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Particles greater than 10m are not harmful because they are filtered out before reaching distal 234 airways order 160 mg kamagra super visa erectile dysfunction 5-htp. When they are less than 1m in diameter they tend to move in and out of alveoli like gases so that they will not deposit and result in an injury order kamagra super pills in toronto erectile dysfunction 30 years old. Silica 160mg kamagra super with visa erectile dysfunction pills for sale, asbestos & beryllium are more reactive than coal dust bringing about fibrotic reaction purchase 20mg prednisone overnight delivery, while coal dust has to be deposited in huge amounts if it has to result in reaction because it is relatively inert trusted 500 mg antabuse. Most inhaled dust is removed out through the ciliary movement after being trapped in the mucus linings. The more reactive particles activate macrophages to release fibrogenic factors, toxic factors and proinflammatory factors. Free radicals: reactive oxygen and reactive nitrogen species that induce lipid peroxidation and tissue damage 2. A- Coal workers Pneumoconiosis _Due to coal dust B- Silicosis _Due to silica C- Asbestosis _Due to asbestos D- Berylliosis _Due to beryllium Coal workers pneumoconiosis Since earlier times of industrialization it has been noticed that coal miners were drying of black lung complicated by tuberculosis. Coal dust mainly contains carbon but has a variety of trace metals inorganic mineral and crystalline silica. Anthracite (hard) coal contains significantly more quartz than bituminous (soft) coal. Anthracite (hard) coal is more frequently associated with lesions in the lungs; hence the name pulmonary anthracosis is coined for coal induced pulmonary lesions. Anthracosis:- Where pigments are accumulated without cellular reaction and symptoms ii. Simple coal workers pneumoconiosis With minimal cellular reaction and little or no pulmonary dysfunction iii. Progressive massive fibrosis:- With extensive fibrosis and compromised pulmonary function Morphology Pulmonary arthracosis - Macrophages in the alveoli and interstitium are found laden with carbon pigments. These macrophages are also seen along the lymphatics including pleural lymphatics or lymphoid tissue along bronchi and lung hilus. Coal macules constitutes of carbon-laden macrophages aggregated, coal nodule is when the macule additionally contains collagen fibers. It is characterized by coal nodules intermingled with collagen fibers with central necrosis, size ranging from 2cm to 10cm. When it progress to progressive massive fibrosis in minority of cases it results in pulmonary hypertension and corpulmonale. Asbestos Related Disease Asbestos is a generic name that embraces the silicate minerals that occur as long, thin fibers. Asbestosis refers to the pneumoconiosis that results from the inhalation of asbestos fibers Pathogenesis Asbestos fibers are thin and long so that they can reach the bifurcations of bronchioles and alveoli. There, they are engulfed by macrophages to induce the cascade of inflammatory process, which finally result in interstitial pulmonary fibrosis.
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Types of collenchyma 71 Collenchyma may contain chloroplasts and carry out photosynthesis order kamagra super 160 mg online erectile dysfunction pump for sale. Collenchyma is divided into three types lamellar buy kamagra super 160mg line impotence fonctionnelle, angular and lacunate collenchyma buy 160mg kamagra super free shipping impotence causes and cures. In the hypodermis of Helianthus discount extra super cialis, only the tangential walls of collenchyma are thickened and the radial walls are devoid of thickening purchase 25 mg clomid visa. In the hypodermis of Datura and Nicotiana, the cell walls of collenchyma are thickened at their angles. In the hypodermis of Ipomoea, the cell wall thickening materials are deposited on the walls bordering the intercellular spaces. On the basis of origin, structure and function, sclerenchyma is divided into two types sclereids and fibres. They are found in bark, pith, cortex, hard endocarp and fleshy portions of some fruits. The rod shaped sclereids with dilated ends are called osteosclereids (bone cells). They provide mechanical strength to the plants and protect them from the strong winds. The fibres that are found in the seed coat of some seeds are called surface fibres. Complex tissue A tissue that consists of several kinds of cells but all of them function together as a single unit is called complex tissue. Xylem Xylem (Greek word xylos= wood) is a complex tissue that is mainly responsible for the conduction of water and mineral salts from roots to other parts of the plant. Earlier formed xylem elements are called protoxylem, whereas the later formed xylem elements are called 73 metaxylem. Xylem is made up of four kinds of cells - tracheids, vessels or tracheae, xylem fibres and xylem parenchyma. There are different types of cell wall thickening due to deposition of secondary wall substances. They are annular (ring like), spiral (spring like), scalariform (ladder like), reticulate (net like) and pitted (uniformly thick except at pits). Here, the conduction of water and mineral salts takes place through the bordered pits. Due to dissolution of entire end wall, a single pore is formed at the perforation plate. If the perforation plate has many pores, then it is called multiple perforation plate. Types of secondary wall thickenings in tracheids 74 Bordered pit Bordered pit Simple pit Simple pit Cytoplasm Nucleus Xylem Vessel parenchyma Tracheid Xylem fibre Fig. Kinds of xylem cells conducting elements in angiosperms and they are absent in pteridophytes and gymnosperms. Xylem fibres The fibres of sclerenchyma associated with the xylem are known as xylem fibres.
