Clinical explanation of Bronchiectasis

Permanent dilatation and distortion of the bronchi is called bronchiectasis. What is it’s effect to human health?

Etiology and Pathogenesis:

Most of the cases of bronchiectasis result from acquired causes.

• Obstruction to the bronchus due to any cause leads to distal collapse of the pulmonary segment. The pull on the bronchi by the collapsed alveoli leads to dilatation of the bronchi. In the initial stages this is reversible and the bronchi regain their normal size when the lung expands. If the obstruction persists, accumulation of mucus occurs distally, infection supervenes and the bronchial wall is destroyed permanently.

This results in permanent dilatation. The infective organisms are streptococci, pneumococci, Klebsiella, and anaerobes.

• Bronchiectasis may follow several viral infections without passing through the obstructive phase.

• Congenital defects in the bronchial wall lead to bronchiectasis. The classical example is Kartagener’s syndrome, which is characterized by dextrocardia, sinusitis, and defects of ciliary function in the bronchi and non-motile sperms.

• Middle lobe bronchiectasis is a sequel to pulmonary tuberculosis. This is caused by obstruction to the middle lobe bronchus by tuberculous glands. This is called “middle lobe syndrome” or “Block’s syndrome”.

Clinical features:

The clinical picture is very chronic, extending over several years.

The common site of lesion is the left lower lobe. Though children may be affected, usually symptoms manifest in early adulthood or middle age. Males are affected more than females. Digital clubbing is a prominent sign, sometimes being associated with hypertrophic pulmonary osteoarthropathy.

Postural cough with the production of large quantities of purulent and foul smelling sputum is the presenting complaint in most cases. On keeping for sometime, the sputum settles into 3 layers as described under lung abscess. Hemoptysis may occur frequently. This may be mild or severe. Recurrent infections such as pneumonia may develop. Repeated affection of the same lobe or segment should suggest the possibility of underlying bronchiectasis. Bronchiectasis sicca is the condition in which bronchiectasis presents with mild or severe hemoptysis without purulent sputum.

Physical examination may reveal impairment of the percussion note and diminution of respiratory sounds over the presence of coarse, persistent leathery rales. At times bronchiectasis may present with one of its complications. These include massive hemoptysis, recurrent pneumonia, emphysema, septicemia brain abscess, and cor pulmonale. Anemia develops in long standing cases due to chronic sepsis and recurrent hemoptysis. In untreated cases secondary amyloidosis may develop.

Diagnosis:

Bronchiectasis should be diagnosed by the long history, presence of clubbing, postural cough, coarse leathery rales over the affected part and reasonably normal general health. Once established, bronchiectasis is not curable by medical treatment.

Differential diagnosis

Bronchiectasis should be distinguished from chronic bronchitis and emphysema, lung abscess, tuberculosis, congenital cystic disease of the lung and malignancy. Lung abscess generally develops acutely. The right lower lobe is affected more often and the signs are localized. Tuberculosis is more common in the upper lobes and clubbing is not prominent in uncomplicated cases. Features like digital clubbing and copious sputum are seen in tuberculous bronchiectasis. Cystic disease is not uncommon. All age groups are affected. A long history or recurrent respiratory disease is present in the majority of cases. Clubbing is not prominent. The cysts may be localized or generalized. Clinical distinction from bronchiectasis is difficult. The presence of cysts in other organs like the kidneys, liver, etc, suggests the probability of congenital cystic disease of the lung. X-ray reveals the presence of soap bubble-like or ring shadows.

Diagnosis is confirmed by bronchography. This procedure is absolutely essential for determining the extent and type of bronchiectasis. Plain X-ray of the chest is not a reliable investigation to assess the site and extent of bronchiectasis.

Management

General measures include high protein diet, treatment of intercurrent infections, and removal of focal sepsis from the upper respiratory tract. Principles of specific therapy include postural drainage, administration of antibodies, respiratory exercises and in selected cases surgical excision. Postural drainage helps in clearing the bronchi and brings about relief. The patient should be instructed to practice postural drainage regularly. This gives relief of cough and also the foul smell. The fetid odor of the breath can be controlled by administering steam inhalations containing tincture benzoin or eucalyptus oil. The choice of antibiotic is determined by microbiological studies. Intermittent antibiotic therapy is required to clear infection and prevent exacerbation. The site of lesion may have to be excised if medical treatment fails.

Indications for surgery:

The following are the indications for surgery.

