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hence the name lockjaw Muscle spasms spread to the face

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Tetanus is a potentially fatal disease: it acts very quickly and often kills before the body’s natural primary response can take place. There are about 1million cases of tetanus a year with between 300,000-500,000deaths. It is a global problem because tetanus spores, which cause the infection, are everywhere. However, due to vaccination programmes, tetanus is rare in the UK with only about 10 cases a year; the main problems are encountered in developing countries where vaccines may be too expensive and equipment may not be properly sterilised. Tetanus is caused by gram positive, obligate anaerobic bacteria: Clostridium tetani which affects skeletal muscles."Gram positive" means that the bacteria has a thick cell wall, while "obligate anaerobe" means that the bacteria can’t survive in the presence of oxygen and survive using anaerobic respiration (without oxygen). The bacteria releases a neurotoxin called tetanospasmin which binds irreversibly to neurones; these are nerve cells that carry waves of electrical activity, known as nerve impulses. When the toxin binds to the neurone it prevents the inhibition of the motor reflex response to sensory stimuli. The motor reflex response is a rapid response to a stimulus, for example the knee jerk is a motor reflex response to tapping a specific nerve, and in this case it prevents us from falling over. However the toxin stops the nerve from suppressing the movement once the stimuli has gone so the movement continues as a muscle spasm which is characteristic of tetanus. Causes: Bacterium Clostridium tetani. Contamination of a puncture wound, e.g.: a piercing. Ear infections as bacteria may enter through ear. Using unsterile equipment in surgery or other similarly invasive procedures such as tattooing and body piercing. Tetanus is associated with rust which is a little misleading. You are not infected by the rust itself it’s just that rust is a rough surface which makes a very good habitat for the endospores of C.tetani. Therefore if you suffer a puncture wound from a rusty object such as a nail, endospores might be delivered into the wound and then you be.e infected. Endospores are non-metabolising structures that metabolise and cause infection once they are in an adequate environment. Since this bacterium is an obligate anaerobe it can’t live in the presence of oxygen, but a puncture wound is a good environment because it is a low oxygen environment. The disease is .mon in areas with hot, damp climates that have soil rich in organic matter, or places where soil is treated with manure. This is because the spores of C.tetani are widely distributed in the intestines of animals such as horses, rats, sheep, cattle, dogs and chickens, and therefore are present in manure. Spores can also be found on skin surfaces and in contaminated heroin. The incubation period for tetanus is usually between 3 and 21 days, so it may be a while before you are aware that you are infected, especially if the site of contamination was a small cut that you were hardly aware of, such as a thorn prick. The further from the central nervous system the contaminated wound is the longer the incubation period. However, the shorter the incubation period the higher the chance of death. Normally symptoms are present after 8 days and they last between 4-6weeks. Symptoms: Firstly muscle spasms occur near the wound Muscle spasm spread to the jaw making it difficult to swallow or open your mouth, hence the name lockjaw Muscle spasms spread to the face, neck, chest, stomach wall, arms and legs. Sensitivity to touch High fever Sore throat Rapid heart beat General tiredness and weakness Sweating Can’t pass urine Difficulty with breathing due to chest muscle spasms and lockjaw Headache Bleeding into the bowels Diarrhoea Direct causes of death include: Blood poisoning Suffocation Cardiac arrest (heart attack) Kidney failure Exhaustion. .plications: Development of pneumonia and other infections Fractures of long bones due to severe muscle contractions Spinal .pression fractures Breathing problems .a. People who are most at risk are: Over 60s as the vaccine was introduced in the 1960s so they may not be properly immunised People who aren’t immunised or have not had the full vaccination course (tetanus occurs almost exclusively in people who are unvaccinated or inadequately immunised.) Those who live in poverty where vaccines may not be available or medical treatment is not adequate and equipment isn’t properly sterilised. Intravenous drug users. There are four different types of tetanus: Local Tetanus. This is a persistent contraction of the muscles in the same areas as the infected wound. This form is generally mild, but also un.mon. Cephalic Tetanus. This is a rare form which involves cranial nerves especially in the facial area affecting expressions, breathing and swallowing. It can affect adults with head injuries or children with ear infections as the bacteria enter through the ear. Generalised Tetanus. This is the most .mon form accounting for about 80% of cases. The first sign is lockjaw (trismus) and facial spasms (risus sadonicus) followed by a stiff neck, difficulty in swallowing and rigidity in the pectoral and calf muscles. Spasms occur frequently and last several minutes shaping the body into a characteristic posture of an arched and rigid back called opisthotonos. The spasms last for 3-4 weeks and it can take months for a .plete recovery. Neonatal Tetanus. This is generalised tetanus that occurs in newborn babies. They are infected because they haven’t obtained passive immunity from their mother because she wasn’t immunised. It occurs through the infection of