Papilledema Case Studies

Papilledema Case Studies
2. Case presentation
2.1. Clinical presentation and history
An obese 41–year–old woman was admitted to Rasool Akram Hospital presenting with a headache, blurred vision, anxiety, and mental depression. She
had been treated with acetazolamide for the management of papilledema, which was unsuccessful, so she was referred to us. Her body mass index
was 38 kg/m2. Her medical history showed consumption of Fluoxetine, Inderal, Haloperidol, Desipramine, and Artan, which were prescribed by her
previous psychologist.
2.2. Diagnostic measures
A neuro–ophthalmologist observed swelling in her bilateral optic disc. Visual field perimetry and visual acuity were in the normal range. Other general
and neurological examinations did not reveal any abnormalities. The laboratory analysis of her blood showed hyperglycemia due to unmanaged
diabetes mellitus (FBS: 180 mg/dl, normal range: 70–100 mg/dl) and hyperprolactinemia (Prolactin: 98 ng/mL, normal range: 2–29 ng/ml). A lumbar
puncture was performed to evaluate her cerebrospinal fluid (CSF). Although she consumed a 250–mg tablet of Acetazolamide every eight hours, her
lumbar puncture opening pressure was 33 cm H2O. Biochemistry and cytological analysis of CSF were within normal limits (Protein: 10 ... Show more
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Because of the misdiagnosis of LP shunt–induced cerebellar tonsillar ptosis, she was conservatively treated with medications, such as Promethazine and
Trifluoperazine. Her nausea and headache were exacerbated, and she was readmitted. Her computed tomography (CT) scan of the brain indicated left
frontotemporoparietal subacute subdural hematoma with subfalcine herniation (Figure 3). In her second surgery, the left parietal Burr–Hole was
performed, and the subdural hematoma was evacuated. The post–operative period was uneventful, and her symptoms disappeared. Her delay brain CT
showed relief of hematoma and herniation (Figure
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Monocular Loss In Amblyopia
Amblyopia is a functional disorder characterized by monocular or binocular reduction in the visual acuity. It is considered the most common cause of
monocular visual loss that affects approximately 1.3 – 3.6% of children (Birch, 2013) . Amblyopia is usually associated with a history of binocular
misalignment (strabismic amblyopia), highly different refractive error for the two eyes (anisometropic amblyopia) or an early visual deprivation
caused by factors such as cataract, lid occlusion or ptosis (Levi, 1994) Aside from the monocular loss in amblyopia, amblyopes usually suffer from
binocularity deficits such as reduced stereopsis, visuomotor imbalance and diminished binocular contrast sensitivity. Binocular vision is immensely
essential in ... Show more content on Helpwriting.net ...
There are a number of studies that have been done investigating the effectiveness of the patching in children considering the age and the duration of
patching. One large trial that investigated the patching in the mentioned groups of subjects is The Pediatric Eye disease Investigator Group. They
investigated the effectiveness of 6 hours vs 2 hours of daily patching in 189 children with moderated amblyopia (20/40 to 20/80) and the average
visual acuity improvement in both of the group was 2.4 lines (A randomized trial of patching regimens for treatment of moderate amblyopia in
children.(the pediatric eye disease investigator group).2003) . However, the trial did not provide details about the binocularity improvement such as
stereopsis in the studied subjects. Even though, patching improves the visual acuity as we addressed above, the compliance is low. Because putting a
patch in front children eyes prevents them from being engaged with the surrounding social activities such as playing and reading and that has at least a
negative psychological effect (Searle, Norman, Harrad, & Vedhara, 2002)

Essay On Binge Drinking During Pregnancy
Drinking alcohol during pregnancy is strongly not recommended because not only will alcohol affect the mother's body, but there are consequences for
the baby as well. Practicing binge drinking is bad for an individual, yet some women still practice binge drinking whether they know or do not know the
consequences. People who have Fetal Alcohol Syndrome cannot change their appearance because it is a permanent condition. The mother is the only
person who can control whether or not to let her child have this condition, so there must some prevention to this. Drinking underage is illegal, so the
government should make drinking during pregnancy illegal as well. Fetal Alcohol Syndrome (FAS) a condition under the umbrella terms fetal alcohol
spectrum disorder (FASD). FAS is at the end of the spectrum that needs health care involvement. In other words, it is the condition that needs the most
attention. From birth, the baby who has an alcoholic mother is likely to be underweight as an infant. According to Floyd, O'Connor, Sokol et al.
(2005), heavy drinking during pregnancy is ... Show more content on Helpwriting.net ...
As Margaret Barrow and Edward P. Riley (2011) stated that children who have FASD are likely to have smooth philtrum, thin upper lip, and besides
they have sleepy eyes, anteverted nares, midface, hypoplasia, flat nasal bridge, ptosis, and strabismus. What described previously are the physical
features of the children who have FAS. More into that, the condition affects the central nervous system, which can impair the children's ability to learn.
"Many children with FASD are described as talkative, short–tempered, impulsive and intrusive with reduced social abilities in cognition and emotion
processing" (Dorrie, Focker, Freunscht, & Hebebrand, 2014). Some sources pointed out that children with this condition are having a hard time to
make friends or following the directions given by their

Megalencephaly-Capillary Malformation Case Study
Megalencephaly–capillary malformation (M–CM) syndrome with ALK1 gene mutation SUMMARY Up to 150 words summarising the case
presentation and outcome (this will be freely available online) Megalencephaly–capillary malformation (M–CM) is a rare genetic syndrome
characterized by megalencephaly and cutaneous capillary malformations in association with focal or generalized somatic overgrowth, neurocognitive
delay and characteristic facies. M–CM is frequently associated with various structural brain abnormalities and must be differentiated from other known
somatic overgrowth syndromes, for appropriate monitoring of known complications and genetic counseling. We report on a 3 years old boy with
Megalencephaly–capillary malformation (M–CM) syndrome novel genetic mutation in ALK1 gene and describe his... Show more content on
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He is now 3 years of age, and was born to healthy non–consanguineous parents by ventouse delivery at 36+ 2 weeks gestation in a good condition.
Mum's antenatal scans showed polyhydramnios, ventriculomegaly and nuchal fold thickening. His weight at birth was 3404 grams (91st–98th centile)
and head circumference was 37 cm at birth(>99.6th centile). Initial Cranial ultrasound at 6 days of age had showed a small germinolytic cyst, which
resolved on repeat ultrasound at 3 months of age. On follow up at 6 months of age, he had global developmental delay, macrocephaly, frontal bossing,
multiple hemangiomas (figure 1,figure 2),cutis marmorata, marked hypotonia with head lag and left sided ptosis. There was no polydactyly or body
asymmetry. karyotype and array comparative genomic hybridization (array CGH) were normal. He was reviewed by geneticist and tested positive for
ALK1 gene mutation. Echocardiography has shown a mildly dilated aortic root with no other cardiac abnormalities. He was reviewed by
ophthalmologists and was noted to have infantile esotropia with left sided Marcus Gunn

