Historical Changes to Illnesses and Infections

Historical Changes to Illnesses and Infections General introduction Every individual or human being desires to live a healthy and respectful life. There is an age old saying â€Å"health is wealth.† Every country desires that its subjects remain healthy to keep itself prosperous and progressive. In spite of the best efforts to achieve this goal, human suffering has become synonymous with the rapid advancements made in technology. It has taken competition to break neck levels and the young generations have given the health parameters a go by. Commercialization in agriculture has assured in a green revolution, yields have increased with bioengineered crops but the nutritional components have progressively decreased. The current day lifestyle of fast food and non exercise has led to a spurt in non communicable and metabolic related diseases.1 If lifestyle diseases are self created destruct buttons, infections have reared its head in spite of the best attempts to tackle them. Charles Darwin’s statement â€Å"survival of the fittest† works aptly in this scenario. Microorganisms and parasites are rapidly adapting to new environs with ever increasing reports of drug resistance.1 Drug discovery programmes today are not restricted to a single country, so also are the markets. Pharma majors invest heavily in research, but their agenda is mainly commercial. Countries with deep pockets also have extensive budgets with investment in drug research focused to their health care needs. Many drugs in the past are due to serendipity, with universities contributing substantially. Academic involvement is significant and academic research, however small, can be a contributor to the development of science and beneficial to mankind at large. Introduction to Infections Rapid growth in population, especially in the developing countries is leading to challenges in combating infectious diseases. Reports state that there are 17 infectious diseases, which include the likes of leprosy, tuberculosis, malaria, leishmaniasis etc., to be endemic in 149 countries, with over one billion people being exposed to them. The World Health Organization has raised the ante and has suggested to the various affected countries to be more focused on disease control. Most of these diseases are vector borne or communicable. Climate change has also been a contributing factor in slowing down vector control programmes. Favourable changes in the weather suiting to the growth of vectors have generated new transmission zones with an increased spread of infections.2 Tropical countries, including India are prone to certain common infections like malaria, dengue, chikungunya, filariasis, tuberculosis, leprosy, leishmaniasis, typhoid etc. The geographical distribution of some of them is localized depending on the regional climatic conditions. 6,60,000 deaths were reported in 2012 due to malaria of which 95% was in Africa.3 A cohort study by Neeraj Dhingra and colleagues suggest that the mortality rates of malaria in India are much higher than reported. They attribute this to a similarity of malarial symptoms with other infections like typhoid, ricketsial fever etc., thereby making malaria go unnoticed. Symptomatically similar typhoid has a fatality rate of 2 lakh deaths per year across the globe.4,5 Dengue and chikungunya, spread by the mosquito Aedes aegypti has been wide spread. Improper sanitation and hygiene has let to their rapid growth and an estimated 2/5th of the world’s population is exposed to them.6 A positive aspect of the WHO report is that the combined efforts of the countries has shown a decreased incidence by 17% and a 26% reduction in morbidity for the period 2000 – 2010.7 There is a lot of concern with reference to tuberculosis (TB). The World Health Organization in its latest report states that over 8.6 million people developed tuberculosis in 2012 with 1.3 million TB related deaths.8 Some reports suggest that there are a million missing patients who are actually positive but undiagnosed and one million infected children.9,10 A significant 13% of this infected population were HIV positive. The report also states that India alone accounted for a staggering 26% of the reported cases. The organisation has stressed the need for better diagnostic methods to detect the infection at early stages especially multi drug resistant tuberculosis (MDR-TB). Patients with MDR-TB are resistant to the first line drugs rifampicin and isoniazid.8 The advent of modern techniques like GeneXpert has helped to identify as many as 64,000 cases in India alone.11 Experts believe that TB is a silent epidemic which has mutated very fast in the last twenty years leading to MDR-TB and extremely drug resistant tuberculosis (XDR-TB) with the first case of XDR-TB reported in the year 1997 at Sewri. Even though there are thirteen drugs available in the management of tuberculosis, it is difficult to treat drug resistant varities.11A Reports of XDR-TB in Africa have been frightening12-13 and according to WHO, accounts for 9.6% of MDR-TB cases. It is now believed that a wrong diagnosis and treatment of XDR-TB as MDR-TB complicates the further treatment. Attempts are being made to develop fixed dose combinations for treatment of TB, especially in children.14 Another mycobacterial infection that prominently bags the headlines is leprosy. 