Diabetic Patients An Ignored Cause Of Abdominal Pain

Truncal neuralgia in diabetic patients: An ignored cause of abdominal pain Mohamed Lotfy, Hazem N. Ashri, Mostafa M. Khairy ABSTRACT Aims: We aim to study diabetic patients, with abdominal pain and neuralgia somewhere else in their bodies, and search for the relation between their abdominal pain and the lower intercostal neuralgia (T7–11 and subcostal). Methods: Between July 2016 and February 2017 this study was carried out in emergency department, Zagazig University Hospital. 23 patients were subjected to this study and divided into (group A = 15 patients had right upper abdominal pain) and (group B = 8 patients had right lower abdominal pain). This grouping was not created for comparative reasons, it was done because we were studying the†¦show more content†¦Truncal neuralgia should be put in the surgeon’s mind when managing any diabetic patient with abdominal pain of unrevealed aetiology by the usually used investigations. Keywords: Abdominal pain, Diabetic, Truncal neuralgia How to cite this article Lotfy M, Ashri HN, Khairy MM. Truncal neuralgia in diabetic patients: An ignored cause of abdominal pain. Edorium J Surg 2017;6():****. Article ID: ********* ********* doi:********** INTRODUCTION Intercostal neuralgia is defined as a neuropathic state affecting the intercostal nerves, presenting as strong pain. It may be shooting, sharp, or of burning quality. The pain is steady and May involve any of the intercostal nerves and the subcostal nerve [1, 2]. Intercostal Neuralgia is caused by a diversity of reasons such as diabetes mellitus, nerve entrapment, ORIGINAL ARTICLE PEER REVIEWED | PROVISIONAL PDF Edorium Journal of Surgery, Vol. 6; 2017. Edorium J Surg 2017;6():****. www.edoriumjournalofsurgery.com Lotfy et al. 2 iatrogenic neuroma, traumatic, persistent nerve irritation and herpes zoster [1]. Intercostal neuralgia is common in diabetes mellitus (DM) patients. It is one of the types of peripheral neuropathies linked to DM. It is present as a localized abdominal or chest pain, which may mimic a referred pain from the intra-abdominal or intrathoracic organs. When it is ignored as a cause of pain in such regions it may lead to do extensive and unneeded clinical investigations and surgical proceduresShow MoreRelatedSymptoms And Adverse Effects Of Adverse Drug Effects1486 Words   |  6 Pagesare common among patients receiving treatments in outpatient department due to lack of proper follow up of treatment. It causes decease compliance to the treatment leading to treatment failure. Aim: The present study was aimed to analyze the pattern, causality and severity of the adverse drug effects complained by the patients at internal medicine outpatient. Materials and Method: It was a cross-sectional study done at outpatient department during four months period. Patients presenting with signRead MoreEvaluation Of The Clinical Reasoning Cycle1721 Words   |  7 Pagesis also a crucial aspect of clinical reasoning. The clinical reasoning process includes collecting cues, processing the information, coming to an understanding of a patient, problem or situation, planning and implementing interventions, evaluating outcomes and reflecting on and learning from the process. Jessica is an epileptic patient, wanting to fall pregnant which is causing her to cease her medication which is prescribed in an attempt to control her seizures. This is care priority as it is dangerous

Trading Strategies For Tactical Portfolio Allocation

chapter*{Introduction} addcontentsline{toc}{chapter}{Introduction} Trading strategies are systematic rules to determine asset allocation. Behind their construction is the notion that contemporary information, whether asset specific or market wide, can predict expected returns. A large body of empirical evidence finds significant returns to these rule based portfolios, suggesting the predictive power of the trading signals from which they are constructed. The performance of trading strategies is an intriguing feature for both financial economists - who read the implied predictability as a challenge for models of market efficiency - and financial practitioners - who exploit strategy performance for tactical portfolio allocation. This thesis investigates various trading strategies in futures markets, aiming to assess their economic value, distinguish sources of associated risk premia and to understand the effect of their implementation on the wider futures market. Futures contracts originated in Chicago over 150 years ago as a vehicle for farmers, concerned with the price risk of their forward harvest, to transfer risk to speculators, looking to exploit price fluctuations for financial gain. From these humble beginnings futures markets have evolved into a burgeoning asset class, covering a wide variety of underlying goods from equities, bonds, commodities, and currencies. 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Ehrenreich skilfully Free Essays