Tia Case Study
NURSING DIAGNOSIS Ineffective tissue perfusion / Altered cerebral tissue perfusion Risk for injury: Stroke Impaired verbal communication r/t
ischemic injury NURSING DIAGNOSIS Ineffective tissue perfusion / Altered cerebral tissue perfusion Risk for injury: Stroke Impaired verbal
communication r/t ischemic injury NURSING INTERVENTIONS Careful monitoring of neurological status (Glasgow come scale, LOC, pupillary
responses, extremity movement and strength, facial symmetry, speech and vital signs). Decrease in LOC may indicate increased ICP. Tube feedings
and IV fluids r/t dysphagia. F/C r/t incontinence, pt is placed on B&B training program. Preventing contractures, building muscle tone with ROM
activities, controlling... Show more content on Helpwriting.net ...
Other symptoms may include: tinnitus, vertigo, blurred vision, diplopia, eyelid ptosis and ataxia. MANIFESTATIONS Contralateral weakness of the
lower face, hands, arms and legs; transient dysphasia; numbness or loss of sensation; headache; temporary loss of vision of one eye; sudden inability
to speak. Other symptoms may include: tinnitus, vertigo, blurred vision, diplopia, eyelid ptosis and ataxia. ETIOLOGY Episode of cerebrovascular
insufficiency with temporary episodes of neurologic dysfunction lasting less than 24 hours and often less than 15 minutes. Most TIA symptoms
resolve within 3 hours. Symptoms lasting longer than 24 hours are classified as a stroke. TIAs are thought to be caused by microemboli that
temporarily occlude blood flow resulting in ischemia of brain tissue. Often occurs in patients with carotid artery stenosis. ETIOLOGY Episode of
cerebrovascular insufficiency with temporary episodes of neurologic dysfunction lasting less than 24 hours and often less than 15 minutes. Most TIA
symptoms resolve within 3 hours. Symptoms lasting longer than 24 hours are classified as a stroke. TIAs are thought to be caused by microemboli that
temporarily

Pathophysiology Case Studies
The patient's eyebrows are symmetrically aligned and show equal movement when asked to raise and lower eyebrows. Eyebrows are of equal length
and width and hair is equally distributed between both brows. Eyelashes appeared to be equally distributed, equal in length and curled slightly
outward. There is a presence of mild eye discharge that is clear in color. No matting of the eye noted. No discoloration of the exterior eye or lids. No
ptosis or edema. Lids close symmetrically with involuntary blinks. The eyes converge appropriately. The Bulbar conjunctiva are clear with few
capillaries present. The sclera appear white. The palpebral conjunctiva appeared shiny, smooth and slightly red in color. There is no edema of the
lacrimal gland. There ... Show more content on Helpwriting.net ...
The pupils of the eyes are black and equal in size. The pupils are 5 mm in diameter bilaterally. The iris is flat and round bilaterally. PERRLA (pupils
equally round respond to light accommodation). There was a positive symmetry of the corneal light reflex noted in both eyes. The optic disc is
yellow–orange in color, round, and have margins that are sharply demarcated bilaterally. The retinal vessels are present in both eyes and are paired
with one artery in each quadrant of the eye. The ratio is 2:3. The view of the macula is unclear at this time. The fundus of the eye is red, clear, and
smooth looking. No lesions noted. The pupils constrict when looking at object that is near and dilate when an object is far. Pupils converge when
object is moved towards the nose. The Snellen eye test revealed that the patient has 20/30 vision in both eyes while wearing corrective lens. Pt had
no trouble seeing objects in the periphery at a 60 degree angle on all directions while looking straight ahead. When using the six cardinal positions, the
patient is able to easily focus on the movement at each of the six positions. CN III assessed with the extraocular muscle exam. CN III in tact. No
nystagmus

The Effect Of Myasthenia Gravis On The Body 's Immune System
Definition:
Myasthenia Gravis (MG) is a chronic autoimmune disorder of the neuromuscular system part of the body. Chronic means persisting for a long time or
constantly recurring. Autoimmune disorder is the confusion of the body's immune system. The immune system form antibodies that mistakenly
identify healthy tissue as foreign and then, the antibodies will attack and/or destroy healthy body tissue. Neuromuscular is the nervous system
relationship with the muscles bring about body movement.
Myasthenia Gravis affects the neuromuscular junction. Neuromuscular junction is the connection or meeting place of the nerve and a muscle fiber.
The nerves communicate with the muscle fiber by telling it to move or contract. The nerves ... Show more content on Helpwriting.net ...
Speech may be slurred and facial expressions may be limited, making it hard to smile. It may be difficult to hold head up due to weak neck muscles.
Weak limb muscles cause difficulty walking, climbing stairs, lifting objects, or holding arms up. Raising the body from a seated position may cause
difficulty. Chest muscles may also be affected, causing difficulty with breathing. This particular symptom may cause serious problems, called a
myasthenic crisis
Diagnosis:
MG may be difficult to diagnose and may not be determined for a couple of years. Reasons are as follows: the onset is gradual with the symptoms
worsening over time, weakness and fatigue can also be signs and symptoms of other diseases, one or more of the voluntary muscle groups may
experience weakness and with different degrees of severity, and also every patient may experiences the disease differently. After the medical history and
physical examination, the physician may see a need for further muscle and neurological tests. Blood tests can detect abnormal antibodies. Nerve
conduction studies and repetitive stimulation tests the nerve's communication with the muscle. When stimulated a number of times the test will
indicate muscle weakness. Single–fiber (EMG) electromyography is a test that measures the communication between the nerve and a muscle by
inserting a small needle into a single muscle and recording the electrical muscle activity. CT scan or MRI may be ordered to check for

Myasthenia Gravis
Myasthenia gravis can be classified as a chronic neurologic disease of the neuromuscular transmission and characterized by presentation of fatigable
muscle weakness to the external ocular, cranial, respiratory and limb muscles (Smith, C., P.A.–C., & Stickler, D., M.D. 2012). The incidence of this
disease is about 20 per 100,000 people in various populations, affecting mostly women in their 20's to 30's and men over the age of 60 (Postevka 2013).
Myasthenia gravis is an autoimmune neuromuscular disorder that annihilation the functional acetylcholine receptors at the neuromuscular joints.
Normally, acetylcholine is used in signal transmission between nerves and muscles, its goal is to provide muscle contractions. But in this case, the
decreasing

