dialysis (which is less efficient than hermodialysis in removing small molecules, but more efficient for middle molecules), and the high risk of neuropathy in patients treated with small surface area dialysers. Also the observation that when weekly hemodialysis time was markedly reduced, neuropathy did not appear provided a membrane highly permeable to middle molecules was used While the identity of uremic toxins is largely unknown, it is suggested that some dialysis schedules permit accumulation in body fluids of molecules in the range 1,000 to 2,000 daltons, and these cause some of the uremic problems encountered by patients on regular dialysis. Stages - of chronic renal failure - 1 Diminished renal reserve - About 50-70% of kidney function has to be lost before the effect, on blood chemistry becomes readily detectable, e.g., by rise of blood urea. 2. Renal insufficiency - from loss of further kidney function. There is moderate nitrogen retention (blood area 50-100 mg /100 ml., plasma creatmine 1.5-2. 5 mg. /100 ml.) and mild acidosis, may occur. Usually no symptoms except nocturia. Hypertension may dominate the clinical picture. 3. Stage of renal failure - Further kidney damage produces considerable nitrogen retention, derangement of plasma electrolytes, anemia and usually marked symptoms. The term 'uremia1 is reserved for the clinical syndrome resulting from advanced renal failure, when glomerular filtration rate is usually less Symptoms Signs Genito-urinary Nocturia Proteinuria Thirst Abnormal urinary sediment Cardio-vascular Fatigue Hypertension Dyspnoea Pericarditis Orthopnoea Management - 1. Monitoring renal functions - (a) Blood urea andcreatinine - levels always raised. However normal levels cannot be taken to indicate that renal function is not impaired. Serial estimations of plasma creatinine provide the best indication of the state of renal function in patients with CRF. Use of reciprocal plots of serum creatinine against time has shown that the decline in renal function is linear with time. An abrupt decline or acceleration in the slope demands a search for the cause (hypertension, UTI, hypovolemia or fluid overload, urinary tract obstruction particularly in elderly males, drugs or pregnancy). Hypercatabolic renal failure refers to rise of urea of more than 65 mmol/litre per day (b) Ultrasound - to ascertain renal size and to monitor renal function regularly in patients with CHF who are prescribed ACE inhibitors (which may cause acute deterioration in renal function). 3. Plasma sodium - Hyponatremia is common. 4 Potassium - Normal values until terminal stages when hyperkalemia occurs. 5. Calcium, phosphate and magnesium - Increased plasma phosphate and decreased calcium levels. Magnesium levels normal or slightly raised. G Uric acid - increased. 7. Hypehipidemia - Raised plasma levels of triglycerides and pre-beta lipoprot.eins. 8. Anemia - Normochromic normocytic anemia almost constant. Contributing factors - (a) Decreased production of erythropoietin by diseased kidney. (ii) Direct marrow suppression by uremic toxins. (iii) Shortened red cell survival. (iv) Increased blood loss. 2. Conservative management of uremic syndrome - (a) Diet - Low protein diet of 40pg of protein (0.6g/kg). The diet must be high in essential amino acids and total caloric intake must exceed 35 kcal/kg/day, using carbohydrate supplements if necessary. (b) Treatment of hyperkalemia - has already been described. 3. Salt and water intake - Salt overload and salt depletion are both hazards. The needs of each patient require individual assessment. Need for salt restriction is indicated by oedema anchor hypertension. Salt
Sunday, July 26, 2009
Market fall pushes T. Rowe Price 2Q profit down
BALTIMORE -- Investment Manager T. Rowe Price Group Inc. said Friday second-quarter earnings fell as revenue from managing investments declined 27 percent from a year ago.
The company reported net income of $100 million, or 38 cents per share, compared with $162.2 million, or 59 cents per share. Revenue fell to $442.2 million from $586.5 million a year earlier.
Analysts surveyed by Thomson Reuters expected profit of 34 cents on revenue of $423.8 million.
The Baltimore-based company said investment advisory revenue earned from mutual funds distributed in the United States decreased 29 percent, or $100.7 million, to $248.8 million. Average mutual fund assets in the second quarter were $179.6 billion, a decrease of 26 percent from the average for the comparable 2008 quarter.However, the company said that trend has reversed and it reported mutual fund assets at June 30 of $189 billion, up $30.2 billion from the end of March
The company reported net income of $100 million, or 38 cents per share, compared with $162.2 million, or 59 cents per share. Revenue fell to $442.2 million from $586.5 million a year earlier.
Analysts surveyed by Thomson Reuters expected profit of 34 cents on revenue of $423.8 million.
The Baltimore-based company said investment advisory revenue earned from mutual funds distributed in the United States decreased 29 percent, or $100.7 million, to $248.8 million. Average mutual fund assets in the second quarter were $179.6 billion, a decrease of 26 percent from the average for the comparable 2008 quarter.However, the company said that trend has reversed and it reported mutual fund assets at June 30 of $189 billion, up $30.2 billion from the end of March
- Exaggeration of deep jerks and extensor plantar response in syringomyelia, spinal tumour, amyotrophic lateral sclerosis and pachymeningitis. I
Reflexes - Exaggeration of deep jerks and extensor plantar response in syringomyelia, spinal tumour, amyotrophic lateral sclerosis and pachymeningitis. III. Investigations - 1. Haematological and biochemical - to demonstrate nature of primary disorder to which muscular wasting is secondary in case of systemic, inflammatory or metabolic disease 2 Serum creatine kinase (CK) - Very high levels in Duchenne and Becker dystrophies, acute polymyositis, and acute myoglobinuric myopathies. In other myopathies it may be normal or only moderately raised. 3. EMG - distinguishes myopathic weakness from that due to chronic denervation or to defective neuromuscular transmission as in myasthenic syndrome. 4. Nerve conduction velocity - Normal in myopathies and spinal muscular atrophies, reduced in demyelinating polyneuropathy. 5. Muscle biopsy and histochemical analysis - Infiltration with fat and connective tissue to varying extent in muscular dystrophies, often with abortive regenerative activity. In polymyositis necrotic changes with inflammatory cell infiltration in perifascicular distribution. Normal in most metabolic myopathies Electron microscopy useful in some metabolic and rare congenital myopathies. 25. PERIPHERAL NEUROPATHY Pathophysiology - Three basic pathological processes affect peripheral nerve fibres - 1. Wallerian degeneration - follows transection of an axon by crushing or injury, with the myelin sheath and axon degenerating distal to the site of division. 2. Axonal degeneration - Most common change, metabolism of the neurone usually affected, resulting in degeneration of the distal portion of the axon. 3. Segmental demyelination - results from disease of the Schwann cell or from a direct attack on the myelin, and the myelin sheath is primarily destroyed leaving the axon intact Clinical classification - 1. Mononeuropathy or focal neuropathy - Single nerve involved CAUSES - (a) COMPRESSION - e.g. compression of radial nerve against humerus (Saturday night palsy). (b) ENTRAPMENT -e.g. (i) Carpal tunnel syndrome - Compression of median nerve as it passes through the carpal tunnel in the flexor retinaculum at the wrist. Causes - (i) Wrist fracture. (ii) Arthritis of the wrist particularly RA. (iii) Soft tissue thickening in myxoedema and acromegaly. (iv) Oedema, notably associated with pregnancy Obesity. (v) No obvious cause. More common in women. Symptoms - Pain, numbness and paraesthesiae in the hand. Pain may radiate to through forearm and occasionally involve the whole arm. Typically pain is most troublesome at night or first thing in morning. Signs - Weakness of abductor policis brevis, with or without wasting, and also weakness of opponens. _ Sensory impairment -of median distribution. Positive Tinel sign - Gentle tapping over carpal tunnel causes paraesthesiae in part of the cutaneous distribution of the nerve. Treatment - (i) Mild case - Wrist splint, diuretics and injection of hydrocortisone into carpal tunnel may give temporary relief. (ii) In severe case - Surgical decompression of carpal tunnel. (c) OTHER CAUSES - Trauma, fractures operations, penetrating injuries, lacerations and injections. 2. Multiple mononeuropathy (mononeuritis multiplex or multifocal neuropathy) - More than one and at times many, individual nerves affected in a patchy distribution CAUSES - (a) Vascular - Diabetes, rheumatoid arthritis, polyarteritis nodosa, SLE, Wegner’s
Trading ban for 6 months not applicable to ESOPs
MUMBAI: Market regulator SEBI has clarified on the interpretation of certain amendments in the insider trading norms, in response to a few queries
from companies. The regulator said the six-month restriction for directors and employees to transact in shares of a company is only intended for trading on stock exchanges and not applicable to the exercise of employee stock options (ESOPs) and sale of these shares. Sebi noted that employees can subscribe to ESOPs, even if they have sold shares during the previous six months, but added that the restriction on market purchases for the next six months would be applicable, once shares bought through ESOPs are sold. The regulator also clarified that employees can sell shares in case of emergency on approval from the company’s compliance department. It also said employees are free to trade in Nifty or Sensex futures, subject to the company’s code of conduct. In response to whether the minimum holding period of 30 days while buying shares through an initial public issue would be applicable to bonus, rights share issues and ESOPs, Sebi said this restriction is limited to IPOs. It added that the company is free to decide the holding period for the others issue of shares.
from companies. The regulator said the six-month restriction for directors and employees to transact in shares of a company is only intended for trading on stock exchanges and not applicable to the exercise of employee stock options (ESOPs) and sale of these shares. Sebi noted that employees can subscribe to ESOPs, even if they have sold shares during the previous six months, but added that the restriction on market purchases for the next six months would be applicable, once shares bought through ESOPs are sold. The regulator also clarified that employees can sell shares in case of emergency on approval from the company’s compliance department. It also said employees are free to trade in Nifty or Sensex futures, subject to the company’s code of conduct. In response to whether the minimum holding period of 30 days while buying shares through an initial public issue would be applicable to bonus, rights share issues and ESOPs, Sebi said this restriction is limited to IPOs. It added that the company is free to decide the holding period for the others issue of shares.
