Persuasive Essay Prompts and Samples - Learn How to Avoid Writing Them Yourself

Persuasive Essay Prompts and Samples - Learn How to Avoid Writing Them YourselfIn order to get the best from persuasive essay prompts and samples, you need to know that you can actually make an effort to create those samples yourself. This is particularly true for those who do not have the right resource to use. You have to take a step back and really try to figure out how the materials could be more efficient.When it comes to persuasive essay prompts and samples, you are going to find that these are much more effective if you are not just using the regular strategies that are commonly used. The reason for this is because of the factors that you might not think about such as how much time it would take you to go through each one of them.One of the things that you might not have thought about, and that is that you are going to need to have some sort of system in place to make sure that you write your essay prompts effectively. The fact of the matter is that you have probably forgotten about your prompts for your essay by now. If you are like most people, chances are that you would try to write your prompts on the spur of the moment.This might be okay for you but the problem with this is that you are not going to have a system that will work for you. Without a system that is going to help you write your prompts, you will be forced to resort to skip them at times, which is not going to help you write your essays effectively.By having a system in place, you are going to have a better chance of writing your prompts effectively. You will also find that it will help you keep your priorities straight. These will be the primary things that you need to remember so that you can work around the time and effort needed to complete each one of them.When you have a system in place, you will be able to do it in a timely manner. This will allow you to stay focused on writing your essays at all times.There are many other things that you will find when you start focusing on writin g your persuasive essay prompts and samples. You can learn more about them by starting your free trial today.

The Use of 3tesla in Clinical Settings

Introduction The Tesla, whose symbol is T, is an international standard of unit’s derived measure for magnetic flux intensity, commonly denoted as B. In the technical field of magnetic resonance imaging (MRI), Tesla (T) is the measurement unit of computing the power of a magnetic field. Before the usage of the 3 Tesla power systems, the strongest field used in medical imaging was 1.5 Tesla.Advertising We will write a custom essay sample on The Use of 3tesla in Clinical Settings specifically for you for only $16.05 $11/page Learn More The new 3 Tesla system generates twice the strength of the previously used 1.5 Tesla imaging system, and can offer 10 to 15 times the power of open MRI scanning systems. The new 3 Tesla system of imaging produces brilliant atomic elements and offers higher image clarity, which is exactingly productive for pathological situations, especially on internal organs, the musculoskeletal system and spine injuries. The modelâ €™s benefits are not only confined to magnetic resonance imaging, but also the high level spatial resolution of the system, which allows for high definition vascular imaging. The system is further, highly efficient, registering shorter scanning durations, and offering increased patient comfort without compromising the quality of the imaging results. The success of the higher field imaging technology has attained such high levels of usage preference, because it has capitalized on improved coil designs, registers higher RF penetration and offers lower signal-to-noise ratios. 1This paper is a discussion of the advantages of using higher magnetic fields in imaging, and the challenges of shifting to higher magnetic fields, drawing from the operational characteristics of nuclear spin.2 Discussion The advantages of using higher field imaging include the realization of a higher signal-to-noise quotient, as opposed to the earlier field models, which offered inferior spectral resolutions for different applications. This advantage is based on improving the model of the proton spin noise signal, placed in a highly tuned low-noise resonant, where there are varied magnetic field gradients, as the 3 Tesla model uses a high intensity magnet as well as a low one. As a result, there is a resultant modification of the projection-reconstruction protocol. In many imaging instances, these areas of benefit impact positively, on the temporal or spatial resolution imaging, as compared to those previously realized using the older lower field systems.Advertising Looking for essay on natural sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More The increased signal to noise ratio, further, leads to decreased acquisition durations and an increased space resolution. S.N.R. offers the opportunity for increased frequency between metabolite climaxes during spectroscopy, which