatient treatment of diabetes, insipidus desmopressin is preferred in comparison to the vasopressin as the former is easy to administer (dose can be precisely tailored) and has greater safety and tolerability (Bichet 2014). The mechanism of action of both vasopressin and desmopressin is slightly different. Vasopressin exhibits its antidiuretic effect by the activation of the V2 R caused by the kidney reabsorption of water. This process is triggered via "Gs protein/adenylyl cyclases/cAMP pathway". The cascade of events leads to the mobilisation of water channel aquaporin to the distal convoluted tubules of kidney nephron and the collecting duct. This action increases the permeability of the lipid bilayer of the cell membrane to water. On the other hand, the antidiuretic mode of action of the desmopressin is by greater antidiuretic potency and decreased pressor activity. In compared to natural hormone this agent has longer half-life and clearance in urine is strong during renal impairment (Ando et al. 2015). The average magnitude, duration of the effect of the intravenous infusion of desmopressin, following 2 hour on urine osmolality and urine flow is dose dependent and clearly reciprocal. The magnitude of the antidiuretic effect of the desmopressin is limited due to a concentrating capacity of the Kidney which is bunted in the patient with central diabetes insipidus as they were already deficient in vasopressin. Thus, at an IV dose of 250 ng the average maximum urine osmolality achieved was 850 mOsm/kg, and the rate of urine output reduced to 1.4 L/day, which is almost the normal range (Kataoka et al. 2015). The action of the agent is prolonged by doubling the dose of desmopressin. When administering the DDAvasopressin orally, maximum plasma concentrationcan be obtained at 90 minutes. Treating vasopressin orally for 5 years as long-term treatment has been found to control diuresis in 8 of the 9 patients. When treated with this agent the patients should be started with the lowest dose possible, and subsequent titration should be followed based on the clinical response. Prior to giving further dosage polyuria should be allowed to develop as sometimes diuresis is transient may be nullified by single dosage. Thus, both the agents are safe therapeutic agents and can be effective to cure Mr. XZ. It is a good alternative treatment for central diabetes insipidus. These agents greatly simplify the management of the disease (Murakami et al. 2014). The patients undergoing pituitary surgery can experience diuresis as they are administered with the large volume of fluids. These patients also exhibit the posttraumatic decrease in AVP levels. These symptoms become difficult t o distinguish with central diabetes insipidus. They are also challenging to manage. In such cases, the patients are administered with DDAVP if polyuria is continued with low urine osmolality (Behan et al., 2015). The medication management in chronic central diabetes insipidus requires "individually tailored dosing schedule". Initially starting with the low dose, the doses are subsequently increased based on the clinical response. Per dose, the average duration of action is between 6-18 hours. However, in some cases single dose at night is sufficient. The dose should be titrated to control nocturia The accredited registered nurses should administer the therapeutic agents. The nurses must inform the managing team if te Mr. XZ is found to have urine output greater than 4mls/kg/hr for two consecutive hours. It indicates the need of repeated serum. There is a need of notifying the management if the serum electrolytes are not in normal range after drug administration (Behan et al. 2015). It is very rare to expect spontaneous or complete recovery from the illness as overcoming hormonal deficiency is uncommon. Reversible in symptoms is seen after neurosurgery. Other drugs that stimulate the body production of the vasopressin are carbamazepine, thiazide diuretics, chlorpropamide, and clofibrate. These drugs provide relief in the severe form of diabetes insipidus. These are the non-hormonal agent, and sometimes-nonsteroidal anti-inflammatory drugs are prescribed. The latter is mainly prescribed in the nephrogenic DI,as a last resort (Arima et al. 2013). Management strategies The nurses must educate the patient (XZ) about increasing the prescribed dosage of drugs based on the thirst level and urinary output. To offload the excess water and diuresis the patients may be advised to delay the dose by one per week, prevent the hyponatraemia, and then take subsequent dosage as normal. For Mr. XZ to have normal lifestyle decreasing thirst and Polyuria is the primary goal (Gleeson et al. 