58% of the 2,32,857 leprosy cases reported worldwide were from India. Though there has been a substantial reduction in the number of cases, there needs to be some more work done till leprosy is completely eradicated.15 An area of concern is the development of resistance to antibiotics. This has impeded global efforts in containing infections. Higher rising incomes and higher rates of hospitalization have let to the higher use of antibiotics. There is also rampant over the counter sales of antibiotics without prescription in many countries including India. Microorganisms, when exposed to sub optimal doses of antibiotics develop resistance by undergoing mutations and these strains are increasingly transmitted. Some of the well documented drug resistant strains are methicillin resistant Staphylococcus aureus (MRSA), Escherichia coli ST131 and Klebsiella ST258.16 Resistance is more to ÃŽ ² lactam class of antibiotics, with a 10 fold increased incidence in the last 20 years. The evolution of hospital MRSA was directly attributed to the indiscriminate use of quinolone antibiotics.17 Recently, the gene responsible for resistance in the malaria parasite Plasmodium falciparam was also identified.18 Inflammation19-21 Inflammation can be defined as series of pathological changes associated with local vascular reactions and cellular responses of living tissue to an injury insufficient to kill the tissue. It is the body’s defence mechanism in order to eliminate or limit the spread of an injurious agent and is characterized by local heat, redness, swelling, pain and loss of function. Depending upon the duration and the mode of onset, the inflammatory reaction can be classified as acute, sub-acute or chronic. Acute inflammation is characterized by a sudden onset and as a short course which may last for a few minutes to several hours. On the other hand, sub acute inflammation is set to last for one to six weeks or more. Chronic inflammation is known to last for months to years and is characterized by proliferation of connective tissue and blood vessels with presence of lymphocytes, plasma cells and histocytes but absence of polymorphs. Another prominent feature is the denaturation of proteins that occur in the region of inflammation. The root cause for inflammation could be a variety of chemotactic factors which could be any one among the following: Membrane derived lipid substances like eicosanoids platelet activating factors, Vasoactive amines, cytokines, lysosomal proteases etc., the most common however being the eicosanoids. The arachidonic acid pathway is well known to be the primary mechanism for the generation of pain and inflammation. The arachidonic acid itself is derived from lipid hydrolysates that are supplied from the diet. At the cellular level, the enzyme phospholipase A2 converts the phospholipids to arachidonic acid. This arachidonic acid is acted upon by two major enzyme systems: namely lipoxygenases and cyclooxygenases. Together, they regulate various immune defenses and pain mediating responses in the body and maintain homeostasis. The enzymes 5-lipoxygenases and 12-lipoxygenases metabolize the arachidonic acid to various leukotirenes which bring about vasoconstriction and vascular permeability, promote adherence of leucocytes to vascular endothelium and induce bronchial smooth muscle contraction. The role of 5-LOX in inflammation is well established. Modulating the activity of these intermediates has helped in the better management of asthma. The prostaglandins, obtained as the major products of action of cyclooxygenases on arachidonic acid show significant physiological activity when activated. Thromboxanes help to increase vascular permeability and in the aggregation of platelets, the prostacyclines decrease vascular tone and decrease platelet adhesion, the prostaglandin D2 increases hyperalgesia in sensory apparent nerve fibres whereas the prostaglandins E1, E2, F1 F2 are known to increase vascular permeability, increases hyperalgesia in sensory apparent nerve fibres, cause inflammation, reduce gastric acidity. Both isoforms of the enzyme cycloxygenase, namely COX 1 and COX 2 are expressed in various cells and tissues. It is well established that COX 1 is expressed more in the stomach and prominently involved in the regulation of acid levels, whereas COX 2 is expressed in tissues only during an injury and releases eicosonoids which regulate