serve as further improvements in the field of medical imaging.3 Highe r field imaging offers higher imaging quality, which is based on better contrast and noise resolution. The noise factor is normally, caused by the random movement of the electrons, ejected by the patient’s body and the detector coils. In the case of using higher field imaging, all other factors remaining constant, the intensity/ power of the signal resulting from a voxel is directly proportional to the voxel volume. In such a case, SNR is equal to the volume of the voxel, multiplied by the square root of the signal acquisition duration.4 Therefore, these developments are employed towards decreasing the Volex volume, towards the improvement of spatial resolution so as to reduce the SNR levels registered. The spatial resolution factor reflects the sharpness of the images collected from the imaging system.5 There is the advantage of chemical shift, which results from fractional shielding of the outer field, at the area of the nuclei – at the nuclei of the electron coverin g of the molecules. The shielding impact is related to the strength of the field, especially, that of the outer permanent magnet. For instance, one impact is that the chemical shift taking place between methylene and water signals is the dominating signals from methylene and fatty acids, which total to an approximate level of 440 Hz at the 3 Tesla field in question. 6As a result, there in an improvement in spectral fat repression and spectroscopy, which are vital in magnetic imaging.7 Based on this advantage, higher field magnetic resonance imaging allows for the effective imaging of aorta, heart, blood vessel and coronary arteries in an effective and speedy, non-invasive manner. 8 This has been made possible by the significant advances in gradient coil technology, a factor that creates better implementation of sequences, including â€Å"balanced steady state free precession.† This allows for faster imaging, increased spatial resolutions, speed and increase in imaging efficie ncies.Advertising We will write a custom essay sample on The Use of 3tesla in Clinical Settings specifically for you for only $16.05 $11/page Learn More Therefore, the model is effective in offering detailed imaging, which is useful in reflecting heart complications and coronary artery conditions. From using this higher field imaging models, medical specialists are able to determine the impacts of such conditions on the hearts and the organs surrounding the heart. This is particularly the case, when trying to determine the thickness and the size of the different chambers of the heart, as well as establish the level of damage that may have resulted from progressive heart complications or persistent heart attack cases. From this breakthrough, heart specialists are able to explain complications of the heart, distinguishing the conditions that need further corrective therapy through models like operation, recommending dietary changes, for instance, the call to reduce the intake of calories from fatty foods.9 Higher field imaging offers highly detailed images from soft-tissue areas, especially, those around and near bone areas. This elevated projection-reconstruction protocol, makes it possible to realize an entirely non-invasive imaging of these opaque organs, at extremely increased levels of clarity, without the usage of x-rays or radio-frequency radiation, which can cause adverse effects. Some of the areas that are effectively addressed by this higher field model include joint problems and spinal injuries. This advantage is of great significance, as it offers a model, from which comprehensive imaging of soft-tissues can be realized and administered, as opposed to the inability to offer such detailed imaging of these areas, which was not realized using lower field imaging. From this strength, medical imaging specialists are able to address complicated conditions, these including sports-related injuries, particularly those that affect areas not fully addressed by low field imaging.10 Higher field imaging has also risen to offer an effective replacement for the traditional model of x-ray mammography, which was used as a critical model for the detection of breast cancer at earlier development stages.Advertising Looking for essay on natural sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More However, the model offers highly yielding benefits, as compared to the traditional x-ray model, as it does not expose the patients to the risk of exposure to radiations, which are attributed to the development of certain types of cancers. The disadvantage of the earlier models of imaging, including x-rays are that, as a result of their high concentration of the energy stored, as well as the vast cross-section of their release, nuclear spin isomers present a threat, thus have attracted further interest towards research on administering models devoid of these defects. In this regard, the higher field imaging model has offered an effective, time saving model, which can help medical