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Conventional Papanicolaou test is the only primary screening tool available since 1969 and it is considered the most successful cancer screening program to date medicine you can order online order topamax 200 mg visa. Nevertheless treatment x time interaction generic 200 mg topamax otc, cytology has its limitations especially technical limitations regarding sampling and laboratory errors in screening and interpretation treatment 5th metatarsal stress fracture cheap 200mg topamax mastercard. While Pap smear remain as a strategy treatment ibs order topamax 100 mg with amex, improving the quality of the laboratory services is paramount to ensure effective early detection of precancerous lesion. In 2015 the Ministry of Health introduced the liquid-based cytology in a phased implementation starting with Kelantan, Johor, Negeri Sembilan and Selangor gradually the whole country. Strategy/Tactics: the milestone of the Papanicolaou test program was analyzed to see the gap and the options of the improvement. The performances of Papanicolaou test services were analyzed through the annual data and report of Papanicolaou test services from all the states. Later, we also map the analysis with the latest incidence of cervical cancer in Malaysia to see the impact of the program. Outcomes: Mandate of the way forward of comprehensive strategy for cervical cancer control program being approved. What was learned: Malaysia is optimistic that cervical cancer reduction program remain a high-profile agenda in the country and therefore we are ready for the change to give a better impact of the program. Early detection increases the likelihood of successful treatment; however, in Samoa, cancer patients often present late, when treatment options are limited and often reduced to receiving palliative care. Low levels of health literacy in relation to cancer causation, risk factors, and signs and symptoms contribute to poor outcomes for cancer patients in Samoa. Aim: the Vave (Quickly) campaign aimed to increase community awareness about the signs and symptoms of cancer, and promote early detection. Strategy/ Tactics: this was a 12-month national social marketing campaign designed to ensure maximum population reach across Samoa. The campaign adopted a multipronged approach with three main components: mass and social media coverage; printed resources; and community education. Program/Policy process: the campaign focused on four of the most common cancers in Samoa: stomach, lung, breast, and prostate. Television advertisements and radio scripts were developed for each type of cancer, piloted and broadcast on the main television and radio stations. Community educators delivered a total of 29 face-to-face education sessions across Samoa; these sessions prioritized villages, schools and church groups in areas with poor television and radio coverage. Outcomes: the campaign was successful in increasing awareness of cancer signs and symptoms in the community. Approximately 2000 Samoans (over 1% of the population) received the face-to-face education sessions; analysis of pre- and postsession questionnaires showed that the sessions were effective in increasing health literacy around cancer signs and symptoms. Limited data on patient visits suggests that the campaign resulted in increased numbers of hospital and general practice visits, and is likely to have contributed to the early detection of some cancers. What was learned: $ the campaign resulted in an increase in inquiries and requests for check-ups; however, limited availability of medical and screening services must be considered when managing community expectations. Formative research and greater involvement of health professionals throughout the campaign would have prevented some implementation issues. Five-year overall survival for all stages combined ranges between 60%-69%, depending on the casemix and the treatment modalities used. Countries with no access to radiotherapy may only offer palliative treatment to women diagnosed with locally advanced cervical cancer. Any curative attempt for these patients should include the two components of radiotherapy: concomitant radio-chemotherapy and brachytherapy. This has enabled many member states to establish safe and effective diagnostic imaging and radiation therapy capacity to provide treatment and higher quality care to many of their cancer patients. Polo International Atomic Energy Agency, Vienna, Austria Aim and purpose: the session aims at outlining actions that the healthcare community can take to improve the current situation and inform cervix cancer control plans. Highlighting the need to address opportunities in the prevention and management of cervix cancer, the session will provide guidance on primary, secondary and tertiary prevention and management of cervix cancer and will discuss the role of radiotherapy, while showcasing examples of collaboration. Current estimates indicate that every year 122,844 women are diagnosed with cervical cancer and 67,477 die of the disease. Cervical cancer in India ranks as the 2nd most frequent cancer among women between 15 and 44 years of age.