the unhealed umbilical stump, especially if it is cut by unsterilised equipment. Also in some countries it is traditional to put manure on the umbilical stump which can lead to infection. In developing countries this form is responsible for 14% of neonatal deaths but it is rare in developed countries. You can do blood tests for tetanus but it takes a number of weeks for the body’s antibodies to appear in the blood and since tetanus can act quite quickly waiting for blood test results takes too long; a diagnosis is often made on clinical basis. This can usually be diagnosed by the characteristic lockjaw and prolonged muscle contractions of skeletal muscle fibres. Also a spatula test can be done which involves touching the pharynx, which is at the back of the mouth, with a soft-tipped, sterile instrument and observing the results. If there is an involuntary contraction of the jaw, making the person bite down on the spatula then the test is positive and the person has tetanus. A negative result would be a normal gag reflex reaction as the person tries to repel the foreign object from their mouth. Treatment: If you suspect that you might be at risk to tetanus you should seek medical help immediately. The wound should be washed clean to remove any dirt and foreign particles from the wound. If it is a particularly dirty or severe wound then dead and infected tissue may be removed by surgery debridement (this involves cutting away the dead tissue). In mild cases: Antibiotics such as metronidazole can be prescribed to fight the anaerobic bacteria. It reduces the number of bacteria present but it has no effect on the toxin that the bacteria produce. If metronidazole isn’t available penicillin may be prescribed but it is not as effective. If you aren’t sure when you had your last tetanus vaccine or have not had a .plete course of immunisation then you may be given a booster shot, however this will not prevent potentially fatal cases of tetanus as it takes up to 2 weeks to develop tetanus antibodies to fight the bacteria. Diazepam, also known as valium, can be given as a muscle relaxant. Passive immunisation with anti-tetanospasmin immunoglobulin is vital. Immunoglobulins are antibodies and form part of the body’s immune response. In this case the immunoglobulin used is an antitoxin which means it blocks the toxins released by bacteria. The antibodies are taken from blood donors who have recently been vaccinated against tetanus and inserted into a vein or muscle (intravenously or intramuscular injections). These provide immediate protection, however they are only temporary because it is a form of artificial passive immunity and the body’s own immune cells haven’t produced the antibodies so memory cells aren’t made therefore if there is a second exposure then the body will still have to make its own antibodies which take time. Also the body regards the donated antibodies as foreign and they are removed from the circulation and destroyed in the liver and spleen. In severe cases: This must be treated in an intensive care unit in hospital. Injecting immunoglobulins is important as it increases clinical improvement from 4 to 35%. Maintaining an open airway is vital; in some cases a tracheostomy is performed which involves creating a hole in the neck through to the windpipe and inserting a tube in to allow you to keep breathing freely although your mouth or throat may be blocked higher up, you may be supported on mechanical ventilation for 3-4weeks. In very severe cases the patient may have to be paralysed and supported on mechanical ventilation. Magnesium can be given as intravenous injection as this prevents muscle spasms, diazepam may also be given as it is a muscle relaxant. Proper nutrition is required: 3500-4000 calories are needed every day with at least 150g of protein a day. The amount must be so high because of the increased metabolic strain caused by the increased muscle activity of spasms. It can often be given in liquid form through tubes directly into the stomach or through a drip into a vein. Prevention: The best prevention against tetanus is proper immunisation as tetanus occurs almost exclusively in people who are unvaccinated or inadequately immunised. In the UK the vaccination is included in children’s vaccination programmes and is part of the .bined diphtheria/tetanus/polio/haemophilus influenza b vaccine. For adults and teenagers it is included in the tetanus/diphtheria/polio vaccine. The vaccination course involves 5 doses of vaccinations: the primary course is given as 3 separate doses each a month apart, normally it is given to babies, starting when they are two months old, but it can be given to adults as well. In children the fourth dose is given three years after their primary course, in adults it is administered ten years after the primary course. Finally the fifth dose is given ten years after the fourth. The primary course provides protection for a number of years while the fourth and fifth doses maintain this protection and should last a life-time. Vaccinations inject a small amount of dead or harmless bacteria into the blood, which the body recognises as foreign. The body’s immune system then produces antibodies to destroy these foreign particles and at the same time memory cells are made so that if there is a second exposure (if you actually were infected by tetanus) your immune response would be much quicker and more effective. After the vaccine it is normal to feel slightly unwell with symptoms including mild headache, aching muscles and mild fever which last a few days. You should not have the vaccine if you already have an illness causing a fever or if your last tetanus vaccination caused a severe reaction although this is very rare. It is safe to have the vaccine if you are pregnant or breast feeding.