Conversely in visceral pain there is often fall of BP and vomiting These manifestations occur reflexly (autonomic reflex). [N.B. Many visceral pains,
muscular spasm may also (unfortunately) cause ischemia of the muscles and further aggravation of muscular pain (and thus a vicious cycle). This lype of condition (e.g. lumbago) are benefitted by massage and physiotherapy (iii) Changes in the autonomic nervous system Somatic pain is accompanied usually, by signs of sympathetic overactivity, eg, rise of BP, tachycardia and pupillary dilatation. Conversely in visceral pain there is often fall of BP and vomiting These manifestations occur reflexly (autonomic reflex). [N.B. Many visceral pains, e.g. intestinal colic, renal colic, myocardial infarction, torsion of ovarian cyst, etc may be associated with vomiting. Thus, (i) Vomiting does not necessarily mean that the pain is of Gl origin, and (n) vomiting often indicates that the underlying pathology is in an advanced stage; eg. vomiting in an acute attack of myocardial infarction often means a grave prognosis). (iv) Reflex response A painful stimulus is usually associated with somatic reflexes also; example: pinprick in the sole of foot withdrawal of the foot. Table 10B1. 21 Types (Classification) of pain PAIN Somatic Visceral (somasthetic) (from viscera) Eg : angina pect oris/peptic ul cer/intestinal colic/renal colic etc. Superficial Deep. (from skin and (from muscles/ subcutaneous tis- bones/joints/fas sue) cia/periosteum) Eg : superficial Eg : Fracture/ cuts/bums etc slipped inter vertebral disc/ arfhritis/fibro sitis, rupture of muscle belly/etc Interrelationship between threshold of pain and its reaction. It is a common experience, that some people, eg, prize fighting sportsmen (particularly boxers), poor manual workers (and others generally considered as occupying the lower rungs of society but physically tough persons), can absorb great pain showing little reactions of pain. On the otherhand, highly sophisticated people, old unmarried women and cantenkorous old persons show excessive reaction to pain. Reaction to the pain also depends upon the environment. Serious injuries may be sustained in a battle field or during boxing match and yet severe pain many not be felt. Question is, what happens ? Is the threshold of pain altered ? Or, some other factors are responsible for this phenomenon ? With our present state of knowledge, a definite answer cannot be given. Previous idea was that the threshold of pain is same in all persons but due to some reasons (not exactly known), the reaction of pain differs from person to person. It will be seen later in this chapter, that ideas have changed; it is now known that within our nervous system, there exists a mechanism, which can inhibit the pain. It is possible (but not proved) that persons who can absorb heavy physical punishment without showing much reactions, have rather a better functioning pain inhibiting mechanism. As an example, the story of a prize fighting boxer, the exworld champion, Muhammed Ah, may be cited. During a title fight, in the 3rd round, he sustained an injury which caused fracture of his jaw. Inspite of this, he continued till the 12th round (and thus received the jabbing, sometimes on the injured region, of a world class boxer). Neurotransmitter and path of pain 1. The transmitter The A (carrying ' first' pain) and the C (carrying the 'second pain') terminate on the dorsal horn of the spinal cord (fig.10B1.3.1). The first neuron ends here Almost certainly the synaptic transmitter is substance P (originally reported by the great pharmacologist Gaddum, together with von Euler in the 1930s), secreted by the terminals of the C as well as A fibers. 2. The path The tip of the dorsal horn ib called 'substantia gelatinosa Rolandf' (SCR, also written as SG). A fibers and C fibers terminate at SGR. From the SGR, the next order neurons arise and cross to the opposite side and form the 'spmothalamic tract' (STT, also called anterolateral system). (Details of the STT have been given in chap 3, sec XB1). In short, the STT reaches, ultimately, the thalamus. From the thalamus, the next order neuron arises to end in the sensory cortex in the parietal lobe. It is important to remember, that some descending fibers from the brain (vide below) terminate on the SCR. They constitute the tract that causes inhibition of pain. In the above description of the path of pain, it was assumed, that the pain arose from a somatic structure Under some conditions, pain can also arise from the viscera. Abdominal visceral pain are carried by afferent sympathetic fibers. These fibers enter the spinal cord travel up vianterolateral system (spmothalamic tract, STT) reach-the thalamus parietal lobe of the cortex. However, cortical representation of visceral (pain) sensation is rather poor. Pelvic splanchnic and vagus (both parasympathetic) are also known to carry visceral pain sensations. Thus, pelvic visceral pain is also carried by pelvic splanchnics. Visceral Pain A viscus is insensitive to most of the sensory stimuli (like touch, thermal sensations etc.). Thus, if a part of the intestine is exteriorized through an abdominal wound and touched, no sensation of touch is elicited. However, pain sensation can, under some conditions, arise from the viscera. Conditions, where the pain sensation can arise from the viscera are : (i) Ischemia. The classical example is coronary artery occlusion resulting in myocardial ischemia cardiac pain. (ii) Obstruction of a hollow viscus. The typical example is obstruction of a segment of large intestine. The part proximal to the obstruction contract violently (as if, it is trying to overcome the obstruction) and intestinal colic results. Actually the pain may be due to the spasm (sustained powerful contraction) of the smooth muscles; the spasm in turn produces ischemia of the muscles pain. Alternatively the violent contraction may cause traction of the mesentery, leading to pain. In the mesentry, there is severe overcrowding of nerves; this is because
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Revenue like this is usually paid for a service. Ultimately I thought the service was intermediation between savers in China, Japan and the Middle East (who want Treasuries) and dis-savers in the Anglo countries (who want to fund exotic credit card debt and mortgages). That remains the only service that looks large enough to justify that sort of revenue. (The real service having been finding suckers such as municipalities and insurance companies to hold the toxic waste such as CDO squared re-securitization paper.)
That said, given almost nobody knows how to make $22 billion per annum trading and jealousy is a common trait, conspiracy theories abound. The current conspiracy theory is that this money comes from front-running clients in the market with very rapid trading. The New York Times recently promoted this view.
That said, given almost nobody knows how to make $22 billion per annum trading and jealousy is a common trait, conspiracy theories abound. The current conspiracy theory is that this money comes from front-running clients in the market with very rapid trading. The New York Times recently promoted this view.
Usually typical 'pea-soup1 Constipation however may be troublesome. 3. Decline (3rd week) - (a) Mild case -Toxemia abates, gradual fall of temperatur
quickens B P tends to fall. Usually there is diarrhoea (c) Temperature - high, with slight morning remissions. (d) Rash - Rose spots on 7th to 10th, day. Usually scanty. Any part of body may be involved but periumbilical area is most common. Slightly elevated and fading on pressure. Appear in crops. Fade in 2 to 3 days. Not constant. In grave cases diffuse purpuric skin eruptions may appear (e) Stools - Usually typical 'pea-soup1 Constipation however may be troublesome. 3. Decline (3rd week) - (a) Mild case -Toxemia abates, gradual fall of temperature (b) Severe Case - Increased toxemia, intestinal hemorrhage or perforation. In very severe cases patient goes into typhoid state largely due to severe electrolyte imbalance. It is characterised by - marked prostration with tendency to slip to foot of bed, delirium or stupor with half-open eyes (coma vigil), muscular twitchings and picking of bedclothes with incontinence of urine and faeces. Death may result from toxic myocarditis. 4. Convalescence - In atypical uncomplicated case fever subsides in four weeks. Return of appetite. Tongue cleans. General weakness. Pulse faster, easily quickened by exertion. Slight peeling of skin and oedema of feet may occur. Femoral thrombosis chief complication. A persistent infection of the gall bladder or less often of the kidneys results in the carrier state RELAPSE - may occur some 10 days after the primary attack especially in those who develop a feeble. immunity as a result of a mild attack or are inadequately treated with short courses of specific therapy. Complications - 1. Gastro-intestinal - (a) Meteorism - Abdomen distended, tense, tympanitic May be accompanied by diarrhoea. Favours perforation and hemorrhage. (b) Intestinal hemorrhage - Usually at end of 3rd week. Sudden onset with faintness, pallor and symptoms of shock, rapid fall of temperature to subnormal, thready rapid pulse, fall of B. P. Stools - Streaks of blood or frank bright blood or tarry stools (c) Paralytic ileus - Distension of abdomen, constipation and persistent vomiting, from extensive intestinal involvement, endotoxemia and hypokalemia. (d) Perforation - Usually at same stage of disease as hemorrhage. Preceding diarrhoea and distension common. May occur in mild attacks. Pain in abdomen and collapse, rapid pulse and local or general peritonitis. (e) Parotitis - Due to oral sepsis. Suppuration common. Danger of aspiration bronchopneumonia. (f) Acute cholecystitis - May occur at onset but usually not till the 3rd week or later. An important sequel is formation of gallstones. (g) Non-perforative peritonitis -In rare cases peritonitis may occur apart from perforation of intestines or other organs such as the gallbladder, spleen, or suppurating mesenteric glands. The symptoms do not differ from those of perforative peritonitis. (h) Acute pancreatitis - Abrupt onset of agonising pain across the upper abdomen radiating sometimes to back and shoulders. Vomiting and distension of abdomen, collapse and shock, abdominal rigidity, pallor or cyanosis. Mistaken for perforation. Increased serum amylase diagnostic. (i) Hepatitis -Jaundice may occur, usually due to intrahepatic cholestasis. 2. Respiratory - (i) Typhoid pneumonia in 2nd to 3rd weeks. (ii) ARDS - in pts with extensive pneumonia, septic shock and associated malaria. 3. Genitourinary - (i) Retention of urine. (ii) Transient hematuria or proteinuria due to immune complex mediated GN (ii) Pyelonephritis and cystitis. 4. Circulatory - (a) Myocarditis - Mild common, rarely severe enough to
Where Goldman Really Makes Its Money
Goldman Sachs made $5.7 billion of trading revenue in the last quarter. That run rate (over $22 billion per annum) is almost as much as the pre-crisis peak.
Twenty-Two billion dollars per annum is roughly $200 per year per household in the United States.
If it is someone's trading revenue, it presumably comes out of someone else's pocket, so measuring it per household is appropriate.
The trading revenue of "Wall Street" investment banks (including Barclays ( BCS - news - people ), the trading parts of Citibank and similar entities) peaked at over $500 per household in the Western world.
Twenty-Two billion dollars per annum is roughly $200 per year per household in the United States.
If it is someone's trading revenue, it presumably comes out of someone else's pocket, so measuring it per household is appropriate.
The trading revenue of "Wall Street" investment banks (including Barclays ( BCS - news - people ), the trading parts of Citibank and similar entities) peaked at over $500 per household in the Western world.
Period of infectivity -From onset of prodromal period to 4 days after appearance of rash. Clinical features - Illness of infection -Febrile catarrhal
days. Period of infectivity -From onset of prodromal period to 4 days after appearance of rash. Clinical features - Illness of infection -Febrile catarrhal attack with fleeting rash in a few hours after exposure to measles. 1. Prodromal stage -usually 4-5 days. (a) Fever - Abrupt rise of temperature to about 40°C (102°F). (b) Catarrh - Coryza, conjunctivitis, photophobia and hacking cough. (c) Koplik's spots (Enanthema) pathognomonic. Appear on 2nd day as minute pin-point bluish white specks with slight reddish mottled areola around them, on buccal mucosa usually opposite lower molars. They look like grains of salt. Variable in number. Occasionally large spots few in number. The spots begin to fade with appearance of rash. Red blotches may be seen on soft palate. Koplik's spots may sometimes occur in the lower lip in front of the lower incisors, and in severe cases the palate and rest of the mucosa are peppered with these spots. (d) Laryngeal involvement -Hoarseness and laryngeal stridor. (e) Gl - Persistent vomiting and diarrhoea. (f) Fleeting rashes - either urticarial or erythematous. 2. Exanthematous stage - (a) Rash - On 5th day, red macules appear first behind ear, along hair line and on posterior parts of cheeks and spread rapidly in a few hours all over the body. Macules appear in crops which by confluence form blotches with crescenteric or thumb nail edge Fully erupted rash deepens in colour, petechiae may occur. In severe measles the rash is confluent, the face is swollen and disfigured and together with the photophobic eyes creates the typical measly appearance. (b) Mucous membrane involvement - includes conjunctivitis, rhinitis, stomatitis, laryngitis, tracheitis and bronchitis. There may also be gastroenteritis. 3. STAGE OF DEFERVESCENCE -Temperature falls by crisis or rapid lysis in 24 to 48 hours. Rash fades from face downwards in same sequence as its appearance, and leaves brown staining often followed by branny desquamation. The more severe the measles, greater the extent of desquamation. At times the normal rash of measles instead of fading becomes a deep purple (purpuric measles) and this may persist for a week or two. Varieties - 1 Modified measles - In measles modified by gamma globulin all symptoms and signs may be suppressed except the rash in the form of discrete macules scattered over the trunk. 2 Measles in adults -Constitutional symptoms may be more severe but less tendency to complications. 3. Atypical measles - in children who have received measles vaccine. Fever with petechial rash and oedema on lower legs and dorsum of feet. 4. Morbilli bullosi - Severe variety in which some of the lesions become bullous. May occur in malnourished children. 5. Hemorrhagic measles (black measles) - Hemorrhages into skin and bleeding from any or all of the body orifices. Complications - 1. Secondary bacterial otitis media. 2. Pneumonia or bronchopneumonia - main cause of death. During the latter part of exanthematous stage, combination of measles and adenovirus infection produces most severe symptoms and prolonged course. 3. Laryngotracheobronchtitis (croup) - due to measles virus. May give rise to stridor. 4. Herpes simplex gingivostomatitis - Vesicles in mouth which rapidly ulcerate causing fever, salivation and difficulty in feeds Disseminated herpes is rare. 5. Acute post-infective encephalitis - is the most common neurological
Broker snap: Housebuilders' rally a 'false dawn'