• The disease is localized to one lung or one segment and is not amenable to medical therapy.
• Socio-economic factors such as non-compliance by the patient
• Uncontrollable hemoptysis in which the site of origin of blood may be detected by emergency bronchoscopy and surgical resection has to be planned;
• To reduce the area of infection-even in bilateral disease sometimes surgical resection may have to be done on the more affected side, with a view to reducing the surface area of infection; and
• To remove an obstructive lesion which tends to perpetuate the condition, eg, bronchial growth or bronchostenosis?

I am Funom Theophilus Makama. I advertise through writing. As a platinum expert Author, I write lots of articles and hence promote interested websites, companies, groups, organizations, and communities through publishing and distributing my articles

Small Business Web Design – Enhance Online Presence

With an efficiently designed website, small business dealers can create a good impression and attract more people to their business. Small business web design services are now provided by leading companies in the field which aim at enhancing the online presence of their clients, thereby bringing more visitors to these websites.

Small business web design companies utilize the services of web developers and talented SEO professionals. Depending on the business owners’ needs, they carry out any sort of web design including data driven, custom, multimedia, flash, and E commerce. These providers can also redesign your existing website for a better look.

With creatively designed websites, proper communication with the website visitors can be attained. An ideal designer highlights the company products and information, appropriately blending graphics and advertising tools. Web designers take care of all aspects involved such as planning, designing, page layout and final finishing touches.

Besides having search engine optimized content, websites have to be effectively designed if you want to attract the right people to your business. To draw more customers, web designers normally utilize effective web design tools. Java, Flash, Video, Audio, CSS based and fast loadable websites are designed by the professionals. Incorporating innovative technology programs such as XML, MySQL, XHTML, PHP, and Javascript, they provide attractive website designs.

Professional website designing is available for all kinds of websites such as those dealing with real estate, finance, E-commerce, education, medicine, family, teens and more. Nowadays these services are available at economical rates to meet the needs of small businesses and home based businesses.

A perfectly designed website will be search engine friendly, meta tag optimized and properly linked with the other pages. So, if you wish to redesign your existing website or are planning to design a new one for your small business, ensure that you associate with a reliable and experienced web design service provider.

Is Leisure Associated With Travel Agency?

Travel agencies are the travel specialists which have revolutionized the world of traveling, add the flavor of leisure and comfort to it. They join hands with airlines, tour companies, hotels along with cruise lines so as to give door step services to the customers like hotel stays, transportation, tours, car rentals making traveling a more enjoyable, convenient and affordable event on passengers part.

All the facilities like food, destination management, insurance, trade fair, air travel tickets etc are arranged in different packages catering to the needs of different kinds of customers.
They also inform their customers regarding tourist attractions, weather conditions, restaurants and other necessary details. Good Travel agents access all types of information and knowledge about the places that can be traveled and are in demand giving a wider choice to customers to choose from.
They prove to be the best insiders who give worthy travel tips of every sort ranging from family travels to business travels, air travels to packing and these tips immensely help to visit the city or country with great pleasure and convenience. Pay less with a travel agent!

Jobs & Career Employment After You Have Graduated From University

University graduates are still sought after, which makes a degree in this difficult financial climate worth its weight in gold. Graduate positions have actually increased over the last year, during the recession, and this is leading companies promoting their HR policies of capturing the best minds straight from university.

Jobs in IT, accounting, mechanical engineering, bio sciences are particularly impressive for the graduate as firms in these sectors offer high salaries and many graduate services that announce jobs, like MilkRound will advertise all of these particular jobs. Some jobs are obviously with companies that could feel the pain of the credit crunch but with any gain of experience, you will become immediately more employable even if the worst does happen to you.

Obviously qualifications and skills will get you so far, but with many graduates applying for the same jobs, how can you set yourself apart and differently then the rest? Well the answer is in your character traits, and making them visible to the recruiter. An attitude of enthusiasm, self- motivation and determination will go a long way in any job interview, some companies who offer jobs at entry level, will make a decision based on this alone!

Obviously verbal and writing skills are a necessity and having problem solving skills and being a team player will also endear you to the employer. It is also important to apply for jobs that you are skilled to do. Obviously jobs with 40k salaries look great and you’d love to be on that one, but you need to stay realistic and gain experience in your first few years after university, so apply for jobs you are happy to do.

If you have a Masters degree of an even higher education award then larger businesses in certain sectors may head hunt you, this is certainly true in the past in the banking, insurance and retail management positions. If you have just a bachelors degree then there are many opportunities out there but it will take you longer to get there!