Asbestos Management Survey

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asbestos awareness training Ex-reading School Caretaker Died Before Court Case Posted By: sinuse A former Reading school caretaker who linked his illness to three jobs died of industrial disease before he was able to take his case to court. An inquest heard that David Hummerstone, a former caretaker at EP Collier Primary School, was taking High Court action against three employers that he said had exposed him to asbestos – yet another sad reminder of how imperative high quality asbestos air testing really is for today’s businesses. Mr Hummerstone died of industrial disease caused by asbestos. He had filed a statement with the High Court stating that he had worked in areas containing asbestos, with one of these being the primary school. Mr Hummerstone, who was 77 at the time of his death, had prepared legal statements for the High Court that were used during the inquest. Emma Jones, assistant coroner for Berkshire, read out documents in a writ against his ex-employers. The inquest heard that Mr Hummerstone had peritoneal cancer, for which asbestos exposure is a known cause. Mr Hummerstone said that he was exposed to asbestos at Columbus Dixon, which was based in a former cinema.

asbestos air testing Royal Shrewsbury Hospital ‘asbestos Exposure’ Investigated Posted By: sinuse Confirmation by the Health and Safety Executive (HSE) that it is investigating claims of asbestos putting workers at risk at Royal Shrewsbury Hospital is also confirmation of what every conscientious business owner knows: that one can ever be too diligent in safeguarding against their staff being exposed to this lethal substance. Prospective and current recipients of Asbestos Awareness Training like that provided by Trident Surveying will take an interest in this news, which concerns remodelling work that took place at the hospital in 2012. Les Small, then hospital project manager, told senior bosses that year of his belief that the construction process had involved damage to asbestos panels. He was dismissed from his job after this disclosure, an employment tribunal later finding in his favour. Mr Small said that during his time as a capital projects manager at the hospital, when work was underway to convert staff residential units into offices, he had suggested to his line managers that damaged materials surrounding some pipes was asbestos. He raised the issue again about a month later and asked why no action was being taken, at which point he was dismissed.

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health and safety training

pastel etc. in animal paintings good features play very important role. You need to buy painting those posses sharp features in order to get intense look from animals. Eyes of animal created by means of painting needs to be expressive. All emotions of animals can be perfectly portrayed by showing that emotions in eyes. Anger

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Photography Look out for animal paintings artist that can offer you with good quality of animal painting at manageable rates. Do you like following life of animals? Following life of animals here means knowing more about them and their behavior pattern. If you like animals then definitely you will like art work associated with animals. Animal paintings artist focus on creating painting that showcases real life of animals. Buying such meaningful paintings can embrace the look of your house. Animal paintings are quiet inspiring and at the same time can take you to the new world. Buying right animal painting can create lot of positive energy around your house. Art lovers like to collect paintings from different animal paintings artist in order to get different kind of art work for home dcor. You will find majority of artists creating animal painting on canvas. Always search for the artist that is highly skilled. Online galleries can make it possible for you to get in touch with artists that are highly skilled when it .es to animal paintings. Which pet do you like the most? Always search for the animal painting depending on your likes and dislikes. Definitely you would not like to have painting in your house of an ugly looking animal. Look out for the gallery that is associated with highly skilled artists who are capable of meeting your needs. Do you know nowadays how pet painting is done? Today artist have adopted several way to create such an innovative painting. To give realistic look to the painting you can find artists making use of charcoal, oil, pastel etc. in animal paintings good features play very important role. You need to buy painting those posses sharp features in order to get intense look from animals. Eyes of animal created by means of painting needs to be expressive. All emotions of animals can be perfectly portrayed by showing that emotions in eyes. Anger, fear, happy, sad etc are few things that you can showcase perfectly by means of creating amazing eye painting. Best part is that you can make use of such paintings for your home as well as for your office. It is suggested to go online to buy such an art work rather than visiting offline galleries and attending exhibitions. Don’t waste your time! Online galleries can offer you with lists of animal paintings artist that can create amazing art work for you. Get that list and inquire about the experience, knowledge and market reputation of the artist. This can make it easy for you to take buying decision. 。

there are a lot of options as to where you can take your business. Keep your eye out for those that are offering bonuses for taking your business to them