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A tuberculous ulcer may perforate the bowel generic kamagra super 160mg fast delivery erectile dysfunction videos, or bleed; because this occurs distally buy kamagra super with visa psychological reasons for erectile dysfunction causes, bleeding is usually from the rectum order kamagra super 160mg free shipping erectile dysfunction pills from india. Do an abdominal ultrasound scan to look for Tuberculosis may be responsible for 80% of all your cases of lymphadenopathy effective super p-force 160mg, and the condition of the liver and kidneys order cheap female cialis online. Presentation is with a swollen abdomen containing many litres of straw-coloured fluid. The fluid accumulates as a result of large If the fluid has fewer lymphocytes than this, the ascites is numbers of exudative miliary tubercles on the peritoneum. In tuberculous but you can be wrong, so take a biopsy of the parietal peritonitis it is usually 4-10g/l, but it may be up to 20g/l, peritoneum and/or the liver. Occasionally the ascites If it contains >4g/l of protein, it is likely to be an exudate. If it contains <4g/l, it is likely to be a transudate as found in cirrhosis or periportal fibrosis. You may be able to get special dipsticks for ascites which, though expensive, are very useful. Suggesting ascites secondary to liver disease: the liver may be enlarged, hard, and irregular, or small and hard to feel; the spleen is usually large; there are usually <4g/l of protein in the peritoneal fluid. Suggesting the nephrotic syndrome: the ascites is less marked than the generalized oedema. B, draw off the fluid Suggesting heart failure leading to cirrhosis and ascites: slowly before you start. C, miliary tubercles of the parietal peritoneum a raised jugular venous pressure, and other signs of heart and bowel. Ascites predominating over other symptoms are subacute or chronic, and may have lasted signs usually requires a mini-laparotomy. The adhesions which stick the loops of the indicated when the ascites is not predominant, as in the bowel together are extensive and difficult to separate, generalized oedema of heart failure, or renal disease. If there is more than mild because there is always a danger that a fistula may follow. Re-examine the abdomen once the ascites is drained obstruction; use these only when extensive matting of bowel away; you may be able to feel a liver, spleen or other prevents you from reaching the site of obstruction, abdominal masses previously obscured. To avoid possible injury to a large spleen, which may be difficult to feel because of the ascites, Avoid these common mistakes: drain the fluid from the right lower abdomen. Tubercles are remarkably uniform in size, (5) If the patient is desperately ill, do not make meddlesome and fairly uniform in appearance (like salt grains). Biopsy the and dangerous attempts to resect grossly scarred bowel, peritoneum by removing an elliptical piece of the parietal nor to free difficult adhesions. Abdominal pain (90%) is usually constant, central, Tenderness is not constant, and palpable masses of worms are and not severe. Suggesting an appendix mass: a short history, and an acute Alternating constipation and diarrhoea, cramps, and onset.