LONDON (SHARECAST) - KBC Peel Hunt, a long time bear on the housebuilding sector, is once again exhorting its clients to take profits on the housebuilders in the wake of what it regards as “a positive spin” put on housing market figures by property web site Rightmove. “Rightmove has hailed the bottom of the housing market, citing a 20% rise in new sellers as evidence. A rise in new sellers in fact has the opposite effect, correcting the buyer imbalance now driving the market,” KBC’s Robin Hardy argues. Hardy is also sceptical about the soothing noises coming from the industry during the recent round of trading updates. These “painted a picture of optimism: price stability, scope for margins to begin re-building and asset values to stop falling. This was based on the distorted price environment, a drift from second-hand into new homes and the favourable selling conditions resulting from available stock,” Hardy believes. The new build industry faces a “hard sell in the autumn,” in Hardy’s view, and “hopes of a return to selling 'off-plan' are a pipedream.” Turning to specific stocks, KBC believes that the recent advance by Barratt Developments – up almost 15% over the last week – probably makes a large cash call more likely, with the broker guessing that the company would tap the market for around £500m. With or without an equity issue, KBC believes Barratt’s valuation is “stretched on an NAV [net asset value] or EPS [earnings per share] basis.” The broker concedes that bulls are driving the share price direction of housebuilders at the moment but claims “the false dawn is coming to an end; a negative tone is set to return but not just yet.” Investors dedicated to maintaining exposure to the sector are advised to switch into “less exposed stocks such as Bellway, weaker performers such as Taylor Wimpey or stocks allied to transactions such as Travis Perkins
. Certain forms of nephritis (e.g. focal glomerulosclerosis and mesangiocapillary glomerulonephritis) recur in transplants, and it is helpful to know
rapidly progressive glomerulonephritis, such as polyarteritis or antiglomerular basement disease. 7. Chronic and end-stage renal failure - provided kidneys are not small and shrunken, biopsy is useful in determining the cause and prognosis. Certain forms of nephritis (e.g. focal glomerulosclerosis and mesangiocapillary glomerulonephritis) recur in transplants, and it is helpful to know this for future management. 8. Special situations - (a) Uncontrolled hypertension may lead to renal impairment, hematuria and proteinuria, and this may occasionally result in nephrotic syndrome. Once hypertension is controlled, renal biopsy may be the sole criterion for determining whether the problem is due to pure hypertension or underlying nephritis. (b) In 10-20% of patients with diabetes mellitus, proteinuria and impaired renal function may be due to causes other than diabetic nephrosclerosis, particularly in those with no other evidence of microvascular disease e g diabetic retinopathy. 9. Renal allograft dysfunction -(a) It provides only reliable method of distinguishing rejection from cyclosporin nephrotoxicity. (b) It helps in deciding the scale of antirejection therapy and differentiating allograft nephropathy form recurrent or de novo nephritis. Contraindications - 1. Single kidney or severe malfunction of one kidney. 2 Uncontrollable bleeding diathesis. 3. Small, shrunken kidneys (difficult to locate and information obtained usually nonspecific). 4 Presence of cystic disease, nephrolithiasis, reflux nephropathy or obstruction or hemangioma. Technique - Localization of the kidney- Lateral border of lower pole of kidney is the safest part to biopsy. Ultrasound is the preferred imaging technique to mark the position of the kidney. It is particularly preferred in patients with impaired function as it avoids use of contrast media (as in IVU) Attachments are available for ultrasound probes which can precisely direct the needle to the kidney Biopsy needle - (a) Franklin-modified Vim Silverman needle (b) Tru-Cut needles are disposable needles and not composed of different parts. (c) Biopsy gun is a spring-loaded device which 'shoots' a variant of tru-cut needle into the organ. (d) Biopsy needles with tips which are easily seen by ultrasound They are smaller but adequate tissue can usually be obtained Biopsy of the native kidney - (a) Pre-medication to allay anxiety and pain. (b) 'Fixing1 the kidney - so that it does not move significantly with patient's respirations. Patient's upper abdomen and lower chest should be supported by pillows so adjusted that patient's diaphragm is well splinted.(c) Sedation - with IV diazepam to produce deep sleep. (d) Position of lower pole of the kidney as determined by ultrasound is marked on the skin and depth of the kidney measured. (e) Biopsy is then performed. Enough tissue must be taken for light microscopy, electron microscopy, immuno-fluorescence or immunoperoxidase techniques and, if appropriate for culture Biopsy of transplanted kidney - The allograft may be easily palpable in the iliac fossa but it should be localised by ultrasound aiming for the lateral border of upper pole. Since transplanted kidney often becomes encased in fibrous tissue, this must be penetrated before biopsy is taken. If it is not, cutting prongs of a modified Vim Silverman needle or cutting tip of a Tru-Cut disposable needle may 'bounce' off the kidney and lacerate it, causing hemorrhage. Fine-needle aspiration biopsy (FNAB) - is used in
. Certain forms of nephritis (e.g. focal glomerulosclerosis and mesangiocapillary glomerulonephritis) recur in transplants, and it is helpful to know this for future management. 8. Special situations - (a) Uncontrolled hypertension may lead to renal impairment, hematuria and proteinuria, and this may occasionally result in nephrotic syndrome. Once hypertension is controlled, renal biopsy may be the sole criterion for determining whether the problem is due to pure hypertension or underlying nephritis. (b) In 10-20% of patients with diabetes mellitus, proteinuria and impaired renal function may be due to causes other than diabetic nephrosclerosis, particularly in those with no other evidence of microvascular disease e g diabetic retinopathy. 9. Renal allograft dysfunction -(a) It provides only reliable method of distinguishing rejection from cyclosporin nephrotoxicity. (b) It helps in deciding the scale of antirejection therapy and differentiating allograft nephropathy form recurrent or de novo nephritis. Contraindications
Where Goldman Really Makes Its Money
Goldman Sachs made $5.7 billion of trading revenue in the last quarter. That run rate (over $22 billion per annum) is almost as much as the pre-crisis peak.
Twenty-Two billion dollars per annum is roughly $200 per year per household in the United States.
If it is someone's trading revenue, it presumably comes out of someone else's pocket, so measuring it per household is appropriate.
The trading revenue of "Wall Street" investment banks (including Barclays ( BCS - news - people ), the trading parts of Citibank and similar entities) peaked at over $500 per household in the Western world
Twenty-Two billion dollars per annum is roughly $200 per year per household in the United States.
If it is someone's trading revenue, it presumably comes out of someone else's pocket, so measuring it per household is appropriate.
The trading revenue of "Wall Street" investment banks (including Barclays ( BCS - news - people ), the trading parts of Citibank and similar entities) peaked at over $500 per household in the Western world
Saturday, July 25, 2009
He would put $162,500 in growth assets, predominantly shares that were activity-managed and well diversified across countries, sectors, industries and
Currency hedging would be put in place and Mr Myles had a preference for some protective strategies against prolonged falls in markets.
Mr Young suggested the couple seek recommendations for a growth portfolio investment, with the knowledge that as a growth investor they would prefer predominantly sharemarket investments with a small fixed-interest component.
As a growth investor, they would have to accept the portfolio might lose value for extended periods in the course of seeking capital appreciation over the recommended minimum period of, for example, five years.
A growth portfolio would have:
• Cash - a portfolio should have some available cash for emergency funds or any investment opportunity that arose.
• Fixed interest - a small weighting of fixed interest would provide some quarterly income to top up cash reserves.
• Property - a small exposure to the listed property sector would provide diversity and a good income from dividends of about 8% to 14%. Listed property stocks were also PIEs where the maximum tax paid on the dividend was 30%.
• Australian and New Zealand equities - Mr Young would have the largest weighting of the portfolio split between New Zealand and Australian shares.
Mr Young suggested the couple seek recommendations for a growth portfolio investment, with the knowledge that as a growth investor they would prefer predominantly sharemarket investments with a small fixed-interest component.
As a growth investor, they would have to accept the portfolio might lose value for extended periods in the course of seeking capital appreciation over the recommended minimum period of, for example, five years.
A growth portfolio would have:
• Cash - a portfolio should have some available cash for emergency funds or any investment opportunity that arose.
• Fixed interest - a small weighting of fixed interest would provide some quarterly income to top up cash reserves.
• Property - a small exposure to the listed property sector would provide diversity and a good income from dividends of about 8% to 14%. Listed property stocks were also PIEs where the maximum tax paid on the dividend was 30%.
• Australian and New Zealand equities - Mr Young would have the largest weighting of the portfolio split between New Zealand and Australian shares.
Investing your windfall
By Dene Mackenzie on Thu, 23 Jul 2009
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
Younger couple
Paying off the mortgage, and any debt - either partially or in full, depending on circumstances - should be a priority for the young family who had inherited money, according to our panel of experts.
"This releases at least $750 a month, assuming a 20-year mortgage payment. To keep the mortgage requires $1.27 to be earned for every dollar paid into the mortgage," Mr Smith, the principal of Smith Financial Planning, said.
The couple should repay student loans and should join KiwiSaver, if they had not already done so.
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
Younger couple
Paying off the mortgage, and any debt - either partially or in full, depending on circumstances - should be a priority for the young family who had inherited money, according to our panel of experts.
"This releases at least $750 a month, assuming a 20-year mortgage payment. To keep the mortgage requires $1.27 to be earned for every dollar paid into the mortgage," Mr Smith, the principal of Smith Financial Planning, said.
The couple should repay student loans and should join KiwiSaver, if they had not already done so.
. The correct view is : during exercise, there is sympathetic stimulation plus adrenalin release 4 rise ot contractility ot heart muscle -> more empt
unrained persons are concerned. The correct view is : during exercise, there is sympathetic stimulation plus adrenalin release 4 rise ot contractility ot heart muscle -> more emptying ot the heart during systole, i.e the end systolic volume becomes less than normal rise in stroke Volume [In trained athletes the picture is perhaps ditterent. In them, the heart rate rises less, heart is enlarged and rise in stroke volume plays a greater role. In them, Starlings law ot heart is an important tactor. ] The heart rate rise is also due to the (1) sympathetic stimulation and (n) adrenalin secretion. (iii) In addition, the reduction ot vagal tone also helps to develop tachycardia. In severe exercise, (iV) the rising body temperature, and (V) lactic acidosis also contribute to it.Cause ot sympathetic stimulation During exercise probably many tactors help to stimulate the sympathetic nervous system. Further, the stimulated sympathetic stimulates, in turn, suprarenal medulla to secrete adrenalin. Question is, what causes the sympathetic stimulation ? The precise picture is not clear. However, some tacts are known; (i) area 4 ot Broadmann, in cerebral cortex. (i.e. the motor cortex tig. 10A. 1. 1. A), when stimulated (as it must be in physical exercise), causes some sympathetic stimulation. These sympathetic stimulation, probably, mostly result in vasodilatation ot muscle vessels, (i.e. the vasodilator sympathetic fibers are stimulated), and have been described again later in this chapter. In short they play strong roles in muscle vaso dilatation but not in cardiac output increment, (n) in the peripheral muscles and pints, there are receptors, which when stimulated, cause retlex sympathetic stimulation. Muscular exercise, because it produces movements ot the joints, cause these receptors to be stimulated; (iii) in sports tournaments (or when an animal sees an approaching enemy), the excitement may cause sympathetic stimulation even betore the actual work has begun. (This however is unlikely to occur when non exciting routine jobs are being done). It should be clear that although there is sympathetic activity and adrenalin secretion, the diastohc blood pressure (DBP) usually faills during exercise; the explanation tor this has been given later. Peripheral Circulatory Changes The blood pressure The systolic blood pressure (SBP) rises as a rule, the diastohc blood pressure (DBP) usually talls and the mean blood pressure (MBP) does not usually change much but may fall in some cases. The pulse pressure rises sharply. Explanation: The SBP depends more on the cardiac output and as the GO rises the SBP also rises. The DBF is more dependent on the peripheral resistance. During muscular exercise, the peripheral resistance (PR) talls, so the DBP also talls usually. The changes mentioned above are seen in isotonic exercises (running/jogging etc.) where the active muscles are allowed to shorten. In isometric exercises (eg. working with a bulworker) where the muscles contract, but do not shorten, both the SBP & the DBP (and hence the MBP also) rise sharply. Hence isometric exercises like pushing a stationary car can be dangerous in an elderly man. Causes ot the tall ot the PR This can now receive attention. During muscular exercise, great circulatory readjustments occur. This includes a vaso dilatation in the skeletal muscles (and in some other regions, see later) and vaso constriction in other organs (see later). As the skeletal muscles account tor about 40% ot the body weight, a generalized vaso dilatation in them, even where the intensity ot the dilatation is slight, causes great reduction ot PR. The blood vessels ot the muscles are compressed while the muscles are contracting, producing a temporary ishcemia but a heavy vaso dilatation (which cancels the ettects due to the compression during contraction) occurs during relaxation. But in isometric contraction the sustained compression leads to rise ot BP (both SBP & DBP). Changes in regional circulation (1) Coronary: The coronary circulation increases and in very heavy exercise the increase may be manifold. Increase (= coronary vaso dilatation) is principally due to local O2 lack caused by the exercise (recall,. O2 lack in the myocardium is the most powerful coronary vasodilator). It should be understood that sympathetic stimulation causes coronary
UPDATE 1-Exelon earnings drop but top forecasts
Adj Q2 EPS of $1.03 tops Wall St. view of 99 cts
* Reaffirms full-year earnings forecast
* Shares slip in pre-market trade
NEW YORK, July 24 (Reuters) - Power company Exelon Corp (EXC.N), which earlier this week withdrew a hostile takeover bid for NRG Energy Inc (NRG.N), posted a 12 percent drop in second-quarter earnings on slack demand for electricity and higher costs for nuclear fuel.