specialists in detecting the incidences of breast cancer, without placing the patients at the risk of the adverse effects of continuous exposure to radiations. The advantage of the model is that it is safe for the detection of sensitive areas, which may not be exposed to the radiations resulting from other d iagnostic models like x-rays. These sensitive areas include the female and male reproductive organs and systems in general, the bladder and the pelvis. Therefore, the new level of imaging has offered a highly effective, time-saving, risk-free model of diagnosing the problems of highly sensitive organs, which can be administered as frequently as possible, as it presents no risk to the recipients of the therapeutic services.11 The challenges of going to higher fields in medical imaging include that the model does not accommodate the diagnostics of people with cardiac pacemakers, as it may cause them fatal effects, due to the interference between the magnetic field of the imaging system and certain components of the pacemaker. The effects result from the likely magnetic field interference, including the effects of heating, reed-switch closure due to the high magnetic field, as well as the stimulation or impact of sensing ability, which results from the gradient fields used in higher fi eld imaging. As a result, the technology presents the challenge of not being able to address the medical diagnostic needs of these excluded groups. However, these groups may be covered by the therapy, after it has been taken through some innovative development or after the adoption of protective measures to protect such patients.12 Other groups that cannot be exposed to this diagnostics model include pregnant women, and the patients using brain and aneurism clips. The effectiveness of higher radiation imaging is affected by certain clothing, especially those that have metallic objects and patients who have used certain make-up compounds, which contain metal particles, as these can ruin or degrade the quality of the images collected.13 One major challenge with the usage of the higher field imaging technology is that the patients undergoing diagnosis, are required to lie down inside the cylinder-like room at the machine, which may be uncomfortable for many; relaxation kinetics develop ment.14 This ineffectiveness is mainly because; the new higher field models are created to offer imaging postures, where the object under imaging is as close as possible to the detection coils, as this increases the level of sensitivity, thus clearer images. These detection coils are responsible for absorbing and re-emitting the field radiation, thus must lie close to the object being imaged, though the proximity may be varied depending on the strength of the field and the magnetic properties of the functional isotopes.15 The niobium titanium superconductor materials used to engineer the higher field imaging systems are limited to certain levels of the magnetic fields, which can be produced by the systems, mainly because of the critical field variation of these semiconductor materials. This challenge draws from the response by the overall magnetization of the nuclear spins, as exploited under magnetic resonance imaging. As a result, the challenge of limited field abilities should be resolved by improving on the semiconductor technology, so that maximum benefit can be drawn from the model. However, this challenge is likely to affect the technology further, as attempts to increase the strength of the fields, will come with corresponding increment in cryogen consumption, weight of the machinery and concerns regarding perimeter fields for sitting. Weight in particular, can be an issue, despite the developments to install principal passive shielding. In the area of safety, major challenges come in the way of ferromagnetic projectiles, heightened electromagnetic effects and heightened torques on medical implants and devices. One major engineering challenge remains the shift towards producing high-strength, homogenous transmission of B1 magnetic fields, and still manages to maintain the regulatory guidelines to be met, with reference to tissue power outlook.16 Conclusion Tesla, whose symbol is T, is the SI unit for magnetic flux intensity. In the field of technical m agnetic resonance imaging, Tesla is the unit of measure for computing the power of a magnetic field. Before the shift to the usage of 3 Tesla power systems, 1.5 Tesla power systems were used. 3 Tesla systems offer twice the strength of the previous systems, and present up to 10-15 times the power of open MRI scanning systems. 