2016). The patients of central diabetes insipidus must be educated about the side effects of desmopressin such as a headache, runny nose, nosebleeds, stomach pain, feeling bloated or dizziness. Mr. XZ must be aware of the symptoms of hypernatremia, which are confusion, nausea and vomiting, and prolonged headache. Desmopressin should be discontinued if the patient is experiencing hyponatremia (Gleeson et al. 2016). The management of the patients with central diabetes insipidus includes monitoring of fluid retention. During initial therapy, the XZ needs to be monitored for hyponatremia, and if confirmed then intravenous fluidsmay be required. The patient should be observed for the volume of water intake, the volume of urine output and frequency, serum sodium, specific gravity and level of thirst. Mr. XZ should be requested for follow up visits post-hospitalisation (Verbalis 2016). There are no specific dietary considerations required for diabetes insipidus even when chronic. The patient Mr. XZ must be educated about adequate intake of water and the importance of the water and salt balance. The urine output can be decreased by taking low protein and sodium diet. The patient should be educated to take precautions when travelling to avoid diarrhoea and vomiting. Mr. XZ can avoid dehydration by travelling at night and preventing exertion from hot weather. Serious problems can be prevented in the patients if they are educated to avoid dehydration. It is necessary to carry water, and the medications support wherever one go, and if possible, it is effective to carry the medical alert card (Kalra et al. 2016). Counselling sessions can be recommended for Mr. XZ. Any chronic illness disturbs emotional well being in addition to the physical well-being. It may be due to embarrassing symptoms such as polyuria. The expensive treatment along with the physical weakness adds to distress. Financial burden is the main source of anxiety and depression in most cases. Psychiatric counselling can be referred for Mr. XZ to relive anxiety and better manage the illness (Morton et al. 2017). Conclusion Hypothalamic pituitary disorder contributes to central diabetes insipidus and is indicated by the absence ofvasopressin, or an insufficient level of ADH. The paper elucidated the aetiology and pathophysiology of the diabetes insipidus. The difference between the central and nephrogenic diabetes insipidus is discussed along with the diagnostic tools available. The paper also highlights the physiological functions of endogenous hormone vasopressin, and agents available for the treatmentof DI, with reference to the pharmacological basis for their therapeutic effects. Lastly, the reasonable management strategies for XZ are proposed. References Abbas, M.W., Iqbal, M.A., Iqbal, M.N., Javaid, R. and Ashraf, M.A., 2016. Diabetes insipidus: the basic and clinical review.International Journal of Research in Medical Sciences,4(1), pp.5-11. Ando, T., Nozaki, A., Akazawa, S., Sagara, I.U., Horie, I., Imaizumi, M., Usa, T. and Kawakami, A., 2015. QOL in the Patients with Central Diabetes Insipidus Under Different Formulations of Desmopressin. InHealth Outcomes/Quality Improvement Research(pp. THR-194). Endocrine Society. Arima, H., Oiso, Y., Juul, K.V. and Nrgaard, J.P., 2013. Efficacy and safety of desmopressin orally disintegrating tablet in patients with central diabetes insipidus: results of a multicenter open-label dose-titration study.Endocrine journal,60(9), pp.1085-1094. Behan, L.A., Sherlock, M., Moyles, P., Renshaw, O., Thompson, C.J.T., Orr, C., Holte, K., Salehmohamed, M.R., Glynn, N., Tormey, W. and Thompson, C.J., 2015. Abnormal plasma sodium concentrations in patients treated with desmopressin for cranial diabetes insipidus: results of a long-term retrospective study.European journal of endocrinology,172(3), pp.243-250. Bernal, A., Maha, J. and Puerto, A., 2016. Animal models of Central Diabetes Insipidus: Human relevance of acquired beyond hereditary syndromes and the role of oxytocin.Neuroscience Biobehavioral Reviews,66, pp.1-14. Bichet, D.G., 2014. Treatment of central diabetes insipidus.2013-09-25)[2014-03-03] https://www. uptodate. com/contents/treatment-of-central-diabetes-insipidus, pp.1-52. Bockenhauer, D. and Bichet, D.G., 2015. Pathophysiology, diagnosis and management of nephrogenic diabetes insipidus.Nature Reviews Nephrology,11(10), pp.576-588. Cull, E.H., Watts, J.M., Tallman, M.S., Kopp, P., Frattini, M., Rapaport, F., Rampal, R., Levine, R. and Altman, J.K., 2014. Acute myeloid leukemia presenting with panhypopituitarism or diabetes insipidus: a case series with molecular genetic analysis and review of the literature.Leukemia