Net earnings fell to $657 million, or 99 cents per share, from $748 million, or $1.13 per share, in the year-ago quarter.
Adjusted earnings for the quarter of $1.03 topped analysts' average forecast of 97 cents per share, according to Reuters Estimates.
The company, which owns the PECO utility in Pennsylvania and ComEd in Chicago, reaffirmed its expectation that it would earn an adjusted $4.00 per share to $4.30 per share for the full year.
Third quarter adjusted earnings are expected to be between 90 cents per share and $1.00 per share.
Shares in Exelon slipped 0.5 percent to $53.75 per share in premarket trading. (Reporting by Matt Daily, editing by Gerald E. McCormick
* Reaffirms full-year earnings forecast
* Shares slip in pre-market trade
NEW YORK, July 24 (Reuters) - Power company Exelon Corp (EXC.N), which earlier this week withdrew a hostile takeover bid for NRG Energy Inc (NRG.N), posted a 12 percent drop in second-quarter earnings on slack demand for electricity and higher costs for nuclear fuel.
Net earnings fell to $657 million, or 99 cents per share, from $748 million, or $1.13 per share, in the year-ago quarter.
Adjusted earnings for the quarter of $1.03 topped analysts' average forecast of 97 cents per share, according to Reuters Estimates.
The company, which owns the PECO utility in Pennsylvania and ComEd in Chicago, reaffirmed its expectation that it would earn an adjusted $4.00 per share to $4.30 per share for the full year.
Third quarter adjusted earnings are expected to be between 90 cents per share and $1.00 per share.
Shares in Exelon slipped 0.5 percent to $53.75 per share in premarket trading. (Reporting by Matt Daily, editing by Gerald E. McCormick
QUANTITATIVE ANALYSIS OF PROTEINURIA - Less than 0.5 g/day - (a) Normal, after prolonged exercise, orthostatic. (b) Abnormal - Orthostatic proteinuria
Primary glomerular disease - Minimal change disease, mesangial proliferate GN, focal and segmental GN, membranous GN, megangiocapillary GN, crescentic GN (ii) Secondary glomerular disease - Diabetes, collagen vascular disease, amyloidosis, drugs (gold, penicillamine, mercury). (b) Overflow proteinuria - Multiple myeloma, amyloidosis, myoglobinuria, haemoglobinuria. (c) Tissue proteinuria - Acute inflammation of urinary tract. QUANTITATIVE ANALYSIS OF PROTEINURIA - Less than 0.5 g/day - (a) Normal, after prolonged exercise, orthostatic. (b) Abnormal - Orthostatic proteinuria can occur in mild or resolving glomerular disease. 0.5-2 g/day- (a) Benign - Usually fixed1 i.e. present at all times. (b) Abnormal - Glomerular disease or proximal tubular lesion, congenital or acquired. More than 2 g/day - (a) Glomerular disease. (b) Overproduction of proteins small enough to escape the glomerular barrier e. g. free immunoglobulin light chains produced by a B cell monoclone. Proteinuria more than 5 glday - (with hypoalbuminemia and oedema) - Nephrotic syndrome, specific glomerular disease, accelerated hypertension, unilateral renal artery stenosis, renal venous thrombosis, severe congestive heart failure. Systemic diseases that may present as asymptomatic albuminuria - Diabetes mellitus, amyloidosis, hypertension, gout, SLE. TESTS FOR PROTEIN - (a) Boiling test - For this purpose the urine must be clear, if opalascent it must be filtered. A test-tube is filled with two-thirds urine and the top portion gently heated over a flame, 2 or 3 drops of acetic acid should be added and the urine boiled If turbidity appears in the urine on boiling and it persists after the addition of acetic acid it indicates presence of albumin and the amount of precipitate indicates the amount of albumin. If the turbidity disappears on addition of acetic acid the turbidity is due to phosphates. (b) Dipstick - Test with fresh specimen and ensure that dipsticks are not out of date. (c) Salicylsulphonic acid - The precipitated proteins form a suspension. Mucin - Traces in normal urine. Increased amounts in irritation and inflammation of urinary tract or vagina Sulphonamides - Crystal forms of certain derivatives of sulphonamide may precipitate out from the urine. Fat globules -After ingestion of large quantities of cod liver oil or other fats, phosphorus poisoning and chronic parenchymatous nephritis. In alkaline urine - Phosphates - in osteitis fibrosa cystica, administration of parathyroid hormone, alkalosis, compensatory measure in acidosis to help maintain acid base balance. Calcium carbonate - as amorphous granules, or rarely as colourless spheres and dumb-bells. Ammonium biurate - "Thorn apple" crystals. 2 ERYTHROCYTES -The excretion of erythrocytes should not exceed 1 X 105/ hour. (a) Dysmorphic pattern - Profusion of erythrocytes of bizarre and dissimilar size with variable haemoglobin concentration (Normal upto 8000 urinary erythrocytes). (b) Isomorphic pattern - Non-glomerular bleeding associated with urinary calculi, tumours and papillary necrosis. Erythrocytes which are uniform in size and shape with normal haemoglobin concentration are not a normal component of urine and thus a count as low as 4000/ml may be a sensitive and specific indicator of non-glomerular bleeding. The number of red cells present provides information on the probable type of underlying glomerulonephritis, particularly if haematuria is associated with other urinary abnormalities, such as the presence of protein, fat and casts. Thus a patient with membranous glomerulonephritis has an erythrocyte count of 20,000-50,QQQ/ml accompanied by marked proteinuria, oval fat bodies and many casts containing fat. Mesangial IgA nephropathy is associated with a count of 100,000/ml or more and there may be no fat, casts or protein in urine. An erythrocyte count of more than 1,000,000/ml is likely to reflect the presence of underlying crescents whatever the nature of the glomerular lesion. The dipstick method detects <>
Pruning VIP Security: a Tough Call for Government
New Delhi, July 12 (IANS): The government has been quick to decide on not upgrading Bharatiya Janata Party (BJP) MP Varun Gandhi's security cover to the Z plus category, but is yet to take a call on whittling down or even dispensing with the bodyguards of a majority of the 395 VIPs in the capital.
Over 9,000 personnel, mainly from Delhi Police, supplemented by hundreds of paramilitary personnel drawn from forces like the Central Reserve Police Force (CRPF), Indo-Tibetan Border Police (ITBP) and the Central Industrial Security Force (CISF), provide security to the VIPs.
The number of armed bodyguards has often been seen as a status symbol in the capital, the major reason why VIPs are so reluctant to have their security cover reduced. Appraisals of all the people protected that the home ministry periodically reviews after receiving inputs from the Intelligence Bureau have revealed that many of them do not require security as the threat perception simply does not exist.
But despite arriving at this finding of many people not facing any threat from either terrorists or criminal groups there has hardly been any case of security being downgraded or removed in the last five years.
"We have had two more appraisal meetings and now the file will move to the home secretary, G.K. Pillai. But I guess the final call will have to be taken by the minister," a top intelligence functionary, who could not be identified, told IANS.
The intelligence establishment reckons that if its recommendations were accepted then only 100 VIPs in the capital would be left with the security cover.
According to senior home ministry officials many VIPs including politicians, former bureaucrats, judges, religious leaders, lawyers, ministers and a few journalists have persisted with their security cover for years because of the pressure they bring to bear on the establishment.
Highly placed home ministry officials told IANS that there were now no known threats to former Jammu and Kashmir governor G.C. Saxena, former union minister and Jammu and Kashmir governor Jagmohan and Punjab Kesri editor Ashwani Kumar Minna.
Former bureaucrats who have held sensitive positions are allowed to keep their security cover for six months after retiring from office. But several have kept their security cover much longer.
"We are examining the cases of former home secretary V.K. Duggal and former national security adviser Brajesh Mishra," said a senior home ministry official.
Last year while hearing public interest litigation on the security provided to VIPs, a division bench of the Delhi High Court headed by Chief Justice Ajit Prakash Shah and Justice S. Muralildhar came down heavily on the government.
The judges said: "We cannot appreciate this. You have made a mockery of the threat perception. The common man is dying in the streets of Delhi and old couples are being strangulated due to lack of security."
Officials pointed out that the government spends over Rs.250 crore (Rs.2.5 billion) annually for the protection of VIPs.
VIP security is broken up into four levels -- Z plus for the top of the heap, followed by Z, Y and X categories. According to ministry officials, Home Minister P. Chidambaram may have to take the tough call of pruning security. "Considering that he moves around with minimal security, he has set the precedent," said a senior official.
Over 9,000 personnel, mainly from Delhi Police, supplemented by hundreds of paramilitary personnel drawn from forces like the Central Reserve Police Force (CRPF), Indo-Tibetan Border Police (ITBP) and the Central Industrial Security Force (CISF), provide security to the VIPs.
The number of armed bodyguards has often been seen as a status symbol in the capital, the major reason why VIPs are so reluctant to have their security cover reduced. Appraisals of all the people protected that the home ministry periodically reviews after receiving inputs from the Intelligence Bureau have revealed that many of them do not require security as the threat perception simply does not exist.
But despite arriving at this finding of many people not facing any threat from either terrorists or criminal groups there has hardly been any case of security being downgraded or removed in the last five years.
"We have had two more appraisal meetings and now the file will move to the home secretary, G.K. Pillai. But I guess the final call will have to be taken by the minister," a top intelligence functionary, who could not be identified, told IANS.
The intelligence establishment reckons that if its recommendations were accepted then only 100 VIPs in the capital would be left with the security cover.
According to senior home ministry officials many VIPs including politicians, former bureaucrats, judges, religious leaders, lawyers, ministers and a few journalists have persisted with their security cover for years because of the pressure they bring to bear on the establishment.
Highly placed home ministry officials told IANS that there were now no known threats to former Jammu and Kashmir governor G.C. Saxena, former union minister and Jammu and Kashmir governor Jagmohan and Punjab Kesri editor Ashwani Kumar Minna.
Former bureaucrats who have held sensitive positions are allowed to keep their security cover for six months after retiring from office. But several have kept their security cover much longer.
"We are examining the cases of former home secretary V.K. Duggal and former national security adviser Brajesh Mishra," said a senior home ministry official.
Last year while hearing public interest litigation on the security provided to VIPs, a division bench of the Delhi High Court headed by Chief Justice Ajit Prakash Shah and Justice S. Muralildhar came down heavily on the government.
The judges said: "We cannot appreciate this. You have made a mockery of the threat perception. The common man is dying in the streets of Delhi and old couples are being strangulated due to lack of security."
Officials pointed out that the government spends over Rs.250 crore (Rs.2.5 billion) annually for the protection of VIPs.
VIP security is broken up into four levels -- Z plus for the top of the heap, followed by Z, Y and X categories. According to ministry officials, Home Minister P. Chidambaram may have to take the tough call of pruning security. "Considering that he moves around with minimal security, he has set the precedent," said a senior official.