3 Tesla imaging systems offer increased image clarity, which is highly effective for pathological situations of the spine, musculoskeletal systems and international organs. The system is also effective, in terms of diagnostics durations, improved patient comfort and high image clarity. The advantages of using higher field imaging include higher signal-to-noise ratio, and comprehensive imaging of soft tissues, especially those around bone areas like joints. The model offers a risk-free replacement of x-ray technology in detecting cancers like breast cancer, and the fact that it is radiation-free. The challenges of shifting to higher fields imaging include that i t cannot be used with patients using cardiac pacemakers and women who are pregnant. The shift to the new technology is also challenged by the interference caused by metals and metal particles, the comfort concerns among many users of the service, and the inability to balance the magnetic fields and the effect it imposes on the health of the patients. The model is also challenged by the semiconductor used, which is affected by its critical field variation. Bibliography Bernstein, Matt, Khan, King, and Xiaojing Zhou. Handbook of MRI Pulse Sequences. Massachusetts: Elsevier Academic Press, 2004. Edelstein, William, Paul, Bottomley, and Lincoln Pfeifer. â€Å"A signal to noise calibration procedure for NMR imaging systems.† Med Phys 11 (1984): 180–185. McRobbie, Donald et al. MRI From picture to Proton. Cambridge: Cambridge university press, 2006. Stafford, Jason. â€Å"High Field MRI: Technology, Applications, Safety, and Limitations.† Aapm, 2007. Web. Westbrook, C atherine, Carolyn Kaut. MRI in Practice. Oxford: Blackwell Science, 1998. Footnotes 1 Catherine Westbrook Carolyn Kaut, MRI in Practice (Oxford: Blackwell Science, 1998), 225. 2 Matt Bernstein, King Khan, and Zhou Xiaojing, Handbook of MRI Pulse Sequences (Massachusetts: Elsevier Academic Press, 2004), 14. 3Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university press, 2006), 28. 4 Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university press, 2006), 202. 5 Jason Stafford, â€Å"High Field MRI: Technology, Applications, Safety, and Limitations,† Aapm, 2007. 6 William Edelstein, Paul Bottomley, and Lincoln Pfeifer, â€Å"A signal to noise calibration procedure for NMR imaging systems,† Med Phys 11 (1984): 180–185. 7 Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university press, 2006), 207. 8 Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university pres s, 2006), 28. 9 Jason Stafford, â€Å"High Field MRI: Technology, Applications, Safety, and Limitations,† Aapm, 2007. 10 Matt Bernstein, King Khan, and Zhou Xiaojing, Handbook of MRI Pulse Sequences (Massachusetts: Elsevier Academic Press, 2004), 15. 11 Matt Bernstein, King Khan, and Zhou Xiaojing, Handbook of MRI Pulse Sequences (Massachusetts: Elsevier Academic Press, 2004), 14. 12 Catherine Westbrook Carolyn Kaut, MRI in Practice (Oxford: Blackwell Science, 1998), 225. 13 Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university press, 2006), 28. 14 Jason Stafford, â€Å"High Field MRI: Technology, Applications, Safety, and Limitations,† Aapm, 2007. 15 Jason Stafford, â€Å"High Field MRI: Technology, Applications, Safety, and Limitations,† Aapm, 2007. 16 Donald McRobbie et al., MRI From picture to Proton (Cambridge: Cambridge university press, 2006), 28. 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Socrates Versus Athenian Democracy essays

Socrates Versus Athenian Democracy essays Socrates and the Athenian democracy of the fifth century BC are very well known to us today. The first, a great Greek philosopher who profoundly affected Western philosophy. The second, a great idea and form of government of the ancient city-state of Athens. These two would come to a clash, resulting the condemnation and death of Socrates, after trial. Socrates' conflict with the Athenian democracy was theoretically reconcilable, but not practicable. His beliefs and the way he supports them, seem to be ideal. This though does not necessarily mean that they are applicable in the Athenian society of that time. This I will try to prove in the continuation. It is important to understand first the norms of conventional, good Athenian citizenship and what were exactly the beliefs and practices of Socrates. The most important aspect of Athenian democracy is the fact that "power is in the hands not of a minority but of the whole people"(Thucydides, II.37). Decisions are made after being discussed and voted. Each citizen's vote stands equal, regardless of occupation or economic status. This is (according to the Athenians) the fairest political system, which actually helps the city-state improve and develop. The majority of the citizens are satisfied, since decisions are made based on their votes, and those who don't agree could present their arguments and try to persuade others. It is the duty and responsibility of the Athenian citizen to be interested and to participate in public affairs since they are considered to be most important for the general good. Citizens have the freedom to express their opinions, elaborate on them, and to listen to what others have to say. This gives them the chance to contradict what they believe is not right and the opportunity to hear perhaps a better suggestion. It can be concluded, therefore, that they are able to improve themselves by developing their ideas, and hearing propositions, which perhaps they...