inflammation. Regulation of COX 2 is therefore a primary focus area in the man agement of inflammation. Arthritis is a very common occurrence these days. Eating habits and non-exercise have let to obesity. Lack of synovial fluids is known to increase friction resulting in the inflammation of the joints. Patients suffering from arthritis are subject to chronic medication and under such circumstances, patient safety becomes critical. The current strategies of NSAID research are to develop selective COX 2 inhibitors. Drugs like celecoxib, rofecoxib have been introduced in the past for the management of chronic inflammation. Figure 1: Scheme of Arachidonic acid pathway Reactive oxygenated species As reported in the initial part, lifestyle related diseases are quite common. Extremely stressful life and the enormous level of pollution that one is exposed to has affected the health of the common man. Free radicals are extensively produced in the body due to various chemo stimuli. These reactive oxygenated species are known to damage various tissues in the body. The role of antioxidants in scavenging these free radicals is well known.22 The reactive oxygenated species are formed due to different mechanisms which could be due to ionizing radiations, byproducts of cellular respiration or due to defence mechanisms of neutrophils and phagocytes. The electrons lost in electron transport chain attack molecular oxygen to form superoxide ion. These superoxide ions are capable of attacking various mitochondrial membranes and fatty acid side chains, thereby damaging them. The body has its own defence against these destructive reactive species like the enzymes superoxide dismutase and catalases which scavenge these radicals. It is also well established now that antioxidants also go a long way in combating this reactive species.23 Combating the menace of free radicals is either by prevention or by scavenging of already existing free radicals. Various enzyme, metals and vitamins work in tandem to remove these reactive oxygenated species.24 a) Anti-oxidative enzymes: These are superoxide dismutase, catalase, and glutathione reductase. They are synthesized in the body and convert reactive oxygenated species like superoxides and hydroxyperoxides into non-reactive oxygen molecules. b) Metal Chelating antioxidant: The role of metal ions in accelerating lipid oxidation is of paramount importance, especially the transition metals like iron and copper. The initiation step of oxygen oxidation requires removal of a hydrogen atom which are catalysed by these metals. c) Singlet oxygen-quenching antioxidants: Singlet oxygen is highly reactive towards any molecule with electron or lone pairs of low ionization energy. d). Radical scavenging antioxidants: These can donate hydrogen atoms to free radicals, can scavenge free radicals and prevent lipid oxidation. Eg: vitamin C, albumin (hydrophilic), vitamin E, carotenoids (lipophilic) Acharya Nagarjuna University, GunturPage 1

The Life and Contribution to the Development of the British Empire of J

The Life and Contribution to the Development of the British Empire of James Cook I) Introduction   Ã‚  Ã‚  Ã‚  Ã‚  The purpose of this paper is to describe the life and the contribution to the development of the British Empire of one of the most important English explorers. It was in the second half of the 18th century when James Cook, originally a poor farm boy, explored and mapped vast uncharted areas of the Pacific and the Atlantic Ocean. However, James Cook was not ‘only’ an explorer. He can also be called a scientist – he managed to introduce new principles into seafaring and cartography. For better understanding, the paper is divided into five chapters. The first chapter is the introduction, which throws light on the purpose and structure of the paper. The second chapter is a brief introduction to the situation in Great Britain in the 18th century. It helps to explain why and how the so called â€Å"the First British Empire† was built up and later destroyed, and what led to the creation of â€Å"the Second British Empire†. The third chapter deals with Capt. Cook’s life and his three unique expeditions to the Pacific. The fourth part of the paper summarises Cook’s achievements and his contribution to the development of the British Empire. The fifth chapter forms the conclusion of the paper. II) A brief introduction to the situation in Great Britain in the 18th century. Great Britain became a great world power in this period. Under the leadership of William Pitt the Elder, Britain’s Prime Minister and at the same time a man who believed that the strength of the nation's economy depended on overseas expansion, the country gained vast territories all over the world and the so called â€Å"the First British Empire† was founded. The reasons why Great Britain was so successful can be divided into four groups: †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"Revolutions† – the Industrial Revolution, a financial revolution and a revolution in agriculture made Britain the leading power in Europe. The creation of the Bank of England in 1694 helped to raise capital for colonial wars and to support British trade. At the beginning of the 18th century a series of mechanical inventions enabled the building of the world's first mechanised factories. A steam engine invented in1769 provided the power to drive machinery and thus enabled mass production of goods. The new ways of making products more quick... .... Impà ©rium. Praha: BB art, 1999 CD-ROM: Encarta 98 encyclopedia. „Cook, Captain James.