By Dene Mackenzie on Thu, 23 Jul 2009
Complications - are caused directly by the virus. No secondary bacterial infection. 1. Arthralgia and polyarthritis - usually in young women with involvement of small joints of hands or feet, at times larger joints. Arthritis may be accompanied by tenosynovitis and peripheral neuritis. 2. Encephalitis - Rare, affects adults more frequently and develops usually within a day or two of the appearance of rash. 3. Guillain-Barre syndrome. 4. Thrombocytopenic purpura - appears after about a week and may occasionally persist for several months. 5. Hepatitis. Diagnosis - 1. By Dene Mackenzie on Thu, 23 Jul 2009
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
(b) All female adults are screened when they reach child-bearing age and are immunized if non-immune with monovalent rubella vaccine. (c) Routine screening and immunization in immediate postnatal period. Immunized mothers excrete the vaccine virus in breast milk, but this is not a contraindication to vaccination or breast-feeding. Congenital rubella syndrome Pathogenesis - The foetus is infected during maternal viremia and the virus gains access to foetal tissues, causing a cytopathic effect or merely promoting an immune response. Defects - The consequences of rubella in pregnancy are varied and unpredictable, ranging from foetal death to birth of an infected but otherwise normal child. 1. TEMPORARY DEFECT - if cytopathic damage to non-organ tissue: (a) Thrombocytopenic purpura. - at birth or shortly after. (b) Hepatosplenomegaly. (c) Hepatitis. (d) Low birth weight. 2. PERMANENT DAMAGE - (Triad of Gregg) if cytopathic effect early in organogenesis: (a) Cataracts and retinopathy. (b) Microcephaly. (c) Congenital heart defects (PDA with or without PS most common) LATE CONGENITAL RUBELLA In some infants, particularly those infected after the first trimester, there is no obvious congenital defect, but the infant sheds the virus. In this group, late congenital rubella features include: 1. Growth retardation. 2: Behaviour disorders. 3. Psychiatric manifestations. 4. High-tone deafness. 5. Insulin-dependent diabetes mellitus PROCEDURES TO BE ADOPTED IN A PREGNANT WOMAN - (a) Suspicion of having rubella-Accurate diagnosis should be established by serological tests. If HAI antibody is present, explain the degree of risk to the patient and decide about termination of pregnancy. (b) Suspicion of having been in contact with rubella - (i) If possible, confirm the diagnosis by serological studies on the original case. (ii) If contact is close and the pregnant woman has decided to continue with pregnancy give 1500 mg. of immunoglobulin IM as soon as primary sample of serum is obtained. If there is no detectable antibody, give further 1500 mg. immunoglobulin within 3-4 days (iii) If she does not want to continue with pregnancy, or if the contact is not close, do not give immunoglobulin. (iv) In either case, take a second sample of blood after 3-4 weeks to see if there has been sera-conversion. The risk to the foetus when the mother has a subclinical attack is not known with certainty but appears to be slight. Should the mother develop an illness with serological evidence of rubella, the risks should be explained and decision taken about termination of pregnancy. 7. CHICKEN POX Epidemiology- Age - Primarily children, uncommon in adults in whom the disease tends to be more severe. Causative agent - Virus is identical to virus of herpes zoster and hence designated varicella zoster virus (V-Z virus). Transmission - Droplet discharges from air passages. May be direct skin contact or by recently contaminated utensils. Incubation period - 14 to 15 days. Period of infectivity - From 7 days before onset of rash until 6 days after development of last vesicle. Clinical features - Stage of invasion or pradramata - not constant. Headache, sore throat and fever for 24 hours. Prodromal rashes - Erythmatous, scahatiniform, morbilliform or urticarial. Rarely hemorrhagic. Stage of eruption -1 ENANTHEM - Earliest lesions on buccal and pharyngeal mucosa 2. EXANTHEM - (a) Evolution - in crops; at first back, then chest, abdomen, face, and lastly limbs. (b) Character - At first macule, in few hours dark pink papule which soon turns into vesicle - (i) superficial i e 'on' rather than 'In' the skin (glass pox), (ii) elliptical or oval ("tear drop" vesicles) with axis parallel to ribs, (iii) unilocular, hence collapse if pierced with needle. Vesicles turn into pustules in 24 hours. Scabs in 2 to 5 days. (c) Distribution-centripetal, i.e. more on upper arms and thighs and upper part of face, and in concavities and flexures. Less commonly lesions on genital mucous membranes, conjunctivae and cornea. (d) Crapping - Rash matures very quickly and most spots dry up within 48 hours of
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
(b) All female adults are screened when they reach child-bearing age and are immunized if non-immune with monovalent rubella vaccine. (c) Routine screening and immunization in immediate postnatal period. Immunized mothers excrete the vaccine virus in breast milk, but this is not a contraindication to vaccination or breast-feeding. Congenital rubella syndrome Pathogenesis - The foetus is infected during maternal viremia and the virus gains access to foetal tissues, causing a cytopathic effect or merely promoting an immune response. Defects - The consequences of rubella in pregnancy are varied and unpredictable, ranging from foetal death to birth of an infected but otherwise normal child. 1. TEMPORARY DEFECT - if cytopathic damage to non-organ tissue: (a) Thrombocytopenic purpura. - at birth or shortly after. (b) Hepatosplenomegaly. (c) Hepatitis. (d) Low birth weight. 2. PERMANENT DAMAGE - (Triad of Gregg) if cytopathic effect early in organogenesis: (a) Cataracts and retinopathy. (b) Microcephaly. (c) Congenital heart defects (PDA with or without PS most common) LATE CONGENITAL RUBELLA In some infants, particularly those infected after the first trimester, there is no obvious congenital defect, but the infant sheds the virus. In this group, late congenital rubella features include: 1. Growth retardation. 2: Behaviour disorders. 3. Psychiatric manifestations. 4. High-tone deafness. 5. Insulin-dependent diabetes mellitus PROCEDURES TO BE ADOPTED IN A PREGNANT WOMAN - (a) Suspicion of having rubella-Accurate diagnosis should be established by serological tests. If HAI antibody is present, explain the degree of risk to the patient and decide about termination of pregnancy. (b) Suspicion of having been in contact with rubella - (i) If possible, confirm the diagnosis by serological studies on the original case. (ii) If contact is close and the pregnant woman has decided to continue with pregnancy give 1500 mg. of immunoglobulin IM as soon as primary sample of serum is obtained. If there is no detectable antibody, give further 1500 mg. immunoglobulin within 3-4 days (iii) If she does not want to continue with pregnancy, or if the contact is not close, do not give immunoglobulin. (iv) In either case, take a second sample of blood after 3-4 weeks to see if there has been sera-conversion. The risk to the foetus when the mother has a subclinical attack is not known with certainty but appears to be slight. Should the mother develop an illness with serological evidence of rubella, the risks should be explained and decision taken about termination of pregnancy. 7. CHICKEN POX Epidemiology- Age - Primarily children, uncommon in adults in whom the disease tends to be more severe. Causative agent - Virus is identical to virus of herpes zoster and hence designated varicella zoster virus (V-Z virus). Transmission - Droplet discharges from air passages. May be direct skin contact or by recently contaminated utensils. Incubation period - 14 to 15 days. Period of infectivity - From 7 days before onset of rash until 6 days after development of last vesicle. Clinical features - Stage of invasion or pradramata - not constant. Headache, sore throat and fever for 24 hours. Prodromal rashes - Erythmatous, scahatiniform, morbilliform or urticarial. Rarely hemorrhagic. Stage of eruption -1 ENANTHEM - Earliest lesions on buccal and pharyngeal mucosa 2. EXANTHEM - (a) Evolution - in crops; at first back, then chest, abdomen, face, and lastly limbs. (b) Character - At first macule, in few hours dark pink papule which soon turns into vesicle - (i) superficial i e 'on' rather than 'In' the skin (glass pox), (ii) elliptical or oval ("tear drop" vesicles) with axis parallel to ribs, (iii) unilocular, hence collapse if pierced with needle. Vesicles turn into pustules in 24 hours. Scabs in 2 to 5 days. (c) Distribution-centripetal, i.e. more on upper arms and thighs and upper part of face, and in concavities and flexures. Less commonly lesions on genital mucous membranes, conjunctivae and cornea. (d) Crapping - Rash matures very quickly and most spots dry up within 48 hours of
Investing your windfall
By Dene Mackenzie on Thu, 23 Jul 2009
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
Economic downturn Living smart
Paying off a mortgage and/or any debt should be a priority for anyone inheriting money during the current recession, a panel of experts selected by the Otago Daily Times recommends.
ABN Amro Craigs sharebroker Chris Timms, wealth management adviser Craig Myles, Forsyth Barr sharebroker Peter Young and financial planner Peter Smith were asked by the newspaper to provide some guidance to two selected groups - a family with three children, parents 35 years old, and with a $100,000 mortgage; and a couple aged 55, with children who had left home, and who had three grandchildren.
Each family was assumed to have inherited $350,000.
Arthralgia and polyarthritis - usually in young women with involvement of small joints of hands or feet, at times larger joints. Arthritis may be acco
Complications - are caused directly by the virus. No secondary bacterial infection. 1. Arthralgia and polyarthritis - usually in young women with involvement of small joints of hands or feet, at times larger joints. Arthritis may be accompanied by tenosynovitis and peripheral neuritis. 2. Encephalitis - Rare, affects adults more frequently and develops usually within a day or two of the appearance of rash. 3. Guillain-Barre syndrome. 4. Thrombocytopenic purpura - appears after about a week and may occasionally persist for several months. 5. Hepatitis. Diagnosis - 1. Virus isolation - Virus may be recovered from nasopharynx, blood, urine and stools. Inoculated into tissue cultures. 2. Serological tests - (a) Haemagglutination-inhtibition test - HAI antibody level rises within 24-18 hours, reaches a peak in 6-12 days and persists for a long time. (b) Complement fixation test -Determination of rubella-specific IgM or IgA antibody if there is delay in obtaining blood sample. Treatment - Bed rest and analgesics suffice for the uncomplicated attack. Rubella proven by antibody estimation in first 4 months of pregnancy is a strong indication for termination. PREVENTION - Rubella immunization: (a) Combined measles, mumps and rubella (MMR) vaccine is given routinely to all children in second year of life. (b) All female adults are screened when they reach child-bearing age and are immunized if non-immune with monovalent rubella vaccine. (c) Routine screening and immunization in immediate postnatal period. Immunized mothers excrete the vaccine virus in breast milk, but this is not a contraindication to vaccination or breast-feeding. Congenital rubella syndrome Pathogenesis - The foetus is infected during maternal viremia and the virus gains access to foetal tissues, causing a cytopathic effect or merely promoting an immune response. Defects - The consequences of rubella in pregnancy are varied and unpredictable, ranging from foetal death to birth of an infected but otherwise normal child. 1. TEMPORARY DEFECT - if cytopathic damage to non-organ tissue: (a) Thrombocytopenic purpura. - at birth or shortly after. (b) Hepatosplenomegaly. (c) Hepatitis. (d) Low birth weight. 2. PERMANENT DAMAGE - (Triad of Gregg) if cytopathic effect early in organogenesis: (a) Cataracts and retinopathy. (b) Microcephaly. (c) Congenital heart defects (PDA with or without PS most common) LATE CONGENITAL RUBELLA In some infants, particularly those infected after the first trimester, there is no obvious congenital defect, but the infant sheds the virus. In this group, late congenital rubella features include: 1. Growth retardation. 2: Behaviour disorders. 3. Psychiatric manifestations. 4. High-tone deafness. 5. Insulin-dependent diabetes mellitus PROCEDURES TO BE ADOPTED IN A PREGNANT WOMAN - (a) Suspicion of having rubella-Accurate diagnosis should be established by serological tests. If HAI antibody is present, explain the degree of risk to the patient and decide about termination of pregnancy. (b) Suspicion of having been in contact with rubella - (i) If possible, confirm the diagnosis by serological studies on the original case. (ii) If contact is close and the pregnant woman has decided to continue with pregnancy give 1500 mg. of immunoglobulin IM as soon as primary sample of serum is obtained. If there is no detectable antibody, give further 1500 mg. immunoglobulin within 3-4 days (iii) If she does not want to continue with pregnancy, or if the contact is not close, do not give immunoglobulin. (iv) In either case, take a second sample of blood after 3-4 weeks to see if there has been sera-conversion. The risk to the foetus when the mother has a subclinical attack is not known with certainty but appears to be slight. Should the mother develop an illness with serological evidence of rubella, the risks should be explained and decision taken about termination of pregnancy. 7. CHICKEN POX Epidemiology- Age - Primarily children, uncommon in adults in whom the disease tends to be more severe. Causative agent - Virus is identical to virus of herpes zoster and hence designated varicella zoster virus (V-Z virus). Transmission - Droplet discharges from air passages. May be direct skin contact or by recently contaminated utensils. Incubation period - 14 to 15 days. Period of infectivity - From 7 days before onset of rash until 6 days after development of last vesicle. Clinical features - Stage of invasion or pradramata - not constant. Headache, sore throat and fever for 24 hours. Prodromal rashes - Erythmatous, scahatiniform, morbilliform or urticarial. Rarely hemorrhagic. Stage of eruption -1 ENANTHEM - Earliest lesions on buccal and pharyngeal mucosa 2. EXANTHEM - (a) Evolution - in crops; at first back, then chest, abdomen, face, and lastly limbs. (b) Character - At first macule, in few hours dark pink papule which soon turns into vesicle - (i) superficial i e 'on' rather than 'In' the skin (glass pox), (ii) elliptical or oval ("tear drop" vesicles) with axis parallel to ribs, (iii) unilocular, hence collapse if pierced with needle. Vesicles turn into pustules in 24 hours. Scabs in 2 to 5 days. (c) Distribution-centripetal, i.e. more on upper arms and thighs and upper part of face, and in concavities and flexures. Less commonly lesions on genital mucous membranes, conjunctivae and cornea. (d) Crapping - Rash matures very quickly and most spots dry up within 48 hours of
UPDATE 1-Exelon earnings drop but top forecasts
Adj Q2 EPS of $1.03 tops Wall St. view of 99 cts
* Reaffirms full-year earnings forecast
* Shares slip in pre-market trade
NEW YORK, July 24 (Reuters) - Power company Exelon Corp (EXC.N), which earlier this week withdrew a hostile takeover bid for NRG Energy Inc (NRG.N), posted a 12 percent drop in second-quarter earnings on slack demand for electricity and higher costs for nuclear fuel.