Throughout the book, Ehrenreich skilfully writes about her day-to-day lifestyle and tries to give a detailed account of her life as a minimum wage worker. She is given a new name, instead of Barbara she is now â€Å"Barb,† an alias given by Wal-Mart due to the limited space available on the employee id. It is also a way for Wal-Mart to depersonalize its employees. We will write a custom essay sample on Ehrenreich skilfully or any similar topic only for you Order Now Since she is assigned to ladies wear, she must memorize the entire clothing layout which â€Å"[w]ithin each brand-name area, there are of course dozens of items, even dozens of each kind of item† (Ehrenreich 155). Her experience accurately corresponds with Max Weber’s Iron Cage theory. By constantly giving tedious and menial work, she becomes â€Å"a passionless, coldly calculating, and instrumentally rational actor† (Weber 128). Weber is describing the effects of modernity of the bureaucratic system on individuals. In order to increase the efficiency of a bureaucracy, an organized social stratification system is needed. This helps define the roles for workers by giving them specific positions. That way, both the employers and employees know what roles to play and follow the rules accordingly. Once their roles are established, personality is no longer an asset or liability for the workers. Instead, the emphasis is placed upon the person’s productiveness. I was initially thrilled to read the things Ehrenreich was writing about serving in Florida. I find it hard to fully engage the contempt-ridden position women described in this section are in.   As she progressed up north to Maine I was pleasantly awaiting something better, as the author was herself.   I too believed that the all white New England state would provide a better opportunity for this experiment.   The maid work she was applying for seemed slightly more pleasant and less degrading. As she proceeded on with her experiment, I again grew ominous thinking of the looming omen of a feces ridden toilet or pubic hair ridden Jacuzzi she would come in contact with. The degradation suffered by these consistently well below the poverty line women is enough to turn ones stomach.   And to have to keep a cheery disposition and never curse on the job created even more of a hostile mindset for myself. She described in this chapter a woman working with her with no front teeth.   How terrifying having a job where one relentlessly cleans someone else’s belongings and tries to maintain there comfort with a good smelling house, meanwhile this ladies mouth is filthy and foul smelling (I assume, because of the rotten teeth observation of Ehrenreich) with no prospect of health or dental care anywhere in the near future or even probably her whole life. The co-workers described in the book amazed me.   With the exception of a few nameless angry people, for the most part there was an unusual camaraderie of people of different ethnic backgrounds and age brackets.   It was uplifting that people in such a miserable position were not vengeful, even after she revealed herself as an undercover writer.   I think this drives the point home about human nature and how one cannot help but relate to someone who is willing to relate to them, especially in a helpless position. One of the most unusual relationships I formed with Ehrenreich over the course of the book was over her experiences with the laundry mat.   It has been roughly 6 years since I have owned a washer and drier.   I think she did an excellent job of explaining/conveying the undignified experience of patronizing these places. Another unusual thing she helped me uncover about myself was as her Wal-Mart experience was developing, she mentions the negative person she potentially could have become after a life spent at these dead-end, low compensating, menial positions.   My own personal experience reflects the same exact occurrence.   I notice a change in myself, almost as if I have some undesirable monkey on my back.   A desperate feeling even lingers after the day is over and I am home. Ehrenreich compares many of her low wage work experiences to times that occurred in her normal life. Like, during one of her orientations for a job she compares the long time to a seven hour air-line delay and say that the air-line delay is better because you can read a book or walk around (Ehrenreich 146). These comparisons help readers understand how different the life of a person living in poverty is form a person living in wealth. Sitting through an eight hour orientation for a job that could easily be learned in half the time is something that millions of Americans must do to get a job. Ehrenreich made it hard to â€Å"feel† for low wage workers at some parts in her book because there were times when she completely left her poverty life and spent a couple minutes in her life full of wealth and prosperity. While working in Minnesota, her motel room gets flooded and she is only worried about her laptop that she brought from her home (Ehrenreich 158). I do not think that too many low wage workers that claim to be living in poverty own a laptop, especially if they are currently living in a motel room. She also talks about what to eat for dinner at some point through her journey and says, â€Å"how about the polenta-crushed salmon filet with pesto sauce and a nice glass of J. Lohr Chardonnay?