Myasthenia Gravis : An Autoimmune Neuromuscular Disorder
Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder meaning grave muscular weakness. Symptoms associated with myasthenia gravis
include painless, fluctuating, and fatigable weakness involving specific muscle groups. Weakness is usually least in the morning and progresses as the
day continues especially with prolonged muscle use. Double vision and drooping eyelids is usually the first symptom complaint from patients with MG.
The patient may complain of difficulty with speech, chewing, swallowing, or breathing. Initial symptoms of difficulty chewing, swallowing, or
speaking is reported in 16% of patients. Weakness can also be present in the arms or legs. Prevalence of MG is currently 20/100,000 in the United
States. The ... Show more content on Helpwriting.net ...
Patients with MG are at a high risk for silent aspiration. Literature has demonstrated that silent aspiration occurs in approximately 50% of those with
MG who aspirate (Higo, Nito, Tayama, 2005). Colton–Hudson reported silent aspiration in 4 out of 7 patients (2005). Kluin et al studied 8 elderly men
with MG and found silent aspiration in 5 out of 8 patients (1996).Due to the high incidence of silent aspiration instrumental evaluation of the swallow
is suggested for patients with MG. In most instances cholinesterase inhibitor medication provides improvement in the patient's swallow. Colton et al
reports that active exercise to maximize the strength of the oropharyngeal muscles are generally limited by fatigability and not recommended for
dysphagia associated with MG (2002). Chewing and swallowing functions may be improved by the administration of cholinesterase inhibitor
medication one hour prior to the meal. Speech–language pathologist can educate patients on taking medication in conjunction with meal times. Other
compensatory strategies can be implemented following instrumental swallowing evaluation. The swallowing quality of life scale (SWAL–QOL) could
be used for patient reported measure of functioning for dysphagia. The SWAL–QOL has demonstrated strong internal consistency and strong test
re–test reliability (McHorney et al, 2002). This test would be beneficial for intervention planning because it

Dna Polymerase Synthesis
There has been an abundant amount of enzymes that replicate a bulk of DNA, which has been discovered in past years. Many enzymes correlate with
DNA to assist them in translating, replicating and transcribing the enzymes in our body (Pierce, 2013). More specifically, an enzyme that is involved
in DNA replication is DNA polymerase. One of the main functions for DNA polymerase is to allow the synthesis of damage, that the past DNA caused,
which blocks replication–fork progression. DNA polymerase can cause a complication and/or mistake, which is caused by a genetic mutation that
occurs before the transcription and replication process of the DNA. One of the mutations, POLG has been directly involved in making DNA
polymerase gamma in mitochondria, ... Show more content on Helpwriting.net ...
Needless to say, genetic engineering in the future, may be used to further detect and learn about the disease. One way genetic engineering can be used
to learn more about to detect the disease earlier is by using the cells with two types of genetic alterations responsible for the PEO mutation. A closer
study of these muscle cells can help determine the abnormalities in the type of DNA that is resulted from the mitochondrial DNA trait. Another way is
by using gene therapy with individuals for treatment to see if the injection of the DNA into the cell will have the resulted goal of changing the genome
(NIH,

Astigmatism Essay
Astigmatism is not a disease but rather a condition. It's an eye condition that causes your vision to worsen over time. This happens because the cornea
(eye) is not curved properly, which is irregular, which sometimes causes one area of the cornea to be steeper or possibly even flatter than the other.
There are two very common types of astigmatism; they are called "Corneal" and "Lenticular" astigmatism. Corneal astigmatism is when one side of the
cornea is either flatter or steeper than the other side. This causes blurred vision because the light that hits the retina at the back of the eye isn't refracted
properly, thus causing an imperfect image. Lenticular astigmatism is when the lens, not the cornea, has variations in its curvature. ... Show more content
on Helpwriting.net ...
Honestly there isn't really a diet that can be recommended, but all you really have to do is make sure you take a break after about an hour of
looking at a computer screen or any other piece of technology and reading. Well actually there is one thing that you can add to your diet that could
help, and that would be to add vegetables, like carrots, that is good for the eyes.
As a result of this project it is important to implement these lifestyle changes, so that if you have astigmatism you don't make it worst, and if you don't
have it you don't increase the risk of developing astigmatism. You can encourage your family and friends by explaining to them the consequences of
developing astigmatism and how important it is to see an eye doctor regularly. http://www.medicalnewstoday.com/articles/158810.php
http://www.livestrong.com/article/14372–causes–of–astigmatism/

Research Paper On Myasthenia Gravis
Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder that is characterized by fatigue and exhaustion of muscle. The skeletal muscles is
having different degrees of weakness and this occurs when nerve cells and muscle are not be able to communicate efficiently and becomes impaired.
This impairment put a stop to the muscle contraction from occurring which can lead to muscle weakness. Myasthenia Gravis originally comes from the
Latin and Greek words that means "grave muscle weakness''. According to Osserman (as cited in Turner, 2007) MG is divided into four groups based
on the severity of the disease – ocular myasthenia, generalised myasthenia of mild or moderate severity, severe generalised myasthenia, and
myasthenic crisis with respiratory failure. The history of MG dated ... Show more content on Helpwriting.net ...
This essay is divided into two sections; the first section will explore the epidemiology of MG, the signs and symptoms of MG, and its impact to the
society; while the second section will examine the structures involved in MG along with the changes that materialized on the normal structures which
lead into the occurrence of the disease.
This paragraph looks into the epidemiology of Myasthenia Gravis in Malaysia and other parts of the world. Epidemiology is a branch of medicine
that investigates factors contributing to increased health or the occurrence of a disease in a particular population (Beaglehole, Bonita, & KjellstrГ¶m,
1993; Tucker, Phillips, Murphy, & Raczynski, 2004, as cited in Brannon & Feist, 2010). According to Breiner et. al. (2016), accurate identification of
patients with MG and careful

Essay On Third Nerve Palsy
Acquired third nerve palsy evaluation depends on the Signs and symptoms which is depend on the location of lesion in nerve track and according to
location of the lesion can cause complete or partial paralysis . Also the evaluation depend on patient's age because the third nerve palsy is most
frequent in peoples older than 60 years and in those with prominent or long–standing risk factors, such as Systemic diseases that may be cause lesion in
nerve track or even in midbrain such as diabetes mellitus, hypertension and vasculitis or trauma or other diseases such as infections and tumors.
Unfortunately no direct medical treatment that changes the course of the disease but the management and treatment depend on the underlying cause of
the third nerve palsy. Emergency treatment is necessary if a life–threatening by disorder. If the patient is conscious and have ophthalmoplegia, ptosis
and dilated pupil that is may be indicate into an intracraneal aneurysm. In the other hand if a patient have complete the third nerve palsy and pupil not
affected ... Show more content on Helpwriting.net ...
in such cases the cause may be a ruptured aneurysm which may be lead to bleeding , then this may cause a coma for person . in such cases the both
pupil will be dilated and they are not responding to fixation light so this may be indicates deep coma or possibly brain death .
So if the underlying cause of third nerve palsy is aneurysm the intervention is primarily aim to avoiding subarachnoid hemorrhage by neurosurgical
clipping or endovascular embolization .and the third nerve recover its function according to the degree and or duration of deficit before operation
But if the ischemic process is cause third nerve palsy usually improve within three to six months .Vascular risk factors should be treated by antiplatelet

