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Gene pairs that had very low percentage of recombination are known as tightly linked genes cheap extra super viagra 200mg on line. The percentage recombination is determined by dividing the number of recombinant offspring by the total number of offspring buy 200mg extra super viagra. Mutation In a species buy 200 mg extra super viagra fast delivery, variations are caused by changes in the environment or any changes in the innate genetic setup of an organism or by the combination of both. In 1901, Hugo de Vries first used the term mutation based on his observation on Oenothera lamarckiana. Based on molecular basis of heredity, mutation is defined as sudden change in the sequence of nucleotides of gene. For example, biochemical mutants of Neurospora failed to synthesize certain amino acids. For example, in the plant Sorghum, recessive mutant fails to produce chlorophyll and therefore they die in the seedling stage. Thus, most of the mutations are harmful, because they disturb the genic balance of the organism. Although most of the mutations are useless and even harmful, and some of the mutations play a significant role in the evolution of new species. Many new strains of cultivated crops and new breeds of domesticated animals are the products of gene mutations. Small seeded Cicer arietinum (bengal gram) suddenly get mutated to large seeded Cicer gigas is the case of gene mutation. Classification of mutation Mutations have been classified in various ways based on different criteria. Depending on the kind of cell in which mutations occur, they are classified into somatic and germinal mutation. They may be autosomal or sex chromosomal according to their type of chromosome in which they occur. They may be dominant or recessive according to their phenotypic expression of mutated genes. The deletion and addition mutation alter the nucleotide sequence of genes and ultimately result in the production of defective protein and this leads to the death of the organism. The substitution mutations can alter the phenotype of the organism and have great genetic significance. When a purine or a pyrimidine is replaced by another purine or pyrimidine respectively this kind of substitution is called transition. When a mutation involves the replacement of a purine for pyrimidine or viceversa this is called transversion. Mutagenic agents The chemical substances and environmental conditions which cause mutations in the organisms are called mutagens or mutagenic agents. Chemical mutagenic agents Chemicals can also be used for inducing mutations in the organisms. Ethyl methane sulphonate 123 has been extensively used for inducing mutations in microorganisms, higher plants and animals. Significance of mutation m Mutations play an important role in the origin of new species and serves as a tool for evolution. Mutant varieties of wheat are early maturing, disease resistance and they are enriched with protein. Cistron is an unit of function, recon is the unit of recombination and muton is the unit of mutation. Chromosomal aberrations In an organism, any visible abnormality in chromosome number or structure from the diploid set is known as chromosomal aberration. The chromosomal aberrations based on the structure of the chromosome are of four types deletion, duplication, inversion and transversion. Structural chromosomal aberrations Deletion The loss of a segment of the genetic material in a chromosome is called deletion. When the deletion occurs near the end of the chromosome, then it is called terminal deletion. When the deletion occurs in the middle of the chromosome then, it is called intercalary deletion. Duplication When a segment of a chromosome is present more than once in a chromosome then, it is called duplication. Inversion It is another chromosomal abnormality in which, the order of genes in a chromosomal segment is reversed by an angle of 180. In pericentric inversion, the inverted segment of the chromosome contains centromere. For example the 17 human chromosome is acrocentric, while in Chimpanzee the corresponding chromosome is metacentric. In paracentric inversion, the inverted segment of the chromosome has no centromere. When translocation occurs between two non-homologous chromosomes, then it is called reciprocal translocation or illegitimate crossingover. In heterozygous translocation, one member of each pair of chromosomes is normal and the other member is with interchanged segment. But in homozygous translocation, both the members of paired chromosomes have translocated segments. Numerical chromosomal aberrations Each species of an organism has a specific number of chromosomes in its somatic cells. Alterations in the number of chromosomes from the diploid set is called numerical chromosomal aberration. Euploidy Euploidy is the variation in the chromosome number that occurs due to increase or decrease of full set of chromosomes. Diploidy In most of the plants and animals, the somatic cells contain two sets of chromosome. Polyploidy Addition of one or more sets of chromosomes to the diploid set results in polyploidy. Watermelon, grapes and banana are autotriploids, whereas apple is an autotetraploid. Allopolyploidy Increase in one or more haploid set of chromosomes from two different species result in allopolyploidy. It is obtained by crossing a wheat Triticum durum (2n = 4x = 28) and a rye Secale cereale (2n = 2x = 14). Then the chromosome number is doubled using colchicine and it becomes an hexaploid. Parent Triticum durum x Secale cereale 2n = 28 2n = 14 (2n = 4x = 28) (2n = 2x = 14) F hybrid (sterile)1 2n = 21 (2n = 3x = 21) Chromosome doubled (Colchicine treatment) 2n = 42 (2n = 6x = 42) Hexaploid Triticale 129 Aneuploidy Variation that involves one or two chromosomes within the diploid set of an organism results in aneuploidy. Hypoploidy Decrease in one or two chromosomes from the diploid set is described as hypoploidy.