Mary Seacole Research Paper Example | Topics and Well Written Essays - 1250 words

Mary Seacole - Research Paper Example Because historians did not begin to study this great women until 1970s, a lot of the information regarding her life was lost with time. All the work done on Mary Seacole, whether in academic papers or in popular media can be dated to within the last 30-40 years. But, even at this late date, historians have dug enough to give us a pretty accurate picture of Mary Seacole's life from her birth to her death. Through the dedicated work of several writers over the past few decades, we know a lot more about Seacole today than we did even twenty-five years ago. Yet, there remain a number of gaps in our knowledge regarding Mary Seacole and as a result of the fact that her life and achievements were completely ignored after her death and hence lost in the mist of time, there is little hope of scholars and historians learning much more about this forgotten heroine. Of the hundreds of books and articles written on Seacole, this essay has shortlisted two books and an article to discuss Seacole's contribution to history. Robinson has done a thorough job of researching Seacole's life and the various influences on it. Her book is much more complete since Robinson takes the pains of putting together bits and pieces of information from various sources to come to conclusions that help us better understand Seacole. Ramdin too analyzes Seacole's life. However, he is almost entirely dependent on her autobiography and as result, Ramdin's book is more a retelling of the Seacole story and does not add much to the canonical information available about Seacole. Since very limited information is available about Seacole, mostly because of lack of interest in her life, it is normal to ask why Seacole's story was lost in time while Nightingale became the inspiration of nurses around the world. Seaton attempts to answer this question and look at the various attempts made in the last few decades to restore her memory. The historians working on Mary Seacole have a tough time finding and validat ing information related to this heroine of the Crimean War. Almost everything that we know today about her life is through her autobiography, "Wonderful Adventures of Mrs. Seacole". But historians like Robinson have been able to glean a wealth of information from other primary things "reported in transcripts...[of] a court case, recorded in her will, and printed in letters published in Punch and The Times." (Robinson 7). For example, Seacole does not mention her maiden name or her father's name anywhere in her autobiography. But based on her will, records of army personal posted in Jamaica around the time Seacole was born and "an entry Kingston Registers of Death of a spinster, Louisa Grant",(10) Robinson was able to deduce to that Seacole's father was named James Grant. Similarly, even though Seacole never mentions the year of her birth, and her birth was never registered, her death certificate helps Robinson place her birth around the year 1805. The first chapter of Robinson's boo k also discusses the presence and influence of several other people in her life including her mother, and a grandmotherly lady who is not identified by name. Robinson also takes pains to explain Seacole's social status in the little Jamaican island as well as in Britain, which she apparently visited as a teenagers. All these details are extremely important in an introductory chapter about a women who

Reflecting on the main issues affecting the international tourism Essay

Reflecting on the main issues affecting the international tourism sector and how these have challenged conventional forms of tou - Essay Example Section 5: How These Factors Are Being Addressed – This section discusses how governments are trying to tackle these issues. Section 6: Conclusion – This section gives a summary of the issues affecting international tourism. Section 7: References – This section states the sources that were used to come up with the findings of this paper. International Tourism Introduction International tourism is to a situation where individuals travel globally outside of their home country and region (Beaver, 2012). This refers to a short movement of individuals from their residential place to another region for diverse reasons such as recreation, business, health or other reasons (Beaver, 2012). Tourism is significant to the world due to the volume of income it brings to nations, and it enhances international relations the world over. International tourism offers tourists great services in the nations they decide to tour while they boost their economy. It aids in providing jobs to the local residents of the nations being toured not just in the tourism, as well as the service industry, but also in the manufacturing industry because many individuals return home with local keepsakes in hand. Tourists are more inclined to have disposable income, which they use in the nations they are touring (Lennon & Foley, 2000). ... Even with all the natural disasters, which have overwhelmed the world of late, as well as the tragedy of 9/11 and the 2005 London Bombing among others, individuals are still traveling the entire world to see tourist attractions and see what other nations have to offer. Other major issues affecting this field can be divided into economical factors, technological factors, political factors, demographic factors