â€Å" Microsoft. CD-ROM.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Microsoft Item: X03-22823 Web sites: http://152.105.19.10/scouts/nunthorp/seeonee/badgewk/history http://www.britannia.com/history. http://freespace.virgin.net/chris.jones/ccsu72.htm http://freespace.virgin.net/chris.jones/ccsu73.htm http://geography.about.com/science/geography/library/weekly/aa101397.htm http://mmbc.bc.ca/source/schoolnet/exploration/cookdeath.html http://members.tripod.com/cuculus/cookbio.html http://winthrop.webjump.com/jcook.html http://www2.lucidcafe.com/lucidcafe/library/95oct/jcook.html http://www.arcticculture.about.com/culture/arcticculture/library/yafeatu res/bl-Cook1.htm http://www.bbc.co.uk/education/archive/voyager/history/hs_cook.shtml http://www.captaincookstudyunit.com http://www.geocities.com/TheTropics/7557/cook.html http://www.jetcity.com/~kirok/cook.htm http://www.lib.virginia.edu/exhibits/lewis_clark/ch4-25.html http://www.mariner.org/age/cook.html http://www.nmm.ac.uk/education/fact_cook.html http://www.pacificcoast.net/~regent/cookbio.html http://www.south-pole.com/p0000071.htm

Farm Girl

Christina Anderson Mr. Kingsley Eng105 1 February 2012 Life Lessons from the Farm Jessica Hemauer’s essay, â€Å"Farm Girl,† tells her life story of living on a farm through her eyes as ten-year-old child to the time of her early adulthood. The purpose of this piece is to teach the importance of life's responsibilities to children, mainly female, and young adults who may not be familiar with the challenges life can bring and to promote the benefits you can gain by overcoming those obstacles.Hemauer uses pathos, which appeals to emotion, logos, designed to engage our logic, and ethos, to prove its credibility, to convey that though growing up on a family farm was a struggle day-to-day, it was valuable life lesson because it shaped her into the well-rounded and hard working person she is today. The essay opens with Hemauer’s with the immediate use of pathos to capture the audience’s emotions and to gain their sympathy towards Jessica. This is seen in the fir st sentence, when she is begrudgingly awakened by her alarm clock, â€Å"BEEP!BEEP! BEEP! It’s 5:00 a. m. My eyes are heavy with sleep and struggle to open†(83). Hemauer uses specific words to achieve ethos, such as, â€Å"heavy† and â€Å"struggle† to convey that, at age ten, she was already faced with tremendous responsibility and commitment everyday, when she heard the sound of her alarm clock. The use of â€Å"5:00 a. m. † also is used to attain sympathy because, in most cases, five in the morning would bring about a sense of disdain at any age, which can then relate back to Hemauer’s audience.Hemauer wants the young readers to attain that sympathy while reading the story so that they may reflect on their own lives and recognize the privileges they have, such as, not having to wake up at five in the morning everyday, and be grateful for them. Hamauer continues with her use of pathos to awaken the readers of the true struggle and difficul ty that is attached to being a young person with responsibilities. While walking down the stairs, in a sleepy daze, to get to the barn, Jessica is startled awake when the door opens to, â€Å"a brisk and bitter wind accompanied by icy snowflakes that feel like needles digging into our faces†(83).The language that Hemauer uses in this citation, specifically, â€Å"bitter,† â€Å"icy,† and â€Å"needles digging into,† evokes complete sympathy for this young girl. It also affects the audience with a twinge of pain due to the imagery describing the bitter cold and the fact that she must endure it. Jessica Hemauer is able to appeal to both pathos and logos in her writing as well. This is shown after the children reach the barn and begin to work on their chores. Jessica’s job is to feed the newborn calves, she indicates, â€Å"Because I am the youngest in the family, this is my favorite chore because I rarely have a chance to look after someone†¦Ã¢ € (84).The sense of pathos is obtained in this quotation because Hemauer uses certain words, such as, â€Å"favorite chore† and â€Å"rarely† to attain sympathy from the reader, by portraying that she was deprived and that she seeked enjoyment from her â€Å"favorite chore. † For