Comparing Online Travel Services To Your Local Travel Agent

Sites such as Expedia, Orbitz, and Travelocity claim to offer the best price – sometimes even guaranteed. They may even claim to offer the best rates on a luxury world cruise, a trip that travel wholesalers publicly prefer to be sold by agents. The emergence of online travel sites have put many agencies out of business, and claim to have conquered the consumer base by offering quality product at a lower cost. When you call your local travel agency and ask for a price quote on an air and hotel luxury travel vacation package, most consumers will check against one of the more popular travel websites to see what prices better. True, two thirds of the time, you will find that the Internet will beat the travel agent price by about $150. The travel website will assure you that it is the same package. The resorts and hotels are aware that you are going to be in the most unfavorable rooms, in fact, that is why they sold them to the Internet travel site at a discounted rate in the first place.

Travel service sites proudly proclaim that they are able to further save customers money by selling large volumes of travel and collecting a smaller fee. Orbitz and Travelocity do have a large volume of travel reservations made, but what little they make in commission they make back in changed or canceled reservations. Most travel agencies offer a travel insurance that covers you and your travel companions if you should have to cancel for a medical or personal emergency.

American Express Travel offers a cancel for any reason insurance that even covers your airline tickets. These Internet booking engines are now beginning to offer “insurance,” but it rarely covers cancellations in full. Your local travel agent is there to offer the customer care you need back at home while you’re traveling abroad. When it comes to planning luxury travel vacation, you are truly better off using a travel agent. If you don’t like your room, your travel agent can have it fixed in a matter of moments. Travel agents are not focused on quantity, but quality. So travel safe, not sorry, and call a travel agent to hear more benefits that each agency offers their clients

Finding the Best Corporate Travel Services

Corporate travel services should be chosen with great care. Engaging the right limousine company to provide corporate travel services is vital to the success of a business.
Important points to consider while making a decision are the ability of the company to adjust to the needs of the business engaging their service, the companies experience in the needed area, and the availability of the company to take care of even the minutest of details.

Creativity is essential for providing corporate travel services to clients that have unique needs or accommodation requests. If a business needs to engage someone to facilitate the performance of an animal show in Tibet, they will need an innovative team working for them to see that the event is successful. When setting up overseas conferences or events, a team of professionals assisting in the varied details that come with dealing with overseas governments and cultures is essential to its success. Sometimes the details can be tricky and require creative solutions where cross-cultural relations are concerned.

Hand-in-hand with the need for creative solutions is the benefit of corporate travel services that are familiar with the area where the event or meeting is taking place. Companies with knowledge and experience can help avoid annual festivals and local events that may make putting on the business’ event difficult. A good limo company can meet this need for complex logistics with enthusiasm and ingenuity.

This attention to detail can help insure a good return on the company’s investment in the event or meeting. Proper management of these details leads to profitable future working relationships between the travel service and the limousine company engaging them.

Working with Employment Agencies – Picking One which Fits into your budget!

Employment agencies are the most useful choice for anyone, who wish to change or find jobs .Nowadays the look for jobs are becoming very hard even when using the normal methods. Today some people are willing pay a particular sum on the agency, provided the agency finds them a good placement. The experienced businesses most often have collaborations with various companies in numerous industries .At often times these agencies would be the just one providing opportunities that cannot be found any place else. You will find agencies which are dedicated to any type of jobs they give. Therefore people from specialized fields like medical care and executive levels can approach these agencies.

“Staffing agency’ is the one other name for the employment agencies. These agencies offers temporary staffing methods of companies which might be in need of workers. Here, the employees do not need to pay the agency any amount of cash as it is the company which contacted the agency. These organizations may help companies find people for those stages of work, from the computer professionals to day’s laborers. The period of time of the agencies work may vary from your day to your months. It is rather present with get the Companies to employ a short while worker permanently, provided their skills be satisfactory

Know of the sort of individuals who the employment office can be ready to work with, before approaching one. There are several agencies which cope with the placements of top level executives, and so they generally expect experienced those that have managerial, leadership qualities. There’s also agencies which will not consume men and women without per year or two experience with regards to providing workers to the medical and computer industries. Folks who currently have work will find it challenging help the agency’s schedule .While temporary workers have zero choice and work the given schedule, understanding that you can find probability of them being hired.

Industrial or general employment agencies can provide jobs for individuals who want jobs for any short period of time period . In terms of employment agencies the restrictions are less as well as the opportunities are lots of. Whether you have completed your school or college , these agencies will find you jobs accordingly. From time to time you will find organizations who claim to be employment agencies and they cheat the innocent with hopes of providing them with good job opportunities. Become acquainted with your neighborhood agencies and don’t let yourself to use any organization that needs contact through 1-900 numbers. The legal employment offices have zero problem should the contract is fully being read before you sign them.