and cultural factors (Ineson, 2005). This paper will reflect on the main issues affecting the international tourism sector and how they have challenged conventional forms of tourism activity. The paper will also discuss to what extent responsible tourism presents an opportunity for addressing some of these issues. Economic Factors Intentional tourism can cost local governments, as well as local taxpayers, loads of money (UNEP, n.d). Developers might require the government to develop the roads, airport, railways and other infrastructure such as enhancing their water transport syst em, and perhaps grant tax breaks and other financial benefits, which are expensive events for the government. Public resources used on support tax breaks or infrastructure might decrease government investment in other vital areas such as health and education (Lennon & Foley, 2000). This, therefore, makes a country oppose international tourism. Raising the demand for basic goods and services from tourists will normally lead to price hikes, which disapprovingly affect locals whose proceeds do not rise proportionately (UNEP, n.d). International tourism and its associated rise in real estate demand have radically increased land values and building costs. Not

Esophagram Barium Swallow Analysis

Esophagram Barium Swallow Analysis Two common radiographic procedures of the upper GI system involving the administration of contrast media are the esophagram, or barium swallow, as it is sometimes referred to, and the upper GI series. Each of these procedures is described in detail, beginning with the esophagram. This examination is used for the patient who have high dysphagia or definite oesophageal symptoms, or have quite often had a normal OGD but are still symptomatic, quite often a motility disorder may be the cause. Esophagram or barium swallow, is the common radiographic procedure or examination of the pharynx and esophagus, utilizing radiopaque contrast medium may be used. The purpose of an esophagram is to study radiographically the form and function of the swallowing aspects of the pharynx and esophagus. No major contraindications exist for esophagrams except possible sensitivity to the contrast media used. the technologist should determine whether the patient has a history of sensitivity to barium sulfate or water soluble contrast media. Known aspiration during ingestion (although this can be overcome by using non-ionic water soluble contrast). The contrast agent for barium swallow is barium sulphate suspension 250% w/v or water soluble contrast medium. Barium sulphate are, high atomic number, not soluble in water, used to coat the lining of organs, supplied in different thicknesses. Used in esophogram, UGI, Small Bowel, Lower GI or BE. History of barium sulphate is starting with, lead substrate-toxic, bismuth subnitrate-toxic, thorium-radioactive, barium sulphte-inert(goes in and comes out the same not absorbed). Barium sulphate mixture are contraindicated if any chance exists that the mixture might escape into the peritoneal cavity. This escape may occur through a perforated viscus or during surgery that follos the radiographic procedure. in either of these two cases, water soluble, iodinated contrast media should be used. Two example of this type gastrografin and Gastroview. Both of these water soluble contrast agent can be easily removed by aspiration before or during surgery. if any of this water-soluble material escape into the peritoneal cavity, the body can readily absorb it. Barium sulfate, on the other hand, is not absorbed. One drawnback to the water soluble materials is their bitter taste. Although these iodinated contrast media sometimes are mixed w ith carbonated soft drinks to mask the taste, they often are used as is or diluted with water. The patient should be forewarned that the taste may be slightly bitter. The technologist should be aware that water soluble contrast agents travel through the GI tract faster than barium sulfate. The shorter transit time of water soluble contrast agents should be kept in mind if delayed images of the stomach of duodenum are ordered. If there is any query that the patient may aspirate, the initial swallow is best carried out using a water-soluble contrast medium, although aspiration of barium has been considered by some to be relatively harmless. Aspiration may not be suspected but unsuspected silent aspiration may be found. The more common pathologic indications for an esophagram procedure suchas, achalasia also term cardiospasm, is a motor disorder of the oesophagus in which peristalsis is reduced along the distal two thirds of the esophagus. Achalasia is evident at the esophagogastric s phincter because of its inability to relax during swallowing. The thoracic esophagus may also lose its normal peristaltic activity become dilated (megaesophagus). Video and rapid digital fluoroscopies are most helpful in diagnosis of achalasia. Anatomic anomalies may be congenital or caused by disease, such as cancer of the esophagus. Patients suffering from a stroke often develop impaired swallowing mechanisms. certain foods and contrast agents are administered during the examination to evaluate swallowing patterns. A speech pathologist may witness the study to better understand the speech swallowing patterns of the patients. Video and digital fluoroscopy are used during these studies. Barretts esophagus, or barrette syndrome, is the replacement of the normal squamos