Causes Of Grave Muscle Weaknesses
Grave muscle weakness– latin expression= happens when the autoimmune disease affects the skeletal muscle. It affects extraocular muscles( control
eyelids) ( control movement) causing an individual to have double vision, or diplopia, or ptosis or ,drooping eyelids.
Normal muscle contaction @ the cellular level.–
Results from the loss of ACh receptors at the motor end plate. Primary cause is a misguided attack on ACh receptors by theimmune system . genetic
factors play a role in predisposing individuals to develeop this condition. ( 197 book) 1st motor neurons that release the neurotransmitter acetylcholine
at the neuromuscular juntion, which then binds to nicotinic acetylcholine receptors on the muscle cell membranes. Binding of accetylcholine to its to
its receptor activates a chain raction in the muscle cell that then produces a muscle contraction. In the body of those with myasthenia gravis
(categorized as a type II hypersensitivity disorder) which causes cytotoxic injury meaning that it results in the lysis, or death of host cells, which is
mediated by autoantibodies, antibodies that are ment for our own cells or proteins. 1.44 patients b cells ( DJFJDS) inappropriately make antibodies that
bind to nicotinic acetylcholine receptors on the muscle cells. When the ... Show more content on Helpwriting.net ...
Anti acetylcholine receptor anitbodies can also activate the classical pathway of the complement. ( complemetn systemis family of small

How Ptosis Affects Patients
There are a variety of cosmetic conditions that can impact your appearance as you age. Unfortunately, ptosis is a condition that can have a major
impact on your appearance and ability to see. For those who suspect they may be developing this condition, answering a couple of questions may
make it easier for them to understand this condition and what to expect of treatment. How Does Ptosis Affect Patients? Ptosis is a condition that will
cause a patient's eyelids to start drooping. Unfortunately, this can be a progressive condition, and it may be possible for the eyelid to worsen as time
passes. This condition can be caused by a number of issues, but it is particularly common in elderly patients. This can be explained by the fact that the
skin around the eyelid will lose much of its elasticity as you age, which can contribute to drooping. In addition to age–related ptosis, it is also possible
for nerve damage to contribute to this embarrassing condition because it may cause the muscle to be either partially or completely paralyzed. Sadly,
ptosis is more than just a cosmetically embarrassing problem because it can also drastically reduce your ability to see, which can make it impossible
to enjoy some of your... Show more content on Helpwriting.net ...
While it is an unavoidable fact that you will require some time to heal following this procedure, the worst of the symptoms will only last for the
first couple of days after the surgery. During this time, you may find that your eyes are almost completely swollen shut. This will be followed by a
general soreness and bruises that may last for up to a week, and your doctor may recommend using ice packs to reduce the swelling as well
prescribing pain medications to reduce your physical discomfort. You will also need to make several follow–up visits to ensure that your eyelid is
healing

Essay A Closer Look at Breast Liposuction
Liposuction: Chest (women)
There might not be anyone who never wanted to have a well structured body. A good sized and shaped breast will add attractiveness to a women's
body. There are lot of women who want to resize their large breast which gives the awkward look and appearance. As liposuction has become one of
the most common procedures nowadays, it is also considered to be the solution for people who suffer from larger breasts. It is also said that,
liposuction is one of the best methods for breast reduction. There are a lot of cases that had proven the success of liposuction procedure in breast
reduction. Who can be the best candidate for breast liposuction? A good candidate is definitely the one who is... Show more content on Helpwriting.net
...
As per the standard protocol, the breasts will be prepped and draped by the surgeon. After that, an incision will be made on the concerned area and
cannula will be inserted through. The cannula will vacuum the fat layer that lies deep beneath the skin. The excess fat will be loosened by using the
cannula. After that, the fat will be eliminated by the vacuum suction. The techniques may vary according to the choice of the surgeon and requirements
of the patient. There are numerous ways through which liposuction can be conducted. But, every one does the same procedures of extracting the excess
fat.
Post–operative care There can be certain negligible issues after the surgery. It can be eased off with proper care and follow–up treatments. You may
even experience swelling and such issues. This will be reduced within a few days. If you have any unusual symptoms like heavy bleeding or a sudden
pain, it should be reported to the doctor immediately and get cured.
The result It will take time to heal the incisions and gradually will get back to normal. You will be able to walk and resume your routine activities a
few weeks. But, you should avoid strenuous activities during this period. Stitches are removed and will be dissolved within the first week or ten days.
It will take a few months to get back to the normal life when you will be able to do strenuous activities without any

Breast Ptosis Essay
Breast ptosis is the medical term for drooping/sagging breasts. Breasts begin to droop for a variety of reasons, including aging, gravity, genetics,
pregnancy, vigorous exercising and weight loss. Today, advancements in the field of plastic surgery have made addressing this issue possible. Dr.
Farbod Esmailian is a double board–certified plastic surgeon in Los Alamitos who frequently performs mastopexy procedures (breast lift surgery) to
address sagging breasts. Dr. Esmailian's skill, experience and expertise allow him to provide women in Orange County with more youthful–looking
breasts.
THE BENEFITS OF A BREAST LIFT PROCEDURE WITH DR. ESMAILIAN
Dr. Esmailian can address a variety of issues to eliminate sagging and improve breast projection. ... Show more content on Helpwriting.net ...
An incision is made around the edge of the areola, down to the breast crease and then along the breast crease itself (horizontally). Dr. Esmailian
removes the excess skin and uses internal sutures to lift, shape and support the remaining breast tissue. This technique is used when a woman has
severely drooping breasts. In addition, this 'anchor' incision technique is the preferred method when Dr. Esmailian is performing a breast reduction and
breast lift, simultaneously.
Crescent Lift – To perform a crescent lift, Dr. Esmailian creates an incision that runs along the outer edge of the upper portion of the areola. Typically,
this incision is used when a woman has minimal sagging. Moreover, this is the incision technique utilized when a woman is having a breast
augmentation with a lift.
Periareolar Lift – A donut–shaped incision is created along the edge of the areola. The skin that remains is pulled inward and then reattached to the
areola/nipple. This approach is ideal for women who have mild/moderate sagging.
All the sutures that Dr. Esmailian uses are absorbable: Therefore, you will not need to have them

Opioids Research Paper
As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care
for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated
stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid
consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on
the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the
pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.... Show more
content on Helpwriting.net ...
As better and more comprehensive education is provided both to the general public and practicing clinicians the hope is to reduce the negativity
surrounding the users of opioids, and to eliminate demeaning language coupled to them as well. This could improve patient morale and help the
needless continuation of physical suffering within patients, as they would be more comfortable approaching and using opioids for therapeutic
purposes1. That being said there are those within our communities who do abuse these substances and pharmacists must recognize the signs of abusers,
it is important for them to reach out, without comment, to help those suffering from opioid abuse once they have been