Activity Internet Marketing Report, Internet Marketing Information

INTERNET MARKETING INFORMATION

NETWORKING

SCAMS, FRAUDS

FAKE E CARDS

HOLIDAY RENTALS

DROP SHIP

One of the first things you should do is check the government regulations that effect Internet marketing. Two of the main regulation deals with e mails. You can only send out your offer to persons who have contacted you about your offer or (a one time only) persons who have contact you with their offer.

You are required to enclose in all your e mails, your e mail address, your business address and phone. If you will be using a autoresponder you are required to have a unsubscribe link, so persons who may have contacted to receive your offers, newsletter, etc. can click on and have their name removed from your list.

It is also very important to remember if you join a MLM as a affiliate the firm you are marketing for meet the regulations, as you too could be charged if they make outrages claims about their product, how much money can be made etc.

The FTC enters Internet, telemarketing, identity theft and other fraud-related complaints into Consumer Sentinel, a secure, online database available to hundreds of civil and criminal law enforcement agencies in the U.S.

and abroad.

Get your own website, avoid the free ones offered by MLM’s. Don’t be restricted to one firm’s product with a free website.

With a free web site you would have no chance of being listed on the search engines, as there would be hundreds of web sites with the same offers. All you are doing is working for free, paying for advertisements for someone else’s products. If there was some product you wanted to sell from a MLM firm, you can join as a reseller and place just the product you want to handle on your website.

NETWORKING

You didn’t learn it at school, or at the office.

Would you believe your mother?

Networking is more then shaking hands, and giving out business cards. Forget about the endless networking skills you may have learned at the office. We just have to put the few lessons mother taught us into practice. As a kid we were always in a hurry to find something better. Our mothers taught us patience.

If your in a hurry you miss the value that can be built taking time with building relations in networking. Establishing a relationship by taking time, gives you a solid framework in networking building.

Your mother worked hard as an example. This is one of the better examples in networking she gave you. That’s why it is called networking, not sit work. For networking to be successful you have to work hard and put out the effort.

Remember her telling you to share your things with others? Some of our best resources are time, money, and information we are willing to give to the relationship. They appreciate us when we are willing to give to the relationship.

She always made you clean up after yourself. In networking, follow-up is required. Whether it’s a promise to meet someone, or just a thank you is one of the most important lessons of networking. These life lessons we learned from mother during childhood are a solid basis’s for strong networking skills.
Thank you mother for all your help.

The biggest time spend in selling, more so in mail order or on the Internet is developing a relationship with your customer and building trust. If you did a good job in the first two, closing a sale will take the smallest of your time spend with your customer.

SCAMS, FRAUDS

Fake e cards.
You get a message with a link to an online greeting card but, when you click it, you end up with a virus on your PC. A couple of simple rules here. Delete any messages that come from someone you don’t know or that don’t address you by name. If they come from someone you know, email that person to check that they sent it before clicking on.

HOLIDAY RENTALS

2009 has seen a surge in ads offering bogus vacation rentals. You pay a deposit or even in full to get a key and that’s the last you hear of them. Scammers are experts at creating phoney look-alike sites where you land after mistyping an address or by clicking on a link supplied in the e mail or ad. Always type in the URL and don’t just click on the link.

DROP SHIPPERS
You can get products to sell via e bay or/and your website by using the services of a drop shipper. A reliable drop shipper will not ask you for a fee. They will allow you to copy pictures of the products they sell. Prices are about half you would pay for retail.

When writing articles to directories, we are not allowed to list URL’s for places to go for free information, such as drop shippers, ebay, and other places. If your interested you can go to our website and in our archives there is over 2 years of free Internet information listing with URL’s. My website is listed in the article source at the bottom of this article.

If you have a website they will allow you to move any listing on their site to yours. You set your price on the product/s you transfer. When an order comes in place the order they will ship it out for you under your shipping label and not include any of their material.

A good way to promote is join as an affiliate, transfer a couple specials onto your site, with a link back to your affiliate page. The cost of setting up a web site is minimum. Check out my website archive for drop ship firms. Transfer a couple specials onto your site, with a link back to your affiliate page. The cost of setting up a web site is minimum. Check out my website archive for drop ship firms.

Disclaimer:
The Author of this article is not responsible for accuracy or completeness nor shall he be held liable for any damage or loss arising out of or in any way related to the information or utilization of it.