† (Ehrenreich 102). This shows that although she was trying very hard to have the constant mid-set of a middle class, working woman, she still dreamed of the life that she left to explore this so different lifestyle. Nevertheless, although Ehrenreich writes a gripping account on the challenges faced by her fellow employees. She fails to address the viewpoints of the employers thus giving somewhat of a biased view. In spite of this, it is readily visible throughout â€Å"Nickel and Dimed,† that there are mysterious forces at work. Ehrenreich, sheds some little light on the welfare reform issue, but grossly understates (if she mentions it at all) proverbial other side of the picture. Specifically, she does not give the psychology or history of this demographic so much as a second glimpse, before declaring from her ivory tower, that the whole of American society should feel some level of social guilt, indeed collective shame, for existing in a world where there are those less fortunate than the average individual. At the conclusion of my reading I felt anger and relief.   Anger because of the government and richest one percent of this country continually turn a blind eye to this enormous part of the population.   After all of the baffling numbers at the end of the book I was edgy, yet somehow didn’t feel completely defenseless. The mere fact that Ehrenreich began and finished her study was enough to prove that there is hope for improvements in this culture. I was relieved. However, I must say that after reading this book, I really do not have a critically different feelings about low wage workers. Works Cited Ehrenreich, Barbara. Nickel and Dimed: On (Not) Getting By in America. Owl Books; 1st Owl ed., 2002. Weber, Max, H.H. Gerth, C. Wright Mills. From Max Weber : Essays in Sociology. Oxford University Press, USA, 1958. How to cite Ehrenreich skilfully, Essay examples

Knowledge Of Use Cases For Different Type †Myassignmenthelp.Com

Question: Discuss About The Knowledge Of Use Cases For Different Type? Answer: Introduction This report provides information about the Use case for a case study. This report aims toward providing the reader with the knowledge of use cases for different type of scenarios. The case study 1 of this report provides the information about the different type of case studies and various type of situations that arise with the case. Some examples have been provided in this report. In the case two of this report provides the description of the total cost of implementing two computers: a Server and a client computer. In addition to this, some information about thebusiness backup storage system has also been provided in this report. UML Use cases Upload Assignment: The students would be able to upload their assignment in the portal. After the assignment is uploaded the system provides various options for the students. They can either the download the uploaded document. They can also comment on the paper that is uploaded. The student would be uploading the assignment in the portal. They would also be able to edit the uploaded document and also they would be able to delete the it if they no longer require it. Delete Subject: Let us consider that the student has uploaded the wrong document and hence the would be require to delete the document that is uploaded online in the system. The student is require to make a lot of changes to the uploaded document, hence they can delete the document form the LMS and upload a fresh document online. Add comment After reading the paper published by some other student on the website the student would be allowed to provides comments on the paper. Let us assume that student likes the paper hence he would be providing a positive comment on the paper. After reading the paper published by some other student on the website the student would be allowed to provide comments on the paper. Assuming that student does not like the paper hence he would be providing a negative comment on the paper. Download Assignment The download option in the system, would help the student to download the required paper of their choice form the website. The download option would also the allow the student to download the paper that are published by the other people that are uploading in the portal. Register for a course The student would be resister online for the courses in the system. The students who are registered in the system would be able to then perform the other actions in the system. The registered student might forget their passwords, hence they would then have to the resent their passwords using the register block in the systems. Receive reports The students would be receiving various type of feedbacks would be receiving the reports Accounting to their document. The students would be appearing in various numbers of tests. Hence they would be able to obtain their reports from the system online. Participate in discussio The students can visits the different type of forums can have very intense discussions with their tutors or trainers.The students can also visit the various type of chat rooms that are present in the systems that would be providing the students of have important discussions on the portal. Course PlanningThe teacher or the trainers would be able to plan the course for the students. They can design an efficient course plan for the students.The trainers can also edit the course plans as they would be able to modify the course plan for the students and would be able to update the course planning for the students.Develop syllabu The trainers would be able to develop the syllabus for the students according to the requirements of the subjects and as well as the students. The trainers would also be updating the syllabus for the students according to the new requirements and