Madame Dubois Alternate Ending
Last night had been the closest thing to a party a Church could throw without somehow going against the bible. Conservative, full–of–shit pastors and
horribly sweetened punch had kept Coley up to at least – ooooh! – midnight; when she got home there was schoolwork to finish and chores to do, until
she was left with only three hours to sleep. As a result, she was slouched in her chair in AP French, having to jolt open drooping eyelids every five
seconds. The air was stifling, and heavy, gesturing the end of a very long spring. A light breeze meandered in through the ajar windows, wafting across
open notebooks yet doing nothing to clear the smothering atmosphere. It seemed all life had been forced off the streets by the suffocating heat, leaving
... Show more content on Helpwriting.net ...
As the petite woman moved out of the way, Coley got a clear view of the valiant offender; a girl, cheeky smirk aimed at the fuming Frenchwoman,
bright brown eyes the very picture of innocence. She diverted her gaze to grin at Coley with unbelievably white teeth (stark against her beautifully
tanned skin); a motion lasting only a fraction of a second, but it was enough to make Coley's heart stutter with some kind of incredible force in a
way it never had before. All it took for Coley to fall in love with Sonya was a smile. Coley had felt something twinge inside her at that moment; Of
course, she was too young, too inexperienced to know what it meant– the very notion of love was something still frivolous and unattainable – but right
then, when her eyes met Sonya's for the first time, she felt something take root inside her; a tiny plant finally pushing its way out of the ground, a
minute mark of green on a barren brown landscape. It took her a moment to realise that she should be smiling back, seeing as the girl had saved her
from a particularly sticky situation. With a huge amount of effort, Coley managed to mouth a mangled thank–you to the extraordinarily gorgeous

Epstein Barr Case Studies
Summary: Maria Hernandez, a 29–year–old school teacher, presents to the doctor's office with fatigue, ptosis and generalized weakness. Ms. Hernandez
recently received a series of botox injections, and is currently taking atorvastatin for her hypercholesterolemia. On physical examination, a slight fever
(100.2), an erythematous pharynx, and ten–pound weight loss were noted; neurological examination revealed ptosis, facial weakness, decreased motor
function as well as bilateral trace reflexes in her patella and ankles. Additionally, chest radiography revealed a small nodule in her right lung, and her
lymphocyte and monocyte counts were elevated on her CBC. Question: Describe the pathophysiology of mononucleosis and the significance of the
mono–spot test.... Show more content on Helpwriting.net ...
Although the aforementioned symptoms are suggestive of IM, a subset of infected patients may be asymptomatic (e.g., subclinical IM) or their
symptoms may be attributable to other illnesses such as acute HIV, cytomegalovirus or Lambert–Eaton myasthenic syndrome.1 In order to differentiate
IM from other illnesses, diagnostic tests such as the mono–spot assay or EBV–specific antibodies should be

Myotonic Dystrophy Case Study
In this article, myotonic dystrophy, the most common inherited type of muscular dystrophy found in adults, is discussed. This disease occurs one out
of every eight thousand people and is said to get increasingly worse as it is passed down from generation to generation. Myotonic dystrophy affects
people by making it to where they cannot relax their muscles after using them; for example, if someone with this disease were to grip something, they
would have a hard time releasing that object. This hinderance in turn causes the muscles to become weak and waste away. This article examines two
different case studies in which two individuals, from the same family, are found to have this muscular disease before symptoms of this actual disease
occur. In the first case study, a thirty–nine year old woman visited her eye clinic for her regular checkup. During the examination, the doctor ... Show
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As noted, though, symptoms do not have to be present in order for one to be diagnosed with myotonic dystrophy: the daughter, for example. When the
genetics of this disease, in these two individuals, were examined, the "expansion of CTG repeats in the DMPK gene" was found, and it was
discovered that they both had DM1. Because of this research, we now know that patients can be diagnosed with myotonic dystrophy without having
systemic symptoms; this disease can be found by physicians simply by a patient having "iridescent cataracts." Finally, to discuss possible treatment
options. Sadly, this disease has no treatment option that will completely rid it from the patient's body. There has been medical advances, however, to
help manage this diagnosis. The managing of this disease depends on where the patient stands symptomatically. These medical advances help allow the
patient to live a fuller and longer life, by slowing the disease's progression on the patient's

The Base of Mitochondrial Diseases Essay
In a single cell there are large numbers of organelles known as mitochondria. These organelles are spherical with a double–membrane, the outer
mitochondrial membrane and the inner mitochondrial membrane (Chial). The majority of energy and power for the body's cells, more than 90% of
what is required to preserve life and encourage growth, originates from these organelles in the form of the molecule adenosine triphosphate (Kurt 11;
"What"). This energy production process is termed oxidative phosphorylation because it occurs in the presence of oxygen (Sirrs). If there is a fault in
this assembling of energy within the mitochondria, it is known as a mitochondrial disease. Usually the organs affected by these diseases are those that
require... Show more content on Helpwriting.net ...
Within each mitochondrion there are many replicas of the mitochondrial genome. There is a "heterogeneous population of mitochondrial DNA within
the same cell, and even within the same mitochondrion; as a result, mitochondria are considered to be heteroplasmic." When a cell divides, its
mitochondria are divided among the two daughter cells, but the mitochondria are distributed arbitrarily. Compared to nuclear chromosome division,
this mitochondria separation is far less methodized and much more haphazard causing the daughter cells to only receive copies of their mitochondrial
DNA that are closely related but not indistinguishable between one another. All of this is also affected by the fact that the mitochondrial genome has a
much higher "mutation rate" than that of the nuclear genome. There is a gene within the nuclear genome dubbed DNA polymerase gamma, and this
gene's function is to cipher the DNA polymerase that causes reproduction of the original mitochondrial genome. There is an exonuclease domain on the
polymerase gamma protein that is engaged in "the recognition and removal of DNA base–pair mismatches that occur during DNA replication." In an
article by Dr. Heidi Chial and Dr. Joanna Craig, they mention a study in which mitochondria were found to have a nucleotide imbalance that correlates
with diminished polymerase gamma reliability and the aforementioned increased

Symptoms And Treatment Of 0.08 / 100 000
Chordomas are considered rare neoplasms with an incidence of 0.08/100 000.(1) chordomas arise from remnant notochord cells found mainly within
the clivus and sacrococcygeal regions . But also, can be found at any site along the vertebral column (2). The presentation of clival chordomas tend to
be late, associated neurological impairment due to involvement of the lower cranial nerves (3). Clival chordomas are also challenging to treat due to
their site , anterior to the brainstem, and their aggressive locally invasive nature (4,5) and they are radioresistant lesions . clival chordomas have
relatively poor survival of 0.9 years without treatment (6). Extended open skull base approaches to the clival region are traditionally the mainstay for
achieving gross total resection in chordoma. Extended subfrontal transbasal, anterior transfacial, and lateral transtemporal or far–lateral approaches
have been described, as well as staged surgical approaches. (7–9) . These approaches to the anterior midline skull base often require extensive removal
of skull base bone and brain retraction, and they put critical neurovascular structures between the operating surgeon and the pathology. With the advent
and incorporation of the rigid endoscope into neurosurgical practice and the active collaboration between ENT surgeons and neurosurgeons, extended
endonasal endoscopic approaches have become well–accepted, minimally invasive routes to the midline and paramedian skull base. The endoscopic