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UnCategorized It truly is a popular fact that gold is selling for very high prices right now. During a high market like this, there is no better time to sell gold that you have laying around the house. It can potential net you a fair amount of cash. The hardest dilemma you will find when it .es to selling your gold is actually finding a .pany with a good reputation. This is the part that puts most people off from this idea. After all, it’s easy to feel apprehensive about sending your valuable off in the mail. People might now be thinking that just taking your gold items to a local shop would be the best thing to do. However, since these places are in it for resale they won’t give you nearly as much money as your gold is really worth. By cutting out the middle man and selling straight to the refiners you are able to get more money and do it more securely for what you have to offer them. Going online to sell your gold is a good way to find yourself getting a large check in the mail. The refiners we referred to above offer the top prices for gold. They also buy silver and platinum as well. They base the amount paid out on how much your items are actually worth, this nets you a bigger profit. In advance of leaping right in and sending your gold to just any online .pany, you first need to locate one you can trust. Make sure the .pany you choose has a good reputation and has been around for a while. The longer a .pany has been in the gold buying business, the better the service usually is. The typical process that all .panies use is a pretty simple one. You call or go on their website and request one of their kits. When the kit arrives you drop your pieces in the shipping envelope and send it back. The postage is almost always covered for this part. Then the refiner looks at your items and decides what they are worth. From there they print out a check and mail it to you and you are all done. Also, now you can find a few .panies that pay out through PayPal instead of a check. Right now is the perfect time for selling your gold and it is now safer than ever to do so. With more and more .panies surfacing, there are a lot of options as to where you can take your business. Keep your eye out for those that are offering bonuses for taking your business to them, this can bring in even more money for the gold you no longer want. 。

Anjuna’s flea market. As always

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Sales Manglam Group is here again with exciting new luxury apartment schemes in its up.ing Aqua Grandiosa project in the beach state of Goa. Specifically located at Arpora in North Goa, Aqua Grandiosa is an initiative by Manglam to offer its customers with some world class facilities. It is based in the prime location .prising of Mackeys Saturday Market, Club Cabana, Baga beach, Ingos Saturday market, Anjuna’s flea market. As always, Manglam has left no stone unturned to ensure that every single matter is equally addressed. To keep maintenance costs down, Aqua Grandiosa is designed with durable and long lasting material, outside as well as inside the flats. This residential project is another successful effort of the .pany to blend art with technology. The flats are loaded with high tech features and artistic designs. Not anyone and everyone can spare enough to buy property in Goa and thats where Manglam can act as a bridge between your dreams of owning a property in Goa and the sky rocketing prices there. We at Manglam always make sure that location of the project is spot on so that the inhabitants dont have any problem in fulfilling their daily necessities. The present Aqua Grandiosa residential scheme is also in tune with our strategy and thus offers best in class facilities and services apart from use of regular high quality materials. Not every apartment in Goa can match the marvellous built quality and features of Aqua Grandiosa residential project. Some of the state of art inclusions of the Manglam scheme .prise of Modular switches for the smart look, Stilt Parking, R.C.C. framed structure for safety of your loved one’s, Stone cladded exteriors, Premium Vitrified flooring for minimum maintenance, UPVC windows, Lifts in each block, P.O.P with elegant paint finish, Toilets with exhaust fan & geyser, Marble flooring, Premium sanitary fittings and fixtures (Kohler/Grohe) and Four side open structure surrounded by garden. Moreover, there are plenty of other fantastic features embraced in the Manglams Aqua Grandiosa which include Swimming pool/ Kids pool, Landscaped garden, Well-equipped gymnasium, Kids activity area, Club house, Power backup for .mon areas, Indoor games like Table Tennis, Pool Table and CCTV secured campus. All wooden flooring in Master bedroom gives an elegant look to the bedroom area. On the other hand, the modular kitchen .es .pletely installed with modern appliances like Microwave, Refrigerator, Hot Plate, Chimney and Geyser. Even the .mon hall is not left untouched, and .es with pre-installed Sofa seating, Dining table, 42 LCD and Air Conditioner. The whole Aqua Grandiosa consists of three apartments divided in Block A, Block B and Block C, a grand Club house and five luxurious villas. The neighbouring area of the residential project offers scenic beauty and enthralling charm of Baga beach and other renowned beaches. Surrounded by the soothing palm trees, you get ample of space and privacy to express yourself. The restaurants in the vicinity of the flats offer delicious dishes with varieties that you havent heard of ranging from continental to Thai to Chinese to the best of Indian dishes. Whatever might be the case; your investment in Aqua Grandiosa will certainly reward you back. 。