epithelium with columnar-lined epithelium ulcer tissue in the lower oesophagus. This replacement may produce a structure of the distal oesophagus. In advanced cases, the development of a peptic ulcer in the distal esop hagus may occurs. The esophagram may demonstrate subtle tissue change in the esophagus, but nuclear medicine is the modality of choice for this condition. the patient is injected with technetium 99m pertechnetate to demonstrate the shift in tissue types in the esophagus. Carcinoma of the oesophagus includes one of the most common malignancies of the oesophagus, adenocarcinoma. advanced symptoms include dysphagia (difficulty in swallowing) and localized pain during meals and bleeding. Other tumors of the oesophagus include carcinosarcoma, which often produces a large, irregular polyp, and pseudocarcinoma. Dysphagia is difficulty in swallowing. This difficulty may be due to a congenital or acquired condition, a trapped bolus of food, paralysis of the pharyngeal or esophageal muscle, or inflammation. Narrowing or an enlarged, flaccid appearance of the esophagus may be seen during the esophagram, depending on the cause of the dysphagia. Video and digital fluoroscopy are the modalities of choice. Esophagram and endoscopy are performed to detect these tumors. The esophagram may demonstrate atropic changes in the mucosa due to the invasion of the tumor as well as stricture. Because the esophagus is empty most of the time, patients need no preparation for an esophagram only, all clothing and anything metallic between the mouth and the waist should be removed, and the patient should wear a hospital gown. Before the fluoroscopic procedure a pertinent history should be taken and the examination carefully explained to the patient. The first part of an esophagrams involves fluoroscopy with a positive-contrast medium. The examination room should be clean, tidy and appropriately stocked before the patient is escorted to the room. The appropriate amount and type of contrast medium should be ready. esophagrams generally use both thin and thick barium. Additional items useful in the detection of a radiolucent foreign body are cotton balls soaked in thin barium, barium pills or gelatine capsules filled with BaSO4, marshmallows. After swallowing any one of these three substance, the patient is asked to swallow an additional thin barium mixture, because the esophagram begins with the table in the vertical position, the footboard should be in place and tested for security. lead aprons, compression paddle, and lead gloves should be provided for the radiologist, as well as aprons for all other personnel in the room. proper radiation methods must be observed at all times during fluoroscopy. With the room prepared and the patient ready, the patient and radiologist are introduced and the patientis history and the reason for the exam discussed. The fluoroscopic examination usually begins with the general survey of the patients chest, including heart, lungs and diaphragm, and the abdomen. During fluoroscopy, the technologists duties, in general, are to follow the radiologists instructions, assist the patient as needed, and expedite the procedure in any manner possible, because the examination is begun in the upright or erect position, a cup of thin barium is placed in the patients left hand close to the left shoulder. The patient then is instructed to follow the radiologists instructions concerning how much to drink and when. The radiologist observes the flow of barium with the fluoroscope. Swallowing (deglutition) of thin barium is observed with the patient in various positions. Similar positions may be used while the patient swallows thick barium. The used of thick barium allows better visualization of mucosal patterns and lesion within the esophagus. The type of barium mixture to be used, however is determined by the radiologist. After the upright studies, horizontal and trendelenburg positions with thick and thin barium may follow. The pharynx and cervical esophag us are usually studied fluoroscopically with the spot films, whereas the main portion of the esophagus down to the stomach is studied both with fluoroscopy and with post fluoroscopy overhaed radiograph. the diagnosis of possible esophageal reflux or regurgitation or gastric contents may occur during fluoroscopy or an esophagram. One or more of the following procedures may be performed to detect esophageal reflux. First, breathing exercise the various breathing exercises are all designed to increase both the intrathoracic and the intraabdominal pressures. The most common breathing exercise in the valsalva maneuver. The patient is asked to take a deep breath and, while holding the breath in, to bear down as though trying to move the bowels. This maneuver forces air against the closed glottis.  