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Other factors to determine include whether a car is available and how far it is to the grocery or convenience store buy extra super viagra pills in toronto, avail- ability of foods at nearby stores buy cheap extra super viagra 200 mg on line, and the patients ability to commute to and transport food from the store to the home (5) generic extra super viagra 200 mg on-line. An environment that promotes physical activity also contributes to nutritional status. If necessary, efforts should be made to assist a patient with applications for food assistance programs (e. Family support and frequency of communication and activity with family and friends also need to be assessed because they too can influence dietary intake (18). In scleroderma, the mouth may become small, making it difficult for patients to feed themselves and consume adequate nutrients. Generic Quality-of-Life Indicators Evaluation of quality of life includes assessing physical ability and functional activity as well as the health-related emotional and social implications. Quality-of-life questionnaires are also available specifically for pediatric or adolescent patients. The most common measures include the Childhood Health Questionnaire, Pediatric Quality of Life Inventory Scales, and Quality of My Life Questionnaire (29). Arthritis-Specic Quality of Life Disease-specific quality-of-life questionnaires have been designed for many rheumatoid diseases. Table 1 lists the disease-specific quality-of-life measures for arthritis and related diseases. They are particularly useful because they provide specific information that is directly related to the disease. Indicators of malnutrition also include rheumatoid cachexia, which involves muscle wasting that is often replaced with fat (30). Even with good disease control and adequate caloric intake, skeletal muscle catabolism persists (31,32). Assessment of caloric and protein intake is important because inadequate intakes will further accelerate muscle loss. Muscle wasting also affects functional status and mobility, which may impair food shopping, meal preparation, and cleanup. As a result of the chronic inflammation, anemia of chronic disease is often present (10,11,34). Medication-related effects on biochemical indices of folic acid and iron status are also common. Some medications such as methotrexate also affect calcium and vitamin D status (1719). Dietary and functional assessments should include attention to energy intake and problems related to obtaining, preparing, and eating food. Patients with social support may have a better quality of life, potentially moderating the impact of pain, depression, and physical disability (33). The disease is chronic and characterized by an age of onset before 16 years of joint swelling, heat, and pain and stiffness of unknown origin (10, 11) that occurs for 6 weeks or more (11). Disease characteristics often include inflammation, fever, damage/deformity of joints, and altered bone growth (10). In abnormal bone growth, one bone may be longer than another at times of accelerated growth and later become stunted. If the abnormal bone growth occurs in the leg, the child may compensate by bending the longer leg until the hips are level. Either arm-span or knee-height measurements are appropriate depending on the location of contractures and range in motion of joints. Growth charts for stature for age, weight for age, and weight for stature are important tools for monitoring growth retardation and body composition changes. Biochemical indices for iron-deficiency anemia should be monitored and assessed to determine the cause and intervention for the anemia. Side effects that affect nutritional status include mouth sores, bone marrow damage and altered iron status (10,34), and blood and protein loss in urine (34). Dietary intake and status may be influenced by many manifestations of the disease, and therefore dietary intake is important to obtain. Energy and protein malnutrition may be found in 10 to 50% of children with this disease (11). Jaw function is compromised in the 20 to 30% of children who have abnormal jaw development (10), and a small jaw or teeth misalignment can result in dysphagia (difficulty swallowing) (10,11). Patients may be depressed and embarrassed, negatively impacting their social life (10,11). Gout is more prevalent in men than women (18,19) with an age of onset after 40 years (18,35,36). Women are more likely to develop gout later in life (after menopause) than men, and the upper extremities are more often affected (35,37). Large tophi on the heels may make it difficult to accurately measure a standing height. Alternative methods of estimating height may be required depending on the manifestations of the disease. Central fat distribution may be measured using waist circumference and risk is increased with a waist circumference of more than 100 cm for men 88 cm for women (39). Patients with gout are often prescribed medications for inflammation and uric acid control. Other anti-inflammatory drugs prescribed for gout include colchicine and corticosteroids. About 80% of patients experience side effects of nausea, vomiting, and diarrhea when taking colchicine (35). Nutritional deficiency of vitamin B12, sodium, and potassium are also related to colchicine (18). Central obesity and serum uric acid levels are associated with insulin resistance, hypertension, high serum lipids, and renal failure. When gathering dietary intake data, it is important to determine intake of alcohol, nonalcoholic beverages, and purine- rich foods. Adequate hydration is important if the patient is at risk for renal calculi (18,19). Dietary intake of purine- rich foods may contribute to as much as one-third of the serum uric acid (18,19, 36,39). However, dietary intake of purine-rich foods and the impact on serum uric acid is controversial. Elevated serum uric acid is caused by inadequate renal excretion (90% of the serum level) and excess synthesis (10% (18,19,36,39)). Dietary intake contributes to excess synthesis; thus, dietary intake of purine-rich foods will have relatively little impact on serum uric acid levels.