Airport Apps: A Win-Win for the Travel Industry

Unpredictable weather, long security lines and extremely time sensitive logistical planning makes it easy to imagine that your last trip to the airport could have involved overstressed airport staff rescheduling a flight for a bunch of cranky travelers that cannot understand why they have to spend the night in Frankfurt and pay 10 euros for a 4-pack of batteries.

It’s not the same at every airport, but I have a feeling we’ve all been there at some point in our travel history. This being said, mobile apps provide airports with a huge opportunity to simplify the travel experience as well as provide travel services and tools to minimize stress.

Receive delay notifications on your mobile before leaving the house
Look for alternative flights when your flight is cancelled
Pre-purchase your ticket for the Heathrow Express on your tablet
Breeze through security with your digital boarding pass
Forward yourself your flight, hotel and car rental info an automatically create a travel itinerary
Snap a pic of your parking spot and tag on a map with GPS
Receive a discount coupon from Starbucks after checking-in at the airport via Facebook

What’s really exciting about this space is that all the features listed above already exist and would impact your travel experience in such a positive way.

But if you took a second to think about what’s to come with NFC, QR codes and ERP solutions – mobile could literally revolutionize what we know today as ‘just another trip to the airport.’

Airport apps: It’s win-win

While the ‘Time Killer App’ you played during your 2-hour delay in Amsterdam was a life-saver, the reality now-a-days is that we are always connected to our mobile devices. Airports can take advantage of this opportunity to positively impact their bottom line pre-during-and-post travel by:

Leveraging the unique power of mobile to increase revenue generation
Creating a richer channel for affiliate merchants to reach the consumer
Anticipating delay drivers, plan preventive actions and take recovery measures
Providing cutting edge customer service

http://www.amadeus.com/airlineIT/the-always-connected-traveller/docs/mobile_infographic.jpg

This means push notifications for final boarding calls, rich promotional splash pages for seasonal offers, coupon system for airport shops, integrating booking engines for flights, hotels and transportation as well as providing city guides, airport maps and weather information for all arrival and departure cities.

How to get it right

This is a business critical app that would differentiate any airport from its peers if it effectively aligned business priorities with the evolving needs of their customers.

Accurate real-time data mixed with valuable content
Entice travelers to purchase and pre-reserve products or services
Ensure travelers get the most out of their airport visit

From there – the sky is the limit.

Alcohol Addiction Facts ? Rehab

If you are suffering from an alcohol addiction, you are not alone. Alcoholism is a word that sometimes has negative social connotations, and just because a person drinks alcohol does not mean that they are an alcoholic. The amount of alcohol consumed varies greatly from person to person that develops alcoholism, and is also affected by genetic predisposition, and social and emotional health. Alcohol by definition is a disease that results from a persistent use of alcohol despite negative personal, emotional, financial, and professional consequences. Heavy alcohol use accompanied by dependence and symptoms of withdrawal, and the inability to recognize that every bad thing has been related to an alcohol addiction.

The sometimes uncontrollable urge to drink leads to constant preoccupation with the drug. Also leads to arrests for drunk driving and extra expenses for a good dui lawyer

According to numerous online sources, the most common substance of abuse resulting in dependence in patients presenting for treatment is alcohol. Overcoming an addiction to anything can be difficult, but there is help and hope available to people who want to stop drinking and get their lives back on track. The mind is more powerful than any drug, and to discover this is to truly be on the road to recovery. Addicts have to make a conscious choice to get and stay sober, one day at a time, and learn how to control the cravings. It’s not something that can be done alone, which is why there are treatment facilities all over the country, most of which are privately owned substance abuse recovery centers. The philosophy of AA or Alcoholics Anonymous has proven to be helpful to many alcoholics in their fight against alcohol addiction, and the program is often used as an adjunct treatment with other therapies, such as in an inpatient setting. AA also encourages communication with a sponsor to help guide the addict through the recovery process, and provide support while working through the program.

Learn more about effects of alcohol as well as alcohol facts and the truth about alcohol addiction and drunk driving. Some online literature discusses at length what drives alcohol addiction, detailing the effects of alcohol and describes some of the research being done to correct drinking problems. Alcohol continues to be the most greatly abused substance despite the wide-spread negative consequences. Even after public outbursts, divorce, loss of employment, revocation of driving privileges, and loss of life and limb, alcoholics continue to drink because it is so highly addicted in people who are predisposed to this disease. If you or someone you know is giving part of their life to alcohol, encourage them to get help. It may take a series of bad events to get the point across, and for many alcoholics, this is what it takes to see their illness in a different light.