Nonpurging type: During the current episode of bulimia nervosa medicine symbol buy topamax 200mg mastercard, the person has used other inappropriate compensatory behaviors such as fasting or excessive exercise but has not regularly engaged in self-induced vomiting or the misuse of laxatives treatment laryngitis purchase topamax 100 mg online, diuretics treatment zona generic topamax 200mg line, or enemas medications hyponatremia cheap topamax 200 mg with visa. In alcohol dependence, the regular use of alcohol has resulted in a state of physiologic tolerance and dependence. A pt may never suffer from withdrawal symptoms and still meet criteria for alcohol abuse. Alcoholism is a multifactorial disorder in which genetic, biologic, and sociocultural factors interact. Routine medical care requires attention to potential alcohol-related illness and to alcoholism itself: 1. Most alcoholic pts do not have dramatic physical symptoms but instead present with psychosocial difficulties. Most common are marital difficulties, job problems (tardiness, absenteeism), and legal problems resulting from driving while intoxicated. Typically, pts will describe a host of difficulties but will then deny that they have a problem with alcohol abuse. Incoordination, tremor, ataxia, confusion, stupor, coma, and even death occur at progressively higher blood alcohol levels. A variety of diagnostic studies may show evidence of alcohol-related organ dysfunction. These benefits must be weighed against the risks of overmedication and oversedation, which occur less commonly with shorter-acting agents. Fluid and electrolyte status and blood glucose levels should be closely followed as well. Cardiovascular and hemodynamic monitoring are crucial, as hemodynamic collapse and cardiac arrhythmia are not uncommon. Generalized withdrawal seizures rarely require aggressive pharmacologic intervention beyond that given to the usual patient undergoing withdrawal, i. Recovery and Sobriety Maneuvers in rehabilitation fall into several general categories. First are attempts to help the alcoholic achieve and maintain a high level of motivation toward abstinence. These include education about alcoholism and instructing family and/or friends to stop protecting the person from the problems caused by alcohol. The second step is to help the pt to readjust to life without alcohol and to reestablish a functional life-style through counseling, vocational rehabilitation, and self-help groups such as Alcoholics Anonymous. The third component, called relapse prevention, helps the person to identify situations in which a return to drinking is likely, formulate ways of managing these risks, and develop coping strategies that increase the chances of a return to abstinence if a slip occurs. Disulfiram (Antabuse; 250 mg/d), a drug that inhibits aldehyde dehydrogenase and results in toxic symptoms (nausea, vomiting, diarrhea, tremor) due to accumulation of acetaldehyde if the pt consumes alcohol, is used in some centers. Disulfiram has many side effects, and the reactions with alcohol can be dangerous. Preliminary studies suggest that the opiate antagonists naltrexone and acamprosate may reduce recidivism in abstinent alcoholics. These receptors mediate the opiate effects of analgesia, euphoria, respiratory depression, and constipation. The semisynthetic drugs produced from morphine include hydromorphone (Dilaudid), diacetylmorphine (heroin), and oxycodone. The purely synthetic opioids and their cousins include meperidine, propoxyphene, diphenoxylate, fentanyl, buprenorphine, tramadol, methadone, and pentazocine. All of these substances produce analgesia and euphoria as well as physical dependence when taken in high enough doses for prolonged periods of time. Three groups of abusers can be identified: (1) "medical" abusers- pts with chronic pain syndromes who misuse their prescribed analgesics; (2) physicians, nurses, dentists, and pharmacists with easy access to narcotics; and (3) "street" abusers. The street abuser is typically a higher functioning individual who began by using tobacco, alcohol, and marijuana and then moved on to opiates. In larger doses, markedly decreased respirations, bradycardia, pupillary miosis, stupor, and coma ensue.

Without a strong background in the scientific elements of pharmacokinetics and pharmacodynamics medications cause erectile dysfunction discount 100 mg topamax visa, this information is meaningless 2 medications that help control bleeding discount topamax 200mg otc. This course will help nurses navigate the relationship between these social and scientific roles medications not to take when pregnant purchase topamax 200mg amex. Continuing Education Credit Designation this educational activity is credited for 6 hours treatment 5th metatarsal shaft fracture discount topamax 100mg fast delivery. Nurses may only claim credit commensurate with the credit awarded for completion of this course activity. Statement of Learning Need Pharmacology continuous learning has become a highly satisfying method for nurses to increase and maintain proficiency in medication administration. Pharmacology learning tools, online or self-study, tailored to nursing knowledge needs are expected to lead to improved sharing of expertise and collaborative practice throughout all levels of acute and outpatient health care settings. Target Audience Advanced Practice Registered Nurses and Registered Nurses (Interdisciplinary Health Team Members, including Vocational Nurses and Medical Assistants may obtain a Certificate of Completion) Course Author & Planning Team Conflict of Interest Disclosures Jassin M. Opportunity to complete a self-assessment of knowledge learned will be provided at the end of the course. The process of drug absorption, distribution in the body, metabolism and excretion is called: a. Are best monitored with tissue samples Cannot cause toxicity Are not altered by diversity of medical conditions Give the best medication therapy with minimized side effects 5. Drug administration falls squarely at the intersection of these two responsibilities. Not only do nurses need to understand the scientific elements of pharmacology but also the social component. A medication suitable for one patient might not necessarily be suitable to another even if that patient is exhibiting a similar condition. The information that nurses obtain from their patients is critical for avoiding drug-drug interactions and drug-food interactions, allergic reactions, and other adverse effects. Professional nurses need a strong background in the scientific aspects of pharmacokinetics and pharmacodynamics. The importance of drug administration and knowledge in the profession of modern nursing cannot be overemphasized. Pharmacology provides a comprehensive understanding with regard to drug usage and precautionary measures that need to be considered during the administration of different drugs so that the drug benefits can be maximized and its harmful side effects minimized. More than ever, nurses are able to access pharmacology resources through electronic nursece4less. Overview Of Pharmacology History And Advancement Drugs are the most vital and extensively researched field of the medical sciences. The advent of drugs started ages ago and health professionals now have a seemingly unlimited variety at their disposal. The rapid advancement in drugs has brought forward new cures, therapies and treatments for the diseases and medical conditions that had previously not been possible to cure. These are due to advancements in pharmacology - the study of actions of drugs on living organisms. The healthcare team, which includes medical providers, nurses and other clinicians, does only need to be aware of older medications, but should also have knowledge of advancements that are occurring and the way they affect the practice of medicine. As mentioned, the science of pharmacology has existed for millennia; and the application and usage of pharmacologic products to relieve adverse conditions and suffering has become widely accepted in almost every country. Modern trends and advancement in medical science have greatly enhanced pharmacology. Drugs have been a fundamental component of the treatment of various diseases from the earliest existence of humankind, using various materials found in nature. With the passage of time, through trial and error, knowledge of pharmaceuticals was developed to distinguish between harmful and beneficial substances to be used as medicine. This led to further investigations of the effects of specific agents on isolated organs. One of many examples of this development in modern pharmacology is the studied effect of ergometrine on strips of uterine muscle.