Myasthenia Granis And Guillain-BarrГ© Syndrome Analysis
Myasthenia Granis is an autoimmune disorder affecting the myoneural function, it is characterized by varying degrees of weakness of the voluntary
muscles, often it affects more men than women. It occurs when antibodies at the ACH sites impair transmission of the impulses across the myoneural
function. Manifestations such as diplopia, ptosis and facial weaknesses are common (Hinkle &Cheever, 2014).
Guillain–BarrГ© syndrome is an autoimmune attack on the peripheral nerve myelin proteins that causes inflammatory demyelination(Hinkle &
Sheever 2014). Guillain–BarrГ© extremities and spreads up words to the arms and upper body which can progress very (Moore, &, Shepard,2014).
Myasthenia granis and Guillain–BarrГ© syndrome are both autoimmune ... Show more content on Helpwriting.net ...
Outcome:
*The patient will not experience any incident of choking by discharge.
*The patient will demonstrate effective swallowing without signs of aspiration duringet hospitalization. (Ludwig, & Ackley 2014)
Intentions to help myasthenia granis and Guillain–BarrГ© syndrome patients to reach the expected outcomes are aspiration should precautions must be
in place, the nurse should consult with the doctor and other Healthcare team members regarding alternative nutrition and hydration when oral nutrition
is not safe.
Nursing alternatives
1.) Remove or reduce environmental stimuli (e.g television) Rationale– with distractors removed, the patient can concentrate on the task at hand,
swallowing.
2.) The Nursery should collaborate with the director for the mechanical soft diet or patient's food preferences. Rationale– dietitians have a greater
understanding of the nutritional values of food and might be very helpful in guiding

Patient S Case Studies
Patient is alert and oriented to time, place, and person. Patient S is relaxed and responds appropriately to conversation. Pupils are equal, round, and
react to light. Eyes open spontaneously to name. Ptosis or face droop is not present. Patient S responds appropriately to conversation and reports
troubles hearing. Apical pulse was in the fifth intercostal space with no thrill. Rate was 89 beats per minutes, rhythm regular, S1 and S2 are crisp and
not diminished. No extra sounds or murmurs were auscultated. Breath sounds equal bilaterally and unlabored with no cough. Abdomen was flat,
symmetric with no masses. Bowel sounds present with no bruits. Skin has consistent color that is appropriate to ethnicity. Skin is warm and dry with

Cholesterol Granuloma Research Paper
A cholesterol granuloma is a rare condition that results from a foreign body response to the presence of crystallized cholesterol (1). It is more
commonly seen in males and usually occurs in middle aged men (4). The most typical locations are middle ear, petrous apex, and mastoid (2). Although
uncommon, orbital involvement usually occurs in the lateral portion of the superior orbital ridge (3). The most common presenting symptom reported
is proptosis (5). Ptosis and periorbital pain have also been reported. Restriction in ocular movements may be seen due to compression of the globe and
extrinsic ocular muscles. Although uncommon, reduced visual acuity has been reported in relation to induced astigmatism or choroid folds involving
the macula (5). Surgical excision has a high success rate with a low incidence of recurrence. We present a rare presentation of an orbital cholesterol
granuloma causing vision loss that was successfully removed by surgical excision.
Cholesterol granuloma is a rare diagnosis that has been reported in several locations.
The common sites of occurrence are the middle ear, mastoid antrum and petrous apex (2). Less frequent locations include the frontal bone, zygoma,
paranasal sinuses, breast, peritoneum, testes, and lung. The first orbital case was reported 1902 (11). When a cholesterol granuloma forms within the ...
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A noncalcifying lesion that is isodense with brain, round with a smooth outline, and located in the superiolateral bony orbit is typically seen on CT (5).
Postcontrast CT scans show no enhancement of cholesterol granulomas (6). On MRI, a cholesterol granuloma show bright signal intensity on both T1–
and T2–weighted images without significant enhancement with gadolinium contrast.(7). Signal of high intensity on both T1– and T2– weighted
images is seen because of the presence of hemoglobin breakdown product around the cholesterol crystals

Botox Poison To Secure
Botox: poison to secure?
Even though the form of the poison, botulinum toxin (botox) secure if easily injected in small proportion by the doctor. The injection is directed
directly to the target makes no effect on other muscles.
Botox, which is one of the commercial names of the botolinum toxin is actually the venom produced bacteria Clostridium botulinum. Food and Drug
Administration (FDA) America itself has approved botox as a temporary treatment for wrinkle removal on the skin of the face of an adult.
PHOTO 1
How Botox
Botox works by blocking nerve activity of the muscles as a result of the activity of the muscles will be down in a while and muscles become
paralyzed. Botox easily injected by the doctor specifically on the part of the skin of the body that needs to be dealt with as in the contraction of the skin.
... Show more content on Helpwriting.net ...
In addition, the eyelids down or ptosis is a very common complication occurred after the injection of botox. Fowl ptosis decline eyelids the top, where
this condition can occur on one or both of the eyes.
Before decided to receive an injection of Botox
To minimize the risk and side effects that may arise, the following are some things that should be attention after undergoing injecting botox:
п‚§ Inform you if you are in the trial period for pregnant women, are pregnant, or lactation.
п‚§ If you experience swelling or infection around the area that will be picked, immediately tell the doctors.
п‚§ Experience muscle disorders such as muscle weakness.
п‚§ Never having difficulty breathing or swallowing.
п‚§ Never experienced allergies or specific reaction against drugs.
п‚§ Consult the expert's pharmacy or the doctor first if you want to consume drugs outside the maintenance of botox, such as drugs diluent blood.
п‚§ Avoid driving or doing any activity that requires vision and good

Surgery : A Plastic Surgery Procedure
A Blepharoplasty is a plastic surgery procedure designed to address issues related to the eyelids. The type of eyelid surgery an individual undergoes
depends on the issues that need to be addressed. The three Blepharoplasty procedures that Dr. John Michael Thomassen performs at his surgical suite in
Fort Lauderdale, near Oakland Park, include: upper eyelid surgery, lower eyelid surgery as well as double eyelid surgery.
What issues can Blepharoplasty address?
Each eyelid surgery addresses problems related to the function and appearance of the eye.
The issues that can be addressed with eyelid surgery include:
Excess skin on the upper eyelids, which can interfere with an individual's peripheral vision Drooping upper eyelids ... Show more content on
Helpwriting.net ...
While a double Blepharoplasty does not intend to completely eradicate this renowned characteristic, it is designed to open the eyes by reducing the
slant and creating a crease in the upper eyelid: Thus, allowing the eyes to stand out.
Who should consider eyelid surgery in Oakland Park?
Individuals whose eyes make them look tired all the time, those who have sagging lower eyelids and/or are unable to completely open their eyes
should consider a Blepharoplasty procedure with Dr. Thomassen at his surgery suite in Fort Lauderdale, near Oakland Park. The removal of excess
tissue and fat from the upper eyelids, lower eyelids, or both can make an individual appear more alert, younger and improve his or her visual field.
Who is a good candidate for eyelid surgery with plastic and reconstructive surgeon Dr. John Michael Thomassen at his surgery suite near Oakland Park?
Individuals who:
are in good health; do not smoke (or are willing to stop smoking for at least several weeks before and after their eyelid surgery); and understand what
benefits can be achieved with a Blepharoplasty procedure.