lymphoma,55(9), pp.2125-2129. De Fost, M., Oussaada, S., Endert, E., Linthorst, G., Serlie, M., Soeters, M., DeVries, J.H., Bisschop, P. and Fliers, E., 2015. The water deprivation test to differentiate diabetes insipidus from primary polydipsia.Endocrine Connections, pp.EC-14. Gleeson, H., Bonfield, A., Hackett, E. and Crasto, W., 2016. Concerns about the safety of patients with diabetes insipidus admitted to hospital.Clin Endocrinol (Oxf),84, pp.950-1. Hagiwara, D., Arima, H., Morishita, Y., Wenjun, L., Azuma, Y., Ito, Y., Suga, H., Goto, M., Banno, R., Sugimura, Y. and Shiota, A., 2014. Arginine vasopressin neuronal loss results from autophagy-associated cell death in a mouse model for familial neurohypophysial diabetes insipidus.Cell death disease,5(3), p.e1148. Juul, K.V., Bichet, D.G., Nielsen, S. and Nrgaard, J.P., 2014. The physiological and pathophysiological functions of renal and extrarenal vasopressin V2 receptors.American Journal of Physiology-Renal Physiology,306(9), pp.F931-F940. Kalra, S., Zargar, A.H., Jain, S.M., Sethi, B., Chowdhury, S., Singh, A.K., Thomas, N., Unnikrishnan, A.G., Thakkar, P.B. and Malve, H., 2016. Diabetes insipidus: The other diabetes.Indian journal of endocrinology and metabolism,20(1), p.9. Kataoka, Y., Nishida, S., Hirakawa, A., Oiso, Y. and Arima, H., 2015. Comparison of incidence of hyponatremia between intranasal and oral desmopressin in patients with central diabetes insipidus.Endocrine journal,62(2), pp.195-200. Kreutz, J., Potorac, I., Lutteri, L., Gennigens, C., Martin, D., Daly, A.F., Bonneville, J.F., Tshibanda, L. and Beckers, A., 2017, May. Adipsic diabetes insipidus revealing a bifocal intracranial germinoma. InAnnales d'Endocrinologie. Elsevier Masson. Moeller, H.B., Rittig, S. and Fenton, R.A., 2013. Nephrogenic diabetes insipidus: essential insights into the molecular background and potential therapies for treatment.Endocrine reviews,34(2), pp.278-301. Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2017.Critical care nursing: a holistic approach. Lippincott Williams Wilkins. Murakami, T., Hatoko, T., Nambu, T., Matsuda, Y., Matsuo, K., Yonemitsu, S., Muro, S. and Oki, S., 2014. Desmopressin orally disintegrating tablet in Japanese patients with central diabetes insipidus: A retrospective study of switching from intranasal desmopressin.Endocrine journal,61(8), pp.773-779. Oiso, Y., Robertson, G.L., Nrgaard, J.P. and Juul, K.V., 2013. Treatment of neurohypophyseal diabetes insipidus.The Journal of Clinical Endocrinology Metabolism,98(10), pp.3958-3967. Qureshi, S., Galiveeti, S., Bichet, D.G. and Roth, J., 2014. Diabetes insipidus: celebrating a century of vasopressin therapy.Endocrinology,155(12), pp.4605-4621. Robertson, G.L., 2016. Diabetes insipidus: Differential diagnosis and management.Best Practice Research Clinical Endocrinology Metabolism,30(2), pp.205-218. Rutishauser, J., Spiess, M. and Kopp, P., 2016. Genetic forms of neurohypophyseal diabetes insipidus.Best Practice Research Clinical Endocrinology Metabolism,30(2), pp.249-262. Umbricht, D., del Valle Rubido, M., Hollander, E., McCracken, J.T., Shic, F., Scahill, L., Noeldeke, J., Boak, L., Khwaja, O., Squassante, L. and Grundschober, C., 2017. A Single Dose, Randomized, Controlled Proof-Of-Mechanism Study of a Novel Vasopressin 1a Receptor Antagonist (RG7713) in High-Functioning Adults with Autism Spectrum Disorder.Neuropsychopharmacology,42(9), p.1914. Valenti, G. and Tamma, G., 2016. History of diabetes insipidus.G Ital Nefrol,33(S66), pp.1724-5590. Verbalis, J.G., 2016. Diabetes Insipidus: Principles of Diagnosis and Treatment. In2016 Meet-The-Professor: Endocrine Case Management(pp. 195-201). The Endocrine Society.

Debut Albums and Cue Card free essay sample

Which part of your house do you like the most? Why? What makes your house pleasant? Do you Like sports? Describe the kind of spots people do In your country. Why? Have you ever tried any sport? Do you think sport affects the person doing it? Is there any sport you would like to try? Cue Card Describe how you usually communicate with your friends. Please say: Are you communicating by phone, letters or e-mails?What are the advantages and disadvantages of these ways? Do your friends agree with this way of communication? Which way do they prefer? Discussion Compare letter-writing nowadays and 100 years ago. What do you think about the future of letter-writing? ; Can you tell me your full name? Do you work or study? Would you recommend that job to others? What places of entertainment have you visited lately? What entertainment facilities are there in your city? What other places would you Like there to be? 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