Net earnings fell to $657 million, or 99 cents per share, from $748 million, or $1.13 per share, in the year-ago quarter.
Adjusted earnings for the quarter of $1.03 topped analysts' average forecast of 97 cents per share, according to Reuters Estimates.
The company, which owns the PECO utility in Pennsylvania and ComEd in Chicago, reaffirmed its expectation that it would earn an adjusted $4.00 per share to $4.30 per share for the full year.
Third quarter adjusted earnings are expected to be between 90 cents per share and $1.00 per share.
Shares in Exelon slipped 0.5 percent to $53.75 per share in premarket trading. (Reporting by Matt Daily, editing by Gerald E. McCormick
* Reaffirms full-year earnings forecast
* Shares slip in pre-market trade
NEW YORK, July 24 (Reuters) - Power company Exelon Corp (EXC.N), which earlier this week withdrew a hostile takeover bid for NRG Energy Inc (NRG.N), posted a 12 percent drop in second-quarter earnings on slack demand for electricity and higher costs for nuclear fuel.
Net earnings fell to $657 million, or 99 cents per share, from $748 million, or $1.13 per share, in the year-ago quarter.
Adjusted earnings for the quarter of $1.03 topped analysts' average forecast of 97 cents per share, according to Reuters Estimates.
The company, which owns the PECO utility in Pennsylvania and ComEd in Chicago, reaffirmed its expectation that it would earn an adjusted $4.00 per share to $4.30 per share for the full year.
Third quarter adjusted earnings are expected to be between 90 cents per share and $1.00 per share.
Shares in Exelon slipped 0.5 percent to $53.75 per share in premarket trading. (Reporting by Matt Daily, editing by Gerald E. McCormick
Frusemide 1g/day may be needed to produce naturesis and reduce oedema. If diuresis is too vigorous, it may precipitate circulatory collapse and acute
insignificant. (b) Diuretics - Frusemide 1g/day may be needed to produce naturesis and reduce oedema. If diuresis is too vigorous, it may precipitate circulatory collapse and acute renal failure. The possibility can be anticipitated by infusion of 'salt-poor1 albumin to maintain plasma volume. (c) Hypehipidemia - There is increased incidence of cardio-vascular disease when proteinuria is heavy and prolonged Hydroxymethyl glutaryl co-enzyme A (HMG CoA) reductase inhibitors may be helpful. (d) Antibiotics - Prophylactic antibiotics should be given against possible pneumococcal peritonitis andsepticemia MANAGEMENT OF RFLAPSE - Relapses may be associated with bacterial or viral infection especially of upper respiratory tract. Treatment consists of - (a) Corticosteroids - for infrequent relapses and if the disease remains sensitive to steroid therapy. The drug may be given as a continuous low dosage regime, each patient should be 'titrated' for the lowest effective dose (usually 5-15 mg/day). This may eliminate the need for giving ACTH, or alternate day steroid schedule to prevent the most important side effect of steroids in children namely growth failure. (b) Cytotoxic drugs - in those who suffer frequent relapses Cyclophosphamide 1.5-2.5 mg/kg/day for 8 weeks induces stable remission averaging about 3 years. Leucocyte count should be checked weekly. Immediate toxicity of the drug is negligible but there may be long-term effects. II. With diffuse membranous glomerulonephritis -Long term outlook is poor. Prednisolone 120 mg on alternate days may result in improved renal function Dipyridamole, warfarin and cyclophosphamide may also produce significant fall in urine protein, rise in serum albumin and improvement in creatinine clearance. 5. RECURRENT HEMATURIA - yndrome dominated by episodes of macroscopic hematuria, at times associated with loin pain and with tendency to exacerbations following viral upper respiratory infections or strenuous exercise. It most commonly affects boys and young males. Microscopic hematuria persists inbetween attacks and protenuria absent or moderate. Renal pathology in most cases is IgA nephropathy (Berger's disease) Course is often benign, some patients tend to develop progressive renal disease Treatment - None specific. 6. PERSISTENT ASYMPTOMATIC PROTEINURIA AND/OR HEMATURIA - in an apparently healthy person is detected on routine medical examination Causes - (a) Primary glomerulardisease - Mesangial proliferative GN, mesangiocapillary GN, membranous GN, focal segmental glomerulosclerosis (b) Multisystem disease - SLE, Henoch-Schonlein purpura (c) Miscellaneous - (i) Renal - Tumors, cystic disease of kidney, renal tuberculosis, tubointerstitial nephropathy. (ii) Non-renal - Urothelial tumors, prostatic disease Investigations -Assessment of renal structure and function including urine microscopy and culture, IVU and ultrasound. Renal biopsy if evidence of disease progression, particular/ if the process is amenable to therapy. 7. HYPERTENSION - Incidence of hypertension in patients with renal disease rises as renal function declines. Two major mechanisms are responsible. (a) Raised BP as a result of renal or renal vascular disease - (i) Increase in body sodium and water content. (ii) Inappropriately increased activity of the renin-angiotensin aldosterone system. (b) Renal damage as consequence of raised BP- The effect of hypertension depends on whether the raised pressure is in the benign phase or accelerated phase. In the latter, rapid progression to renal failure is the rule. 4. ACUTE RENAL FAILURE (ARF) Definition - ARF may be defined as an sudden fall in glomerular filtration rate sufficient to cause uremia. Oliguria (<>
UPDATE 2-American Express Q2 earnings fall, shares down
EPS 9 cents
* Revenue falls 18 percent to $6.1 bln
* Shares decline 5 percent in after-hours trading (Adds Reuters Estimates, financial details, CEO comments)
By Juan Lagorio
NEW YORK, July 23 (Reuters) - American Express Co (AXP.N), the largest credit card company by sales, reported quarterly earnings that fell in line with expectations on Thursday, hurt by weakness in cardmember spending, record credit losses, restructuring charges and the repayment of government funds.
Net income fell to $337 million, or 9 cents per share, from $653 million, or 56 cents per share, a year earlier.
Earnings from continuing operations declined to $342 million or 9 cents per share from $660 million or 56 cents in the same quarter last year.
The results included a reduction of 18 cents per share related to the repurchase of preferred shares from the U.S. Treasury Department.
Excluding that charge, earnings per share were in line with analysts expectations of 27 cents, according to Reuters Estimates.
Total revenue fell 18 percent to $6.1 billion, while consolidated expenses fell 16 percent to $4.1 billion, helped by a restructuring plan.
In the U.S. card service business, net charge-offs -- a measure of bad loan write-offs -- rose to 10.0 percent from 8.5 percent in the previous quarter.
"Although it is still too early to point to any sure signs of an economic recovery, the number of cardmembers who are falling behind in their payments, the volume of bankruptcy filings and the level of loan write-offs were better than we had expected," Chief Executive Kenneth Chenault said in a statement.
Provisions for losses decreased 22 percent to $1.2 billion.
American Express shares fell 5 percent to $27.99 in after-hours trading after closing at $29.45 on the New York Stock Exchange. (Reporting by Juan Lagorio; Editing by Phil Berlowitz)
Malaysian shares seen down next week: Analyst
KUALA LUMPUR: Malaysian share prices are expected to drop next week following recent rallies, an analyst said Friday."There have been rallies for the past eight or nine days -- the market is becoming more and more overbought so we are looking at a healthy correction," Stephen Soo, technical analyst with local brokerage TA Securities, told AFP. "We also expect the blue-chips to consolidate," he added. Soo said he expected the bourse to trade between 1,165 and 1,188 points next week. For the week to July 24, the Kuala Lumpur Composite Index gained 34.98 points, or 3.12 percent, to close at 1,155.88.
* Revenue falls 18 percent to $6.1 bln
* Shares decline 5 percent in after-hours trading (Adds Reuters Estimates, financial details, CEO comments)
By Juan Lagorio
NEW YORK, July 23 (Reuters) - American Express Co (AXP.N), the largest credit card company by sales, reported quarterly earnings that fell in line with expectations on Thursday, hurt by weakness in cardmember spending, record credit losses, restructuring charges and the repayment of government funds.
Net income fell to $337 million, or 9 cents per share, from $653 million, or 56 cents per share, a year earlier.
Earnings from continuing operations declined to $342 million or 9 cents per share from $660 million or 56 cents in the same quarter last year.
The results included a reduction of 18 cents per share related to the repurchase of preferred shares from the U.S. Treasury Department.
Excluding that charge, earnings per share were in line with analysts expectations of 27 cents, according to Reuters Estimates.
Total revenue fell 18 percent to $6.1 billion, while consolidated expenses fell 16 percent to $4.1 billion, helped by a restructuring plan.
In the U.S. card service business, net charge-offs -- a measure of bad loan write-offs -- rose to 10.0 percent from 8.5 percent in the previous quarter.
"Although it is still too early to point to any sure signs of an economic recovery, the number of cardmembers who are falling behind in their payments, the volume of bankruptcy filings and the level of loan write-offs were better than we had expected," Chief Executive Kenneth Chenault said in a statement.
Provisions for losses decreased 22 percent to $1.2 billion.
American Express shares fell 5 percent to $27.99 in after-hours trading after closing at $29.45 on the New York Stock Exchange. (Reporting by Juan Lagorio; Editing by Phil Berlowitz)
Malaysian shares seen down next week: Analyst
KUALA LUMPUR: Malaysian share prices are expected to drop next week following recent rallies, an analyst said Friday."There have been rallies for the past eight or nine days -- the market is becoming more and more overbought so we are looking at a healthy correction," Stephen Soo, technical analyst with local brokerage TA Securities, told AFP. "We also expect the blue-chips to consolidate," he added. Soo said he expected the bourse to trade between 1,165 and 1,188 points next week. For the week to July 24, the Kuala Lumpur Composite Index gained 34.98 points, or 3.12 percent, to close at 1,155.88.