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In 1772 purchase extra super viagra 200 mg otc, a British scientists called as Joseph Priestley (1733-1804) discovered the laughing- gas (N2O generic extra super viagra 200 mg without a prescription, nitrous oxide) buy extra super viagra on line amex. In 1800, Humphry Davy (1778-1829), a British chemist, following his experiences determined that the nitrous oxide is suitable for surgical anaesthesia. Horace Wells (1815-1848), an American dentist, used nitrous oxide during a dental extraction in 1844. On the 16th of October 1846 (Ether day), William Morton (1819-1868), an American dentist narcotized a patient in a Massachusetts General Hospital of Boston. This was the first public demonstration of a surgical intervention in which the patient was narcotized by ether. Jackson, who was a chemist, discovered the ether and first performed a self- experiment in Boston. The patient inhaled the gas and after an initial anxiety he falled asleep shortly after it. A neoplasm of the left jaw was removed by professor John Collins Warren in 5 minutes. After the patient became consciuos he declared that he did not feel any pain during the operation. In 1847, Ignc Semmelweis (18181865), a Hungarian obstetrician, introduced the compulsory hand-washing with chlorinated lime to prevent the puerperal fever. Thereafter, the mortality rate of women, who were in labour, decreased from 30% to 1%. It unambiguously proved that decomposing organic matter on the specialists hands, who made the examinations and treatments, propagated the mortal disease. In 1847, Kolletschka, who was a professor of forensic medicine, died in sepsis following an injury during an autopsy. Based on the report of autopsy of Kolletschka, Semmelweis determined that his septic clinical picture was similar to those seen in autopsies of women who died in puerperal fever. He recognized the common cause: The corpusles from the dead body could enter into the blood stream. Semmelweis had to face many rejections when he introduced the effectiveness of hand disinfectioning. The Hungarian surgeon, Jnos Balassa (1814-1868) was the first one in Hungary who applied ether narcosis. He was 28 years old when they nominated him as the head of the department of the Surgical Diseases. He established and made internationally known the independent Hungarian Surgery by his multi- faceted surgical works and publications. He took part in the preparation of the universities educational reform and in the organization of modern surgical education. He performed a large number of urinary bladder incisions and the disintigration of the stones. His written works are of great importance in abdominal hernias and plastic surgeries. He set up the Medical Weekly Journal in 1857, which is the fifth one among the oldest medical journals all over the world and also a 8 part of the Hungarian Cultural Heritage. He was contemporary with the Pl Bugt (1793- 1865), who created many (medical) words and so the main parts of those words which are used nowdays in the medical literature are orginating from him. He also assumed that microscopic particles, which are originated from the surrounding tissues, cause wound infection and pus formation. Sndor Lumnitzer (1821-1892), a Hungarian surgeon, effectively dealed with the plastic surgery. Sir Joseph Lister (1827-1912), who was a professor of surgery in Glasgow, based on the germ theory of Louis Pasteur introduced the disinfectioning processes in surgery. He believed that even in the case of a complicated fracture there is only a need to inject a material into the wound which can kill the septic germs. Lister found the carbolic acid (phenol) as an effective material for this purpose. In the operating theatre Lister sprayed carbolic acid onto the operative area, onto the instruments and bandages, and even onto the air. His antiseptic theory revolutionized the surgery, since the surgeons were incapable of managing the wound infection until that time. Hmr Hltl (1868-1940) played an important role in the spread of the antiseptic surgery in Hungary. Emil Theodor Kocher (1841-1917), a Swiss surgeon, edited his book about the surgical removal of goitres. Jules mile Pan (1830-1898), a French surgeon, resected the stomach partially due to a pyloric cancer and then sewed the remaining part to the duodenum. Theodor Billroth (1829-1894), an Austrain surgeon, performed the first successful gastrectomy. In his experiments, he developed the optimal methods for surgical treatment of the cancers of the bladder and intestines. Gustav Adolf Neuber (1850-1932), a surgeon from Kiel, applied the aseptic treatment of wounds aimfully to prevent the infections. Ernst von Bergmann (1836-1907), a surgeon who introduced the gas sterilization of the instruments in his clinic in Berlin. His classic report on early operative interference in cases of appendicitis was presented before the New York Surgical Society in its scientific session. He described that in 99% of cases the symptoms of inflammation are originated from the right lower part of the abdomen (i. He determined the area of greatest abdominal pain which is the exact place of the typical muscle guarding (nowdyas, known as McBurneys point). Later, he set forth in another paper 9 the incision that he used in cases of appendicitis, now called McBurneys incision. Wilhelm Conrad Rntgen (1845-1923), who was a German physicist, discovered the X- ray which revolutionized the patient treatment. Halsted (1852-1922) was a surgeon at the Johns Hopkins Medical School, who developed the surgical rubber gloves. In 1890 he asked the Goodyear Rubber Company to manufacture thin surgical gloves for his chief scrub nurse (and his later wife) Caroline Hampton) who was suffering of dermatitis due to use of disinfectants. Bloodgood (1867-1935), who was Halsteds student, initiated the rutine use of surgical gloves in 1896. This method reduced the incidence of the dermatitis, as well as the number of the postoperative wound infections. During sterile intervention, all participants use paper or textile cap - which covers their whole hair- as well as surgical mask. At the Vienna Surgical Society he reported the first case of renal autotransplantation in which the kidney was placed in the the neck of a dog.

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