a child or young adult who does not have day to day responsibilities, such as chores, they would view this with a sense of gratitude for the lifestyle that they have. This statement also gives a sense of logos because it is a cause and effect situation.Hemauer states that because she is the youngest, she rarely has the chance to look after others. This would make sense to Hemauer audience do to their age demographic. The young readers could view themselves in a similar situation by not be trusted with great responsibility due to their age. Though Jessica Hemauer appeals to pathos in her writing, she also addresses logos as well. For example, when Jessica considers being more involved in her school she realizes there is no possible way, by stating, â€Å"If I join a club that practices after school, I can’t participate.If I join a club that meets before school, I can’t attend meetings†(85). Hemauer uses logos in this specific case to clearly address the predicament that Jessica struggles with when it comes to responsibility and personal preference. This may be difficult for her audience to understand because, most likely, children or young adults that have had the privilege of growing up without having to make these sorts of decisions could not relate. Most often then not, the only thing that children have is free time.This further proves the author’s purpose for this essay because it demonstrates to children or young adults with less responsibility that, when it comes down to it, you will have to make the sacrifice of what you want for the responsibilities that you already have. Furthermore, Hemauer uses logos later in her essay, to explain some of the benefits of having a large amount of responsibility at such a young age. This is shown when she is reflecting on her past experiences and how they have helped her today, by saying, â€Å"I have always had a challenging amount of responsibility, and I have learned to complete tasks in a timely fashion†(86).The audience will view this as a challenge and a possible goal to set for themselves by seeing her accomplishments due to her initial struggle, further proving the author’s purpose for this piece. This aids to Hemauer’s ethos as well because she is proof, as an author, as to how time management and responsibility has shaped and benefited her. Hemauer’s â€Å"Farm Girl† is a reputable source for ethos due to the fact that it is an autobiographical essay. Hemauer is telling the audience the story of her memoir based true occurrences that happened in her life on her family farm.These events describe the endeavors she faced and the accomplishments she obtained due to the effort that she put forth everyday from a young age till now, as a successful author. Though the target audience for this piece may experience difficulty relating specifically to certain events, such as, walking a half a mile in a blizzard to reach barn to milk cows, they understand what it is like to be a child and what they desire. They know from reading â€Å"Farm Girl† that Hemauer did not always enjoy life on the farm but in the end, it made her a stronger person.Hemauer truly practices what she preaches, which demonstrates a great source of trust and ethos towards her readers. Jessica Hemauer displays ethos within â€Å"Farm Girl† as well by showing credible and believable sources within the story. An example of this can be found at the end of the essay, when Jessica’s Boss is paying her a compliment by asking where he can find more people like herself; her response is, â€Å"Try hiring some farm girls. I hear they turn out pretty good†(87). Within this statement, the audience can come to the conclusion that Jessica Hemauer’s work shows good example of ethos due to the inclusion of the bosses’ question.The ethos that forms from that statement is telling the audience that due to the fact that she is a hardworking, determined, and successful worker, she did not need to tell us that she is good; she can have the support of others to tell her she is instead. In conclusion, Jessica Hemauer’s essay, â€Å"Farm Girl,† is an inspiration towards those who may not be burden by great responsibility at a young age. Hemauer achieves this through her use of pathos, by indicating her past struggles through a sense of sympathy, and by doing so, she is able to reach out to the audience.The author was a success through her indication of logos by presenting her logical analysis towards Jessica’s time management predicament. Lastly, Hemauer not only indicated the use of e thos with her essay, by giving the audience a credible source to trust, being an autobiographical piece, but the audience knows that the essay is credible and believable due to the examples she presents within the essay. The combination of these three elements makes â€Å"Farm Girl† an influential essay that teaches the lesson that hard work really does pay off in the end.