An initial consultation with Dr. John Michael Thomassen for eyelid surgery near Oakland Park
During the initial consultation, patients should be prepared to discuss their medical history. This information should include current medications,
medical conditions and past surgical procedures/treatments. Dr. Thomassen will want to know what the patient

Rubinstein-Taybi Syndrome
There are over 5,000 genetic disorders passed down through the generations. These disorders are caused by abnormalities within the chromosomes of an
individual. Rubinstein–Taybi syndrome, or RSTS, is a rare genetic disorder that occurs in 1 child out of anywhere between 100,000 to 125,000
children. It was identified by Dr. Hooshang Taybi, a pediatric radiologist, and Dr. Jack Rubinstein, a pediatrics professor, in 1963.
RSTS is mainly caused by a deletion within the arm of chromosome 16. However, not all patients have a mutation on the chromosome. According to
the Genetic and Rare Diseases Information Center, the disorder can "be caused by a mutation in the CREBBP or EP300 gene... or other genes that have
not yet been identified" (GARD 1). CREBBP and EP300 are both codes for different binding ... Show more content on Helpwriting.net ...
Most children with the disorder have extreme developmental and intellectual delays. According to an article from the National Organization of Rare
Disorders, as children age, they "experience poor growth and exhibit short stature" (NORD 1). The organization also states that most children
experience developmental milestones, like crawling and expressive speech, later than normal. Children also experience behavioral issues, including the
inability to pay attention, sensitivity to varying sounds, and spontaneous moods. Congenital heart defects, abnormal lungs, spinal deformities, and
various malignancies are common among individuals diagnosed with RSTS. Many physical features are also affected. The American Association for
Pediatric Ophthalmology and Strabismus describes the ocular symptoms of RSTS as downward "slanting... eyes, widely spaced eyes, strabismus (eye
misalignment), ptosis (droopy eyelid),... frequent eye infections... [and] congenital glaucoma" (AAPOS 1). Diagnosed individuals may also have a
beak–like nose, small head, small mouth or jaw, overly broad fingers (mainly thumbs) and toes, or warped or duplicated foot

Myasthenia Gravis: It's Diagonosis and Treatment Essay
MYASTHENIA GRAVIS, IT 's DIAGONOSIS AND TREATMENT
Myasthenia gravis [MG] is a rare, autoimmune neuromuscular disorder. The incidence rates has been reported as 2–7/10000 in central and western
Virginia ( Thanvi ,2004).The onset of [MG] is depends on age and gender .In patients younger than 40 years, women are more susceptible than man to
[MG],with a ratio of 7:3 :Above the age 50 [MG] are slightly more common in men with a ratio 3:2.Myasthenia gravis are very rare in children.Juvinile
[MG] is an autoimmune disorder ,while congenital [MG] results from genetic mutations that impair neuromuscular transmission. It has been suggested
that incidence of [MG] falls after 70 years of age. A recent study using AChR antibody as a diagnostic... Show more content on Helpwriting.net ...
The functional loss of AChRs reduces the probability of successful neuromuscular transmission following adequate release of acetylcholine by the
motor nerve terminal (Gardener,1968).The relationship between myasthenia gravis and thymoma was noted more than 200 years ago,thymic
abnormalities are found in nearly 75% of patients with myasthenia gravis.Of these ,germinal hyperplasia is noted in 85% and thymic tumours in
15%.Antistriated muscle antibodies are present in 90% of patients with myasthenia gravis and athymoma (B Thanvi and lo ,2004).
The following figures 1 and 2 display what exactly happens at the postsynaptic membrane when affected by [MG].
Figure 1.The cleft space is small compared Figure 2.Note changed

Pancoast Tumor Case Studies
A Pancoast tumor is a carcinoma in the apex of the lung that involves the brachial plexus, subclavian, sympathetic chain, upper ribs, or vertebral body.1
Involvement of these structures causes pain or tingling in the arm, and possible paralysis. A Pancoast tumor is most commonly a non–small cell lung
carcinoma. 2 In the case where the tumor involves the sympathetic pathway leading to the eye, the patient can present with constriction of the pupil
(miosis), drooping of the eyelid (ptosis), and diminished sweating (anhydrosis).3 These symptoms will present on the ipsilateral side of the face as the
tumor. Interestingly, although Horner's syndrome suggests there is more invasion, there is no correlation to prognosis.4 In treatment of a Pancoast

Kearns Sayre Syndrome Case Studies
The patient was diagnosed with Kearns–Sayre syndrome due to the finding that confirm the diagnose which are the early onset of the disease, external
ophthalmoplasia with ptosis, heart block and furthermore the muscle biopsy was done to confirm the diagnose of this syndrome which showed a high
concentration of mitochondria with size abnormality.
For the management of this patient with KS syndrome supportive care for the symptoms, in which providing Coenzyme Q10 for improving heart and
muscle function since the patient has only a low grade of heart block.
For the ophthalmic manifestation that present in this patient the doctor suggesting a surgery for treating the ptosis ,but he highlight that the recurrence
of the ptosis

Cochlear Script
Script
Question 1: Hearing aids and cochlear implants have different functions to help improve your hearing. You currently have use hearing aids. Hearing
aids come in many forms and offer different features. Hearing aids makes the sounds and voices around you louder. Here is a picture of hearing aid
that you have. Depending on the hearing aid, the battery and ear piece will vary in size.
You mentioned that you have ptosis. A hearing aid may be difficult to operate because the buttons are small and the battery doors are small. One of the
benefits of a hearing aid is that you can take them out when every you want and do not need to have surgery.
To get a cochlear implant you will need to have surgery. The surgeon will cut an incision in your

Myasthenia Gravis Research Paper
Local Disease – Myasthenia Gravis Introduction Myasthenia Gravis is an autoimmune disorder in which antibodies destroy neuromuscular
connections which leads to problems with the nerves that control muscles. The disease is characterized by weakness and fatigability of skeletal
muscles. The muscles mainly affected are that of the eye, mouth, throat and limbs. The key concept underlying the disease is the decrease in the
number of available acetylcholine receptors at neuromuscular junctions due to an antibody mediated auto–immune attack. The disease was first
documented by the great physiologist Thomas Willis about 300 years ago (1). More importantly, extensive research and studying has led to greater
understanding of the disease during the ... Show more content on Helpwriting.net ...
Statistics have helped to conclude that Myasthenia gravis affects about 20 per 100,000 people worldwide. In Australia, a study published by Gattellari
M, Goumas C and Worthington JM revealed that in 2009, there were 2574 prevalent cases of symptomatic and treated Myasthenia Gravis,
corresponding to an annual crude prevalence rate of 117.1 per 1 million residents. An interesting fact revealed was that the disease tended to affect
younger females and older females than other gender–age based groups. The method used for this study was utilization of prescriptions for
Pyridostigmine Bromide from a national prescribing database to estimate incidence and the prevalence of symptomatic and treated disease. In reality,
prevalence and cases take a higher figure because many cases remain undiagnosed or unreported. Treatment/therapies
The treatment of myasthenia gravis compromise of methods that are employed to supress the immune system from being hypersensitive and
hyper–reactive. Also, invasive procedures like surgery is used to surgically remove the thymus.