Deltoids are usually spared and may appear enlarged due to severe atrophy of upper arm muscles. Pelvic girdle musculature usually becomes affected at
dystrophy - Either sex. Onset usually in third decade. (i) Pelvifemoral form - Weakness begins in pelvic girdle musculature (psoas, glutei and quadriceps) and results in waddling lordotic gait with difficulty in climbing stairs. Winging of scapulae. (ii) Scapulohumeral form- Weakness confined initially to shoulder girdle and upper arm muscles. Deltoids are usually spared and may appear enlarged due to severe atrophy of upper arm muscles. Pelvic girdle musculature usually becomes affected at a later stage. The disease runs a variable course leading to severe disability in fourth or fifth decade. CPK is elevated and muscle biopsy shows non-specific dystrophic changes. (b) Scapuloperoneal muscular dystrophy - Presents in early adult life with foot drop due to weakness of anterior tibial and peroneal groups. Extensor digitorum muscle is characteristically spared and may be hypertrophied. The disease runs a benign course. Wasting and weakness in upper limbs is initially confined to scapular muscles but later spreacte to involve biceps, triceps, forearm extensors and sometimes small muscles of hand. (c) Congenital muscular dystrophy - One of the causes of the floppy infant. Myopathy manifests at birth or early life. Small, weak, hypotonic muscles, proximal usually more affected than distal. Both sexes (3) Autosomal dominant muscular dystrophy - (a) Facioscapulohumeral dystrophy - Either sex. Onset usually in adolescence. Initial involvement, sometimes symmetrical, of facial and shoulder-girdle muscles, soon followed by weakness of anterior tibial and peroneal muscles, usually with spread within 20 or 30 years to pelvic muscles. Profound facial weakness produces pouting of the lips and a transverse smile. Slow insidious progression with periods of long arrest of the disease. (b) Distal muscular dystrophy of Welander - Very rare Presents with slowly progressive, predominantly distal wasting and weakness. Muscle biopsy similar to myotonic dystrophy. (c) Ocular and oculopharyngeal muscular dystrophy - Presents in adult life with ptosis and extraocular weakness, usually without significant diplopia. Dysphagia is prominent in some families. Face and sternomastoicte are commonly affected and most patients develop weakness in the legs. Relatively benign course. Muscle biopsy shows vacuolar changes. Management - None specific. Principles are to treat complications such as respiratory and urinary infection if and when they occur, to avoid trauma which may easily result in fracture of limb bones and to keep the patient active as long as possible. II. Myotonic disorders -Failure of voluntary muscles to relax immediately innervation ceases. 1. MYOTONIC DYSTROPHY (Dystrophia myotonica) - (i) Onset - Most patients present in adult life with distal weakness and wasting in upper or lower limbs. (ii) Muscle weakness/wasting - (a) Myopathic facies - Ptosis, hanging jaw, haggard appearance, temporal wasting. (b) Weakness of neck flexion, wasting of sternomastoicte. (c) Distal limb weakness with wasted brachioradialis. 3. Frontal baldness. Hyperostosis frontalis interna. 4. Cataracts (post. subcapsular) 5. Cardiac conduction defects (Heart block, at rial arrhythmias). Cardiomyopathy. 6. Hypoventilation, post-an aesthetic respiratory failure. 7. Hypersomnolence, mental retardation. 8. Hypogammaglobulinemia. 9. End-organ resistance to insulin (Impaired glucose tolerance). 10. Dysphagia, oesophageal dilatation. Investigations - (a) CPK - Normal or slightly elevated. (b) EMG - Characteristic myopathic picture with myotonic discharges. (c) Muscle biopsy - Chains of central nuclei, marked variation of
UPDATE 4-Starwood Q2 profit beats Street, shares surge
Adjusted 22 cents EPS vs. 17 cents consensus
* Cuts 2009 full-year outlook
* In discussions to sell non-core assets
* Shares jump over 9 percent (Adds CEO, CFO comment from earnings call, information on supply pipeline, updates shares)
By Deepa Seetharaman
NEW YORK, July 23 (Reuters) - Starwood Hotels & Resorts Inc (HOT.N) posted a better-than-expected profit on Thursday, buoyed by cost cuts, and its shares rose over 9 percent.
Costs and expenses for the second quarter fell by about one-fifth, driven by a more than 30 percent drop in general and administrative costs.
"We continue to beat expectations on cost containment," said Chief Executive Frits van Paasschen during a conference call with analysts.
The majority of those savings are sustainable, with the exception of one-time items and a reduction in bonuses to hotel managers this year, van Paasschen noted.
Shares rose $2.00, or 9.4 percent, to $22.28 in afternoon trading. Rival Marriott International Inc's (MAR.N) stock gained 6 percent, while Host Hotels & Resorts Inc (HST.N), which owns several Starwood properties, saw its stock gain 9 percent.
Starwood reported net income of $134 million, or 74 cents per share, compared with the year-earlier $105 million, or 56 cents per share.
The 28 percent jump in net profit was fueled a gain from a tax incentive program in Italy. Excluding that gain and $26 million in other charges, Starwood earned 22 cents a share.
The results surpassed analyst expectations of 17 cents per share, according to Reuters Estimates.
Revenue fell 23.4 percent to $1.2 billion, slightly lower than analysts' forecast.
But the hotelier, which operates the St. Regis, W and Sheraton chains, also cut its full-year outlook and offered third-quarter estimates that fell far short of analyst expectations.
Chief Financial Officer Vasant Prabhu during the call noted that business was stabilizing, but recovery remains slow.
* Cuts 2009 full-year outlook
* In discussions to sell non-core assets
* Shares jump over 9 percent (Adds CEO, CFO comment from earnings call, information on supply pipeline, updates shares)
By Deepa Seetharaman
NEW YORK, July 23 (Reuters) - Starwood Hotels & Resorts Inc (HOT.N) posted a better-than-expected profit on Thursday, buoyed by cost cuts, and its shares rose over 9 percent.
Costs and expenses for the second quarter fell by about one-fifth, driven by a more than 30 percent drop in general and administrative costs.
"We continue to beat expectations on cost containment," said Chief Executive Frits van Paasschen during a conference call with analysts.
The majority of those savings are sustainable, with the exception of one-time items and a reduction in bonuses to hotel managers this year, van Paasschen noted.
Shares rose $2.00, or 9.4 percent, to $22.28 in afternoon trading. Rival Marriott International Inc's (MAR.N) stock gained 6 percent, while Host Hotels & Resorts Inc (HST.N), which owns several Starwood properties, saw its stock gain 9 percent.
Starwood reported net income of $134 million, or 74 cents per share, compared with the year-earlier $105 million, or 56 cents per share.
The 28 percent jump in net profit was fueled a gain from a tax incentive program in Italy. Excluding that gain and $26 million in other charges, Starwood earned 22 cents a share.
The results surpassed analyst expectations of 17 cents per share, according to Reuters Estimates.
Revenue fell 23.4 percent to $1.2 billion, slightly lower than analysts' forecast.
But the hotelier, which operates the St. Regis, W and Sheraton chains, also cut its full-year outlook and offered third-quarter estimates that fell far short of analyst expectations.
Chief Financial Officer Vasant Prabhu during the call noted that business was stabilizing, but recovery remains slow.
The disease runs a variable course leading to severe disability in fourth or fifth decade. CPK is elevated and muscle biopsy shows non-specific dystro
dystrophy - Either sex. Onset usually in third decade. (i) Pelvifemoral form - Weakness begins in pelvic girdle musculature (psoas, glutei and quadriceps) and results in waddling lordotic gait with difficulty in climbing stairs. Winging of scapulae. (ii) Scapulohumeral form- Weakness confined initially to shoulder girdle and upper arm muscles. Deltoids are usually spared and may appear enlarged due to severe atrophy of upper arm muscles. Pelvic girdle musculature usually becomes affected at a later stage. The disease runs a variable course leading to severe disability in fourth or fifth decade. CPK is elevated and muscle biopsy shows non-specific dystrophic changes. (b) Scapuloperoneal muscular dystrophy - Presents in early adult life with foot drop due to weakness of anterior tibial and peroneal groups. Extensor digitorum muscle is characteristically spared and may be hypertrophied. The disease runs a benign course. Wasting and weakness in upper limbs is initially confined to scapular muscles but later spreacte to involve biceps, triceps, forearm extensors and sometimes small muscles of hand. (c) Congenital muscular dystrophy - One of the causes of the floppy infant. Myopathy manifests at birth or early life. Small, weak, hypotonic muscles, proximal usually more affected than distal. Both sexes. (3) Autosomal dominant muscular dystrophy - (a) Facioscapulohumeral dystrophy - Either sex. Onset usually in adolescence. Initial involvement, sometimes symmetrical, of facial and shoulder-girdle muscles, soon followed by weakness of anterior tibial and peroneal muscles, usually with spread within 20 or 30 years to pelvic muscles. Profound facial weakness produces pouting of the lips and a transverse smile. Slow insidious progression with periods of long arrest of the disease. (b) Distal muscular dystrophy of Welander - Very rare. Presents with slowly progressive, predominantly distal wasting and weakness. Muscle biopsy similar to myotonic dystrophy. (c) Ocular and oculopharyngeal muscular dystrophy - Presents in adult life with ptosis and extraocular weakness, usually without significant diplopia. Dysphagia is prominent in some families. Face and sternomastoicte are commonly affected and most patients develop weakness in the legs. Relatively benign course. Muscle biopsy shows vacuolar changes. Management - None specific. Principles are to treat complications such as respiratory and urinary infection if and when they occur, to avoid trauma which may easily result in fracture of limb bones and to keep the patient active as long as possible. II. Myotonic disorders -Failure of voluntary muscles to relax immediately innervation ceases. 1. MYOTONIC DYSTROPHY (Dystrophia myotonica) - (i) Onset - Most patients present in adult life with distal weakness and wasting in upper or lower limbs. (ii) Muscle weakness/wasting - (a) Myopathic facies - Ptosis, hanging jaw, haggard appearance, temporal wasting. (b) Weakness of neck flexion, wasting of sternomastoicte. (c) Distal limb weakness with wasted brachioradialis. 3. Frontal baldness. Hyperostosis frontalis interna. 4. Cataracts (post. subcapsular) 5. Cardiac conduction defects (Heart block, at rial arrhythmias). Cardiomyopathy. 6. Hypoventilation, post-an aesthetic respiratory failure. 7. Hypersomnolence, mental retardation. 8. Hypogammaglobulinemia. 9. End-organ resistance to insulin (Impaired glucose tolerance). 10. Dysphagia, oesophageal dilatation. Investigations - (a) CPK - Normal or slightly elevated. (b) EMG - Characteristic myopathic picture with myotonic discharges. (c) Muscle biopsy - Chains of central nuclei, marked variation of
Shares rose $3, or 6.7 percent, to $48.22 in morning trading
On Thursday the Kingsport, Tenn.-based company said its second-quarter profit fell 43 percent to $65 million, or 89 cents per share, well above the 71-cent estimate by analysts, according to a Thomson Reuters poll.
The company said it expects full-year earnings to be "toward the high end" of its previous guidance of between $2 and $3 per share. Analysts have projected earnings of $2.48 per share.
Deutsche Bank ( DB - news - people ) analyst Jason Minor said the second-quarter results underscored the company's operating strength.
With cost reductions gaining traction, volumes picking up and margins up sharply versus the first quarter, Eastman's second-quarter results highlighted its operating leverage as earnings again improved beyond expectations."
The company said it expects full-year earnings to be "toward the high end" of its previous guidance of between $2 and $3 per share. Analysts have projected earnings of $2.48 per share.
Deutsche Bank ( DB - news - people ) analyst Jason Minor said the second-quarter results underscored the company's operating strength.
With cost reductions gaining traction, volumes picking up and margins up sharply versus the first quarter, Eastman's second-quarter results highlighted its operating leverage as earnings again improved beyond expectations."