A modified valsalva maneuver is accomplished as the patient pinches off the nose, closes the mouth, and tries to blow the nose. The checks should expand outward as though the patient were blow ing up a balloon. A Mueller manoeuvre can also be performed as the patient exhaled and then tries to inhale against a closed glottis. With both methods, the increase of intraabdominal pressure may produced the reflux of ingested barium that would confirm the presence of esophageal reflux. The radiologist carefully observes the esophagogastric junction during these manoeuvres. Second is water test that done with the patient in the supine position and turned up slightly on the left side. This slightly LPO position fills the fundus with barium. The patients are asked to swallow a mouthful of water through a straw. Under fluoroscopy the radiologists closely observe the esophgogastric junction. A positive water test occurs when significant amounts of barium regurgitate into the esophagus from the stomach. A compression paddle can be placed under the patient in the prone position and inflated as needed to provide pressure to the stomach region. The radiologist can demonstrate the obscure esophagogastric jun ction during this process to detect possible esophageal reflux. The toe-touch manoeuvre is also performed to study possible regurgitation into the esophagus from the stomach. Under fluoroscopy the cardiac orifice is observed as the patient bends over and touches the toes. Esophageal reflux and hiatal hernias are sometimes demonstrated with the toe-touch manoeuvre. If the patient is a female, then a menstrual history must be obtained. Irradiation of an early pregnancy is one of the most hazardous situations in diagnostic radiography. X-ray examinations such as the upper GI series that include the pelvis and uterus in the primary beam and include fluoroscopy should only be done on a pregnant female when absolutely necessary. In general, abdominal radiographs of a known pregnancy should be delayed at least until the third trimester or, if patients condition allows (as determined by the physician), until after the pregnancy. This waiting period is especially important if fluoroscopy, which greatly increase patient exposure is involved. Potential difficulties that may arise out of a Barium Swallow is discomfort of air insufflation. Poor tolerance of swallowed gas mixture can make for poor stomach and oesophageal distension. Where buscopam injection is used to relax bowel for better pictures, patients may experience some blurring of vision.  Tendency  of barium to cause constipation in the days following the procedure. Need for an interpreter in non-English speaking patients. Disadvantages of Barium Swallow Useful for functional assessment allows the assessment of motility, reflux and distension. In comparison to gastroscopy, barium swallow is safer. Available resource. It is difficult to compare costs between barium studies and endoscopy and they may be of comparable costs. However is some centres barium studies are much more accessible to GPs and may be arranged with much less delay for the patient than gastroscopy. Not as comprehensive or accurate method for diagnosis of some conditions in comparison to gastroscopy. Not able to take samples or provide treatment as part of the procedure. Radiation exposure. Dose is 2 3 millisieverts compared with chest film 0.06 millisieverts and background radiation of 2millisieverts per year. Users of ionising radiation are required to inform all women of child bearing age about the risks of radiation in pregnancy. Pregnancy is a relative contraindication to the use of radiation but generally in the context of the barium enema the urgency is such that can delay or choose alternative investigation.

Desert Flower Essay

As they say, everyone has one story to write about – their own. But when you have a story like that of Waris Dirie, it will make a book truly worth reading. Last weekend while I was browsing at the local bookstore, I picked up Desert Flower. Waris Dirie grew up as a nomad in Somalia, until she ran way from home at the age of 14. With no language skills, no formal education and not much of external support, the lady goes on to become a model and then a UN Ambassador. She has been subjected to so many horrors, which would have definitely crushed a lesser human being. How does anyone not feel bitter after being subjected to genital mutilation at the age of five and then having had to survive a few rape attempts? At every step of the way, she is faced with so many hardships and you often find yourself wondering how in the world would she get out of this one? You find yourself wishing that somehow, she would. And then miraculously, she does. If it were fiction, I would have scoffed at it saying its too far-fetched. But that this is someoneà ¢Ã¢â€š ¬Ã¢â€ž ¢s real life makes it truly exceptional. For many parts of the book, I felt that I was part of a surreal world. After a long time, I felt like this was a book that stretched the boundaries of my imagined world – life in an African desert had definitely been a black box to me. The book is well written. I loved the simple way in which the story is told. It is in stark contrast to the twists and turns that happens in the story matter. And that the book treats some of the unfortunate, shocking I should say, incidents so matter of factly leaves it to the reader to fill up the emotions – which is such a better way of writing, than to try and direct our feelings. Despite all the differences that most readers would have with the author, the book has a universal appeal. At the core, it is a story of human determination and grit. A young woman who, with her confidence and perseverance, overcomes the many prejudices, myriad difficulties and outright injustices to find a place of her own in this world and to then strive towards making this world a better place for the rest of us to live in. Now isnà ¢Ã¢â€š ¬Ã¢â€ž ¢t that who we all really wish we were – whether we are born a Somali nomad or not? All in a all, a book not to be missed.