Princess Atyah's Song By Michael E. Levy
It was the year 1929, and the oldest discovered piece of ancient sheet music was inscribed on a stone tablet unearthed in a Hurrian ruin near Lake Van,
Turkey. The lyre piece, translated from Hurrian as "Princess Atyah's Song" was then transcribed and interpreted by modern string aficionado Michael
E. Levy into a contemporary rendition at an Ancient History symposium in Chicago. It was perhaps an ill–fated decision, to take something filled with
some much sacred potential, and bring it into the modern realm without abandon. Levy performed the piece in front of an audience of a baker's dozen
archaeologists and music historians in a small rented venue nearby the symposium's main venue. The next night, everyone that had been in attendance...
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As the years went by, Atyah would grow more beautiful and her kin more haggard and aged. Atyah was so entranced by her own beauty and class that
she grew paranoid, believing that her sisters and cousins were hell–bent on taking her life. Rumors swirled that one of her relatives had already hired an
assassin to dispose of Atyah in the most heinous of ways. Fearful for her life, Atyah called upon one of her handmaidens to travel into the city and
find the most "powerful of sorcerers." A few days later, the handmaiden returned with an old blind beggar. Atyah is enraged by the find, until the
beggar demonstrates his abilities by creating fire out of thin air. Atyah tells the beggar that she needs him to cast a curse that will protect her from
any assassins. She is especially worried that she will be attacked in the privacy of her chambers, while sleeping. The beggar then writes a cursed
"phrase" on Atyah's eyelids, claiming that whoever sees these letters and reads them will instantly drop dead. She is to put the letters on her eyelids
before sleep and wash them off before she leaves her room to see others. Satisfied with the beggar's suggestion, Atyah orders two of her best and most
trustworthy handmaidens to be blinded. Every night, they are to draw the characters on her eyelids and wash them off by morning. For a long period
of time, Atyah was happy with this arrangement, but as

Xanthelasmen Research Paper
A state as Xanthelasmen (Xanthelasmen eyelid) known, a well defined yellowish fatty deposits under the skin, usually in or around the eye, has taken
to heart disease in combination. These yellow formations occur in the upper or lower eyelid in the vicinity of the inner corner of the eye. The results
of the study were published in the British Medical Journal. The relationship between heart disease and Xanthelasmen Both men and women can suffer
from this condition, especially after age 40. This yellow growth are the result of cholesterol deposits and show a high level of cholesterol in almost half
of patients with this condition. These growths are smooth and painless and do not affect vision. In fact, people with Xanthelasmen often seek

Diabetic Retinopathy
1. Briefly define the following parts of the eye and their role in vision:
A. Optic Nerve: each of the second pair of cranial nerves, transmitting impulses
to the brain from the retina at the back of the eye.
It is where energy is converted into electrical energy so it can travel to the brain and trigger
responses. The optic nerve is a continuation of rods and cones which make up the retina.
However, at its head, there is a blind spot because there are no photoreceptors in this part of
the optic nerve. This blind spot does not cause problems for people when seeing.
B. Macula: an oval yellowish(means that it absorbs blue and violet light which would
harm the retina thus acting as a protector/ sunblock for the retina.
)area ... Show more content on Helpwriting.net ...
However, even patients with controlled diabetes can develop diabetic retinopathy.
It is important for diabetic patients to be examined yearly because there are no
symptoms of diabetic retinopathy so early detection and treatment can help reduce the
risk of permanent vision loss. two forms of diabetic retinopathy:

Nonproliferative: this is where exisiting blood vessels in the retina completely deteriorate. These
deteriorated blood vessels can become blocked or develop into aneurysms. Then fats, fluids,
and proteins leak out of the abnormal blood vessels. The fluids then collect in the retina and
cause the macula to swell, this is called edema. Edema impairs the vision responsible for
seeing fine detail and reading.
Proliferative: This is where new blood vessels grow on the surface of the retina which cause
small hemorrhages and bleeding. This causes scar formation which allows the clear gel of the
vitreous to adhere to the retina. This puts pressure on the shape of the vitreous causing it to
change its shape and tear the retina causing retinal detachment. It can treated can be treated
three ways:
Photcoagulation: A focal is used to burn the areas of the retina where the abnormal

Cranial Nerves: A Case Study
Cranial Nerves: CN I: Able to correctly identify scents bilaterally. CN II: Vision 20/20 OS, 20/20 OD, full visual fields intact. Red reflex present
bilaterally. Optic disc is 1.5 mm, round, well–defined margins, creamy pink with paler cup. CN III, IV, and VI: Full extraocular movements intact. No
ptosis or nystagmus noted bilaterally. Pupils equally round, react to light and accommodation (PERRLA) CN V: Temporal and masseter muscles
contact bilaterally. Able to identify light, sharp, dull touch to forehead, cheek, and chin. Corneal reflex present. CN VII: Able to smile, frown, wrinkle
forehead, show teeth, puff out cheeks, purse lips, raise eyebrows, and close eyes against resistance. CN VIII: Able to hear whispers from 3 feet
bilaterally.

Brow Ptosis Research Paper
Brow ptosis (a sinking down of the brow) contributes to the sagging of the upper eyelid. This condition causes an individual's face to look tired, sad
and aged. Left untreated, the upper eyelid may begin encroaching upon an individual's upper visual fields; additionally, over time, horizontal
wrinkles may appear across the forehead. These wrinkles can contribute to headaches and ocular fatigue. The brow could fall to below the
supraorbital ridge (the base of the forehead). Brow Lift Procedures Vary Each patient is unique, which is why there is no single ideal brow
appearance for everyone. Dr. Thomas S. Guillot tailors each patient's brow lift procedure to meet his or her needs. Some of the things that Dr. Guillot
considers include: Gender... Show more content on Helpwriting.net ...
Guillot at the First Choice Surgery Center in Baton Rouge. Dr. Guillot will suggest general anesthesia or intravenous sedation. Types of Brow Lift
Procedures There are several approaches that Dr. Guillot can take to correct brow ptosis. These surgical approaches include: Direct brow elevation– is
used for patients who have thick eyebrows with localized small/moderate amounts of eyebrow ptosis. Scarring is evident when this method is used on
Individuals with light brows. This is a common method for elderly patients who have predominantly lateral brow ptosis with functional hooding
causing visual field deficits. Internal browpexy and browplasty – these procedures are most useful for individuals with mild cases of brow ptosis. Mid
forehead brow lift – is ideal for individuals who have significant brow ptosis with preexisting deep forehead furrows. This method is primarily
indicated for men who have very high frontal hairlines or widespread male pattern baldness, significant brow ptosis and deep forehead creases.
Endoscopic forehead lift. Coronal forehead lift – used for individuals who have some form of eyebrow ptosis with generalized forehead

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