the standards set by the different universities. Assign tests The trainers would be able to design tests for the students for checking out the mental ability of the trainees and also the knowledge on the prerequisite knowledge of the students. The trainers would able to assign different tests for the students of the university so that they can assess the learning outcomes for the students. Provide reports The trainers would be able to provide the report of the students for checking out the mental ability of the trainees and also the knowledge on the prerequisite knowledge of the students. The trainers would able to provide results of the tests for the students of the university so that the learning outcomes for the students can be documented in the reports. (Computer components and the Operating System) Cost of Server Machine: According to the minimum hardware requirements the costs of the machine are provided below. Intel Boxed Core i7-6900K Processor (20M Cache, up to 3.70 GHz) FC-LGA14A 3.2 8 BX80671I76900K: $1013 CORSAIR Vengeance LED 32GB (4 x 8GB) DDR4 DRAM 3000MHz (PC4-24000) C15 Memory Kit - White LED (CMU32GX4M4C3000C15): $290 (approx) Gigabyte GT 420 2GB 128-Bit DDR3 PCI Express 2.0 x 16 ATX Video Graphics Cards GV-N420-2GI REV3: $43 (approx) Blueendless 2.5" HDD 100GB Portable External Hard Drive USB Hard Disk Storage Devices Desktop Laptop (Black): $20 (approx) Hence, the total cost of implementation of the system: $1366 (approx) Cost of client Machine: According to the minimum hardware requirements the costs of the machine are provided below. Raspberry Pi Model B 512 MB RAM: $37 (approx) Intel Celeron G3900 Dual-core (2 Core) 2.80 GHz Processor - Socket H4 LGA-1151Retail Pack: $42 (approx) Blueendless 2.5" HDD 100GB Portable External Hard Drive USB Hard Disk Storage Devices Desktop Laptop (Black): $20 (approx) For the server computers the most efficient solution is the implementation of the cloud architecture. The cloud solution provides very efficient backup techniques for the storage of the data on the server. The servers night face the risk of losing data or even they might face the risk of the data getting damaged. Bu the cloud solutions prevent the data from the servers from getting lost. They also provide efficient backup facilities hence, even if the data is lost or is deleted from the servers they can be restored very easily. Conclusion For conclusion it can be said that the report provides the important details about the use case and the computers components for the reader to gain efficient knowledge on the systems. The case study 1 of this report provides the information about the different type of case studies and various type of situations that arise with the case. Some examples have been provided in this report. In the case two of this report provides the description of the total cost of implementing two computers: a Server and a client computer. In addition to this, some information about the backup storage system has also been provided in this report References Amazon.com: Online Shopping for Electronics, Apparel, Computers, Books, DVDs more. (2017).Amazon.com. Retrieved 27 August 2017, from https://www.amazon.com/ref=nav_logo Botelho, R. M., Franco, J. A., Christenson, R. E. (2015, August). System-Level Vibration Testing of Psychology Hardware Components Using Real-Time Hybrid Substructuring. InASME 2015 Noise Control and Acoustics Division Conference at InterNoise 2015(pp. V001T01A015-V001T01A015). American Society of Mechanical Engineers. Keren, O., Polian, I., Tehranipoor, M. M. (2016). Hardware Security (Dagstuhl Seminar 16202). InDagstuhl Reports(Vol. 6, No. 5). Schloss Dagstuhl-Leibniz-Zentrum fuer Informatik. Nogueira, S., Sampaio, A., Mota, A. (2014). Test generation from state based use case models.Formal Aspects of Computing,26(3), 441-490. Oleksowicz, S. A., Burnham, K. J., Southgate, A., McCoy, C., Waite, G., Hardwick, G., ... McMurran, R. (2013). Regenerative braking strategies, vehicle safety and stability control systems: critical use-case proposals.Vehicle System Dynamics,51(5), 684-699. Pezzini, P., Ferrari, M. L., Tucker, D., Traverso, A. (2014, June). Research and Educational Opportunities in Hardware-in-the-Loop Simulation of Advanced Power Systems: An International Perspective. InASME Turbo Expo 2014: Turbine Technical Conference and Exposition(pp. V006T08A006-V006T08A006). American Society of Mechanical Engineers. Raychev, N. (2015). Ensuring a spare quantum traffic.International Journal of Scientific and Engineering Research,6(6), 1355-1359. Szydlo, T., Nawrocki, P., Brzoza-Woch, R., Zielinski, K. (2014, September). Power aware MOM for telemetry-oriented applications using gprs-enabled embedded devices-levee monitoring use case. InComputer Science and Information Systems (FedCSIS), 2014 Federated Conference on(pp. 1059-1064). IEEE. Trefke, J., Rohjans, S., Uslar, M., Lehnhoff, S., Nordstrom, L., Saleem, A. (2013, October). Smart Grid Architecture Model use case management in a large European Smart Grid project. InInnovative Smart Grid Technologies Europe (ISGT EUROPE), 2013 4th IEEE/PES(pp. 1-5). IEEE. Zhang, Z., Barbary, K., Nothaft, F. A., Sparks, E., Zahn, O., Franklin, M. J., ... Perlmutter, S. (2015, October). Scientific computing meets big data technology: An astronomy use case. InBig Data (Big Data), 2015 IEEE International Conference on(pp. 918-927). IEE