Drugs And Substances In Sonnys Blues By James Baldwin

The short story, â€Å"Sonny’s Blues†, is about a man, the narrator and his brother, Sonny, and his returning from prison after selling and battling with heroin. Written by James Baldwin, the story takes place in Harlem, and throughout, there are certain settings that make the narrator feel a particular way. When the narrator encounters Sonny’s old friend, witnesses a revival, and recalls the story of the death of his each draw out different emotions. As a high school teacher, the narrator often sees many young boys and girls who went through a lot of the same things they experienced. Something that was frequently found around the schools they attended was drugs and drug addicts. This is how Sonny was introduced to drugs. After a long six and†¦show more content†¦He notices a woman in the crowd â€Å"[smoking] a cigarette between he heavy, chapped lips, her hair a cuckoo’s nest, her face scarred and swollen from many beatings† (Baldwin 108) . This woman is conversing with the woman with the tambourine and the narrator points out that they addressed each other say â€Å"Sister†. From this, the narrator believes that the women know that while one is a church-goer and the other faces challenges at home, possibly domestic abuse, they are not that different from one another. Even Sonny if affected by the revival. Sonny says, â€Å"her voice reminded me for a minute of what heroin feels like sometimes† (Baldwin 109). The enjoyment Sonny finds in the music gives him a sort of high, as he describes. This scene is an example of symbolism. Sonny is a troubled man, who has recently gotten out of prison and taken a completely different path than his brother, however, his brother realizes that they are not that different. They both have experienced death, the rough neighborhoods of Harlem, love their family and just want what is best for one another. When Sonny returns back to his brother house, the two share an intim ate moment where Sonny explains how drugs made him feel, physically and emotionally. From the beginning of the revival, to the end of the conversation with his brother, the narrator has a new-found understanding for Sonny’s actions. Throughout Sonny’s adolescent, he and his father argued many times. TheShow MoreRelatedAdversity In Sonnys Blues By James Baldwin892 Words   |  4 PagesJames Baldwin’s â€Å"Sonny’s Blues† utilizes race, poverty, stereotypes, and adversity to shine a light on the struggle to escape circumstance. Throughout the text, Baldwin describes the hardships leaching the life out of Harlem’s black community from the narrator’s perspective. Sonny, the narrator’s brother, struggles with his identity and ability to feel emotion leading him to the world of music and drugs, â€Å"To be aware of oneself, Baldwin believes, is to feel a sense of loss, to know where we are andRead MoreJames Baldwin s Sonny s Blues1 452 Words   |  6 PagesJames Baldwin’s Sonny’s Blues is a short story that, for some people, could be considered a challenging read. Not because of the level of difficulty, but for the fact that it shares a lot of human angst. However, Baldwin’s story still manages to be entertaining, as well as holding many life lessons in it. Baldwin’s story teaches lessons such as; dealing with suffering, being supportive, and accepting differences. 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While James Baldwin’s â€Å"Sonny’s Blues† illustrates a young man struggling to find his identity while being pushed around by what society and his family wants him to be. Both of these characters exhibit an underlying struggle of alienation but both also demonstrate a cravingRead MoreDrug Addiction : The Pain And Despair Of Inner Cities1904 Words   |  8 PagesDrug Addiction: The Pain and Despair of Inner Cities Drug addiction has been a destructive element in American society for many decades. It saw a considerable upswing in the 1950 s spreading rapidly through many major US cities. Prior to its infestation of affluent suburban neighborhoods in the 60 s and 70 s, it was associated with low-income neighborhoods striking out the poor despondent underclass. Its rapid spread found its way into the consciousness of the media including many well-known literary