care of your friend's feeling....!!!

i don't know wats wrong with everyone around me... all they keep talking about that i'm is kedekut and berjimat... is that a sin..!!!! i'm doing that for a reas0n, for sure.. they never asked me why i'm being like that... i'm the oldest children in family... i'm not from rich family...and my dad have a finance problems past 1 year.. i'm trying to help him with my JPA money... i bagi mak duet dapur... belanja adek2 mkn, baju kalau i balek rumah... bukan nk mengungkit......tapi bila dieorang ckap macam tu.....macam nak terkeluar je jantung ni sbab marah.... adeyh... ahhh...sakit ati  betul... sometime i also belanja dieorang eat KFC, help them...aahh.. why i have friends like this... i hope.. u not doing this to ur friends like that... it's very hurting me inside...

Acute Respiratory Distress Syndrome (ARDS)

morphology:

• gross            :- lung are dark red, firm, airless, and heavy
• microscopic :- capillary congestion, necrosis of alveolar epithelial cell, interstial and intra-alveolar edema and hemorrage and collection of neutrophil in capillaries, hyaline membranes lining the distended alveolar duct. 

 

thyphoid fever

bacteria                             = salmonella typhi
transmission through        = fecal oral
                                           =contaminated water@food
clinical manifestation
= prolong fever (pyrexia of unknown origin with stepladder pattern)
= constipation in early of the disease followed by diarrhea
= diarrhea and vomiting in children
= malaise
= increasing headache
= relative bradycardia
= end of first week :- rose spot (rash)
= 7th - 10th day :- spleen is palpable                                  ( clinical manifestation=from Davidson's         
= abdominal distension and tenderness                                  principal and practice of medicine )          

#  caldinal sign

• fever -stepladder pattern
• relative bradycardia
• spleen palpable
• rose spot
• characteristic toxemia 

Pathogenesis : 

demam @ step to fever