The contents of capsules other than Modified-release (Sustained-release) Capsules do not contain any added colouring agent. Hard Capsules: Hard capsul
fillers, wetting agents and disintegrating agents. The contents of capsules other than Modified-release (Sustained-release) Capsules do not contain any added colouring agent. Hard Capsules: Hard capsules contain the medicament(s) in the solid form. Where two mutually incompatible drugs are present in the mixture, one of the drugs can be put as a tablet or pellet or in small capsule and then enclosed with the other drug in a large capsule.Soft Capsules: Soft capsules shells are usually formed, filled with medicament and sealed in a combined operation on machines. In some cases, shells for extemporaneous use may be performed. The shells which are thicker than those of hard capsules are formed to produce capsules which are spherical, oval or cylindrical with hemispherical ends. The shells may sometimes contain a medicament. They may contain a preservative to prevent growth of fungi. The contents of soft capsules usually consist of liquids or solids dissolved or dispersed in suitable excipients to give a paste-like consistency but may also consist of powders or granules. As soft gelatin shells contain appreciable amounts of water, migration of capsule contents, particularly of% water-soluble ingredients, may occur. Modified-release Capsules: Modified-release (Sustained-release) Capsules are hard or soft capsules in which the contents or the shell, or both, contain auxiliary substances or are prepared by a special process designed to modify the rate at which the active ingredients are released Enteric Capsules: Enteric Capsules are hard or soft capsules prepared in such a manner that the shell resists the action of the gastric fluid but is attacked by the intestinal fluid to release the contents. STANDARDSContent of active ingredients: Determine the amount of active ingredient(s) by the method desctibed in the Assay and calculate the amount of active ingredient(s) in each capsule. The result lies within the range for the content of active ingredient(s) stated in the monograph. This range is based on the requirement that 20 capsules, or such other number as may be indicated in the monograph, are used in the Assay. Where 20 capsules cannot be obtained, a smaller number, which must not be less than 5, may be used, but to allow for sampling errors the tolerances are widened in accordance with Table 1. The requirements of Table 1 apply when the stated limits are between 90 and 110%. For limits other than 90 to 110%, proportionately smaller or larger allowances should be made. Uniformity of weight: This test is not applicable to capsules that are required to comply with the test for Uniformity of content for all active ingredients.Weigh an intact capsule. Open the capsule without losing any part of the shell and remove the contents as completely as possible. To remove the contents of a soft capsule the shell may be washed with ether or other suitable solvent and the shell allowed to stand until the odour of the solvent is no longer detectable. Weigh the shell. The weight of the contents is the difference between the weighings. Repeat the procedure with a further 19 capsules. Determine the average weight. Not more than two of the individual weights deviate from the average weight by more than the percentage deviation shown in Table 2 and none deviates by more than twice that percentage. TABLE 2Average weight of capsule Percentage deviation contents Less
Ford Price Target Raised at Goldman, Deutsche on Mulally Gains
Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said.
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s Patrick Archambault wrote in a July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote.
A rising share price may allow Ford to sell more stock, Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million shares in May, raising $1.6 billion.
Ford’s adjusted loss was 21 cents a share, excluding one- time costs and gains, narrower than the 50-cent average loss estimate among 12 analysts surveyed by Bloomberg. Net income was $2.26 billion, or 69 cents a share, primarily on a $3.4 billion non-cash gain resulting from shrinking debt.
Ford passed Toyota Motor Corp. for second place in U.S. market share through June, behind GM.
July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said.
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s Patrick Archambault wrote in a report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote. A rising share price may allow Ford to sell more stock, Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s Patrick Archambault wrote in a July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote.
A rising share price may allow Ford to sell more stock, Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million shares in May, raising $1.6 billion.
Ford’s adjusted loss was 21 cents a share, excluding one- time costs and gains, narrower than the 50-cent average loss estimate among 12 analysts surveyed by Bloomberg. Net income was $2.26 billion, or 69 cents a share, primarily on a $3.4 billion non-cash gain resulting from shrinking debt.
Ford passed Toyota Motor Corp. for second place in U.S. market share through June, behind GM.
July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said.
The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s Patrick Archambault wrote in a report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18 cents, or 2.6 percent, to $6.83 at 9:36 a.m. in New York Stock Exchange composite trading as U.S. stocks fell.
“Overall, we were impressed with the execution of Ford’s turnaround plan,” Lache wrote today, maintaining his “hold” rating. Ford’s North American region, its biggest, “appears to be on the right track.”
Mulally cut $10.1 billion from the Dearborn, Michigan-based automaker’s liabilities this year with a debt exchange and seeks union concessions to match those granted to General Motors Co. and Chrysler Group LLC in U.S.-backed bankruptcies. Smaller sales declines at Ford have helped boost U.S. market share.
Ford more than tripled this year through yesterday for the second-biggest advance in the Standard & Poor’s 500 stock index. The shares surged 9.4 percent yesterday after Ford’s second- quarter adjusted loss beat analysts’ estimates.
The results show Ford may be “best positioned to deliver” on auto industry “momentum,” wrote Archambault, who is based in New York and advises buying the shares. Mulally has reduced costs while also raising prices, Archambault wrote. A rising share price may allow Ford to sell more stock, Joseph Amaturo, a New York-based analyst for Buckingham Research Group, wrote today. He rates the stock as “neutral.” JPMorgan Chase & Co. and Credit Suisse Holdings USA Inc. made similar predictions last week. Ford issued 345 million
A The infra-red absorption spectrum, Appendix 5.4, is concordani wilh the reference spectrum of carbimazole or with the spectrum obtained from carbima
odour, characteristic Solubility Freely soluble in chloroform; soluble in acelone; sparingly soluble in ethanol (95%), slightly soluble in water and in ether Storage Store in well-closed containerst. STANDARDSCarbimazole contams not less than 98.5 per cent and not more than 100.5 per cent of C7H10N202S, calculated with reference to tne dried substance Idenlification A The infra-red absorption spectrum, Appendix 5.4, is concordani wilh the reference spectrum of carbimazole or with the spectrum obtained from carbimazole RS. B: Heat 0.2 g with 5 ml of dilule hydrochloric acid on a water-bath for 1 hour. Cool, extract with three quantities, each of 5 ml, of chloroform, wash he combined chloroform extracts with 0.5 ml of water, filter through a dry filter paper and remove the chloroform The residue, after crystallisation from ethanol (95%), melts at about 140°, Appendix 8.8. C: To a small quantity add 1 drop of dilute potassium iodobismuthate solution, a scarlet colour is produced. Methimazole: Carry out the method for thin-layer chromatography, Appendix 4.6, using silica gel G as the coating substance and a mixture of 80 volumes of chloroform and 20 volumes of acetone as the mobile phase. Apply separately to the plate 10 ul of eachof two solutions in chloroform containing (1) 1 0% w/v of the substance being examined and (2) 0005% w/v of methimazole RS and develop immediately. After removal of the plate, allow it to dry in air and spray with dilute potassium mdobismuthate solution Any spot corresponding to methimazole in the chromatogram obtained with solution (1) is not more intense than the spot in the chromatogram oblamed with solution (2) Sulphated ash: Nol more than 0 1 %, Appendix 3 22 Loss on drying Nol more than 0 5%, determined on 1 g by drying over phosphorus pentoxide at a pressure not exceeding 0.7 kPa for 24 hours, Appendix 8.6. Assay: Weigh accurately about 50 mg and dissolve in sufficient water to produce 500 0 ml To 10 0 ml of the solulion add 10 ml of IM hydrochloric acid and sufficient water to produce 100 0 ml and measure the absorbance of the resulting solution at the maximum at about 291 nm, Appendix 5.5 Calculate the content of C7H10N202S taking 557 as the value of A(1%, 1 cm) at the maximum at about 291 nm CARBIMAZOLE TABLETS Usual strengths: 5 mg, 20 mg. Storage: Slore in well-closed containers in a cool place STANDARDSCarbimazole Tablels contain not less than 90 0 per cent and not more than 110.0 per cent of the stated amount of carbimazole, C7H10N202S. The tablets may be coated. Identification: A: Shake a quantity of the powdered tablets equivalent of 50 mg of Carbimazole with two quantities, each of 5 ml of chloroform. Combine the chloroform extracts, filter and evaporate the filtrate to dryness. The infra-red absorption speclrum of the residue, Appendix 5.4, after drying al 60° at a pressure nol exceeding 0.7 kPa for 30 minutes, is concordani with the reference spectrum of carbimazole or with the spectrum obtained from carbimazole RS. B: To a small quantity of the powdered tablets add 1 drop of dilute polassium iodobismuthate solution; a scarlet colour is produced. Methimazole: Comply with the test described under Carbimazole, using as solution (1) a solution prepared by shaking a quantity of the powdered tablets equivalent to 10 mg of Carbimazole with 2 ml of chloroform for 5 minutes and filtering Uniformily of content (For tablets containing 10 mg or less): Comply with the requirements stated under Tablets using the following method of analysis Powder one tablet, add 300 ml of waler warmed to a lemperature nol exceeding 35°, shake for a few minutes and add sufficient water to produce 500 0 ml Mix well, filter, dilule further, if necessary wilh water and complele the Assay beginning al the words "Measure Ihe absorbance " Other requirements Comply with Ihe requirements of lests slated under Tablets. Assay: Weigh and powder 20 tablets. Weigh accurately a quantity of the powder equivalent to 40 mg of Carbimazole, add 300 ml of water warmed to a temperature not exceeding 35°, shake for a few mmutes and add sufficient water to produce 50.00 ml. Mix well and filler; dilute 50.0 ml of the filtrate to 500.0 ml with water and mix well. Measure]
Ford Price Target Raised at Goldman, Deutsche on Mulally Gains
Officer Alan Mulally added U.S. market share and boosted prices without a federal bailout, two analysts said. The shares may reach $9.50 in six months, Goldman, Sachs & Co.’s Patrick Archambault wrote in a July 24 (Bloomberg) -- Ford Motor Co.’s stock may gain as much as 36 percent after Chief Executive report. Deutsche Bank’s Rod Lache in New York raised his target price to $8 from $5.50. Ford slid 18
This first affects vertical movements (initially only willed movements), and congugate lateral gaze involvement at a later stage. 5. Cerebral anoxia
degenerative condition of unknown etiology. It resembles Parkinsonism in the association of hypokinesia with hypertonus, differing from it in that it is associated with a diagnostic disorder of ocular motility. This first affects vertical movements (initially only willed movements), and congugate lateral gaze involvement at a later stage. 5. Cerebral anoxia - Diffuse cerebral anoxia resulting usually from cardiorespiratory arrest can lead to Parkinsonism due to bilateral basal ganglia infarction. In younger people severe hypotension wit.h hypoxia in opiate overdosage and carbon monoxide poisoning are the usual causes. G. Dystonia musculorum deformans (Torsion spasm) Disease of basal ganglia of unknown etiology characterised by occurrence of slow, strong, sustained, twisting, turning and writhing movements of the somatic muscles, particularly muscles of girdle and trunk Abnormal movements and spasm of muscles produce bizarre stepping gait and often dysarthria, facial grimacing and torticollis. 7. Spasmodic torticollis - Usually starts in adolescence or early adult life and characterised by marked tonic or clonic movements of sternomastoid, trapezius and other muscles of neck. This results in the neck being twisted to one side, the shoulder being elevated and sometimes, the head tilted backwards. The movements are intermittent, aggravated by emotion and anxiety and stop during sleep. Distinction between hysterical and organic torticollis may be difficult 20 HEREDITARY AND DEGENERATIVE DISORDERS Cerebral Palsy Definition - The term cerebral palsy refers to a variety of neurological deficits, permanent but nonprogressive, mainly affecting motor function, as a result of prenatal insult, birth injury or some illness in early infancy. In addition to motor defects, intellectual impairment is common Risk factors Prenatal - Malformations, obstructive lesions in the brain (e.g. cysts, peri ventricular leucomalacia), infection, exposure to toxins, genetic predisposition. Perinatal- Asphyxia, hemorrhage, low birth weight, prematurity. Postnatal - CNS infection and trauma. Clinical Features: SPASTIC - (a) Spastic hemiplegia - Commonest type. May be associated hemisensory and hemianopic visual field defect and sometimes dysphasia Seizures may occur. (b) Spastic diplegia - Difficulty in walking, scissor gait. Upper limbs relatively spared. (c) Tetraplegia - Equal involvement of all four limbs. Seizures likely, and primitive reflexes (tonic neck, Mora, sucking, grasping) persist well beyond normal age. Limbs may become spastic by end of first year. 2. EXTRAPYRAMIDAL -Choreoathetosis and dystonia. Associated difficulty in articulation, draolling and emotional lability. Usually normal intelligence. 3. ATAXIC- Cerebellar ataxia often associated with mental retardation. 4. MIXED SYNDROME - Combination of spastic paraplegia and ataxia. Investigation - (a) Intrauterine infection if under 3 years of age. (b) Chromosome analysis if features are dysmorphic or intrauterine growth is poor. (c) EEG if seizures. (d) Brain imaging to look for maldevelopment, atrophy, peri ventricular leucomalacia, or migration defects. Management: 1. Physiotherapy - to be started early. 2. Drugs - (a) Spasticity - Baclofen acts peripherally, dantralene has direct effect on muscle. (b) Dystonia - Diazepam, benzhexol, tetrabenzene. 3. Surgery- (a) Neurasurgical- Selective dorsal root rhizotomy. (b) Orthopoedic for structures and other deformities. Syringomyelia Definition - A chronic progressive disorder in which cavitation (syrinx = pipe) develops within the spinal cord, either involving the central canal, the central grey matter of the spinal cord
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