DOH Advisory in the Philippines for PAPAL VISIT 2015

Reference: DOH

Road to IELTS:Tips For Your Reading Test

Tips For Your Reading Test

• Don’t start by reading the whole text and then the questions: you don’t have time to do this. Start by skimming: look at the title, headings the text. This will give you a good overview.

• Now look at the questions and underline key words. As you do this, think of synonyms for these words because these are likely to occur in the text. For example, the word “game” might appear in the question, where the original word in the text is “match”. 

• Make sure you are familiar with the question types. You can only do this by spending as much time as possible practising. 

"To do well in the Reading test, you have  to understand the task types, and you'll need strategies for reading quickly and efficiently."

Meningococcemia

What Is Meningococcemia?

Meningococcemia is a bacterial infection caused by the Neisseria meningitides bacteria. This is the same type of bacteria that causes some types of meningitis. When the bacteria infect the membranes (meninges) that cover the brain and spinal cord, the infection is called meningitis. When the infection remains in the blood, but does not infect the brain or spinal cord, it is called meningococcemia.

Neisseria meningitides bacteria are common in your upper respiratory tract and do not necessarily cause illness. The disease spread from person to person when someone infected with the bacteria sneezes or coughs. Although anyone can get meningococcemia, it is most common in babies, children, and young adults.

An infection by Neisseria meningitidis, whether it becomes meningitis or meningococcemia, is considered a medical emergency and requires immediate medical attention.

What Causes Meningococcemia?

Neisseria meningitidis, the bacteria that causes meningococcemia, can harmlessly live in your upper respiratory tract. However, simply being exposed to this germ is not enough to cause this disease. According to the Indiana State Department of Health, up to 10 percent of people may carry these bacteria (ISDH)—and not all of these people become sick.

An infected person can spread these bacteria through coughing and sneezing.

What Are the Symptoms of Meningococcemia?

You will generally only have a few symptoms at first. These symptoms are common and include:

• a fever
• a headache
• a rash consisting of small spots
• nausea

You might also feel irritable or anxious.

As the disease progresses, you will develop more serious symptoms. These include blood clots and patches of bleeding under your skin.

As the condition progresses, you may be lethargic or slip into a stupor. You may also go into shock.

How Is Meningococcemia Diagnosed?

Meningitis is usually diagnosed through blood tests. Your doctor will take a sample of your blood and then do a blood culture on it to determine if bacteria is present. Your doctor might perform the same test using fluid from your spine instead of your blood. In this case, the test is called a cerebrospinal fluid (CSF) culture. He or she will get CSF from a spinal tap (lumbar puncture). Blood is usually drawn from a vein in your arm or hand.

Other tests your doctor might perform are:

• skin biopsy
• blood clotting tests
• complete blood count (CBC)

He or she might also perform tests on your urine.

How Is Meningococcemia Treated?

Meningococcemia must be treated immediately. You will be admitted to the hospital and possibly kept in an isolated room to stop the bacteria from spreading.

You will be given antibiotics through a vein (intravenously) to begin fighting the infection. You will probably also receive intravenous fluids.

Other treatments depend on the symptoms you have developed. If you have blood clots, for example, you will receive care to treat them. If you are having difficulty breathing, you will receive oxygen. If your blood pressure becomes too low, you will receive medication to help treat that issue.

Meningococcemia can sometimes lead to bleeding disorders. If this occurs, your doctor or healthcare provider might give you platelet replacement therapy.

In some cases, your doctor might also wish to give your close contacts antibiotics, even if they show no symptoms. This can help prevent them from developing the disease.

Who Is Likely to Develop Meningococcemia?

According to the Illinois Department of Public Health, around half of the total number of cases of meningococcal disease (which includes meningococcal meningitis and meningococcemia) occur in children under 4 years old (IDPH).

If you have recently moved into a group living situation (such as a dormitory) you are more likely to develop these conditions. If you are planning to enter into such a living situation, your doctor may tell you to get vaccinated against this condition.

You are also at greater risk if you live with or have been in very close contact with someone who has the disease. Consider speaking to your doctor if this is the case. He or she may choose to give you preventive antibiotics.

Tips to Prevent Meningococcemia

There is no sure way to prevent meningococcemia.

A vaccine exists, but it is only effective against some types of the bacteria that cause this condition. Furthermore, most doctors only give this vaccine to people in certain categories such as teenagers and people about to move into a dormitory for the first time.

You can help reduce your risk of meningococcemia by avoiding people who are coughing, sneezing, or showing other signs of illness. This means not sharing anything that comes into contact with the mouth unless it has been washed after it was last used.

Reference: http://www.healthline.com/health/meningococcemia#Diagnosis4

Road To IELTS: Important Rules And Procedures You Need To Know

Important Rules And Procedures You Need To Know


Identity checks 

When you fi ll in the IELTS Application form you will specify your proof of identity document, which must be a national ID card or your passport. You must bring the same document on the
test day. Before you take the test you may have your photo taken to be embedded on your Test Report Form.

Don’t forget to bring your identity document for the Speaking test.

What to bring on test day(s)

As well as your identity document, you may need to bring two recent (not more than six months old) identical passport-sized photographs. Check your test documentation to seewhether this applies to you. The only other items you can bring into the test are pens, pencils and erasers.

Remember to switch off your mobile phone: failure to do so could result in you being disquali ed!

Taking the test

You will do the Listening test first, and then the Reading and Writing. The Speaking test may be on a different day, up to seven days before or after the written papers. Remember that you must complete the answer paper in pencil as it will be processed by a machine that can’t read ink. At the end of the test, stay in your seat until you are given permission to leave the room.



Screenshot of  IELTS Application Form

Reference: http://www.ieltspractice.com/?utm_source=Guide1&utm_medium=btm_website&utm_campaign=StudyGuide

Road To IELTS: Four Tips For Your Writing Test

The Basics

The Writing test lasts an hour and is in two parts:

Task 2 is the same for both IELTS Academic and IELTS General Training: you will be asked to write a short essay (min. 250 words) in response to a point of view, a problem or an argument.

Task 1 (min. 150 words) is different:

• Academic: you will interpret and describe information in a chart, diagram,

table or graph.

• General Training: you will write a letter in response to an everyday situation or

problem, e.g. looking after someone's house while they are away on holiday.

"In the writing test, effective time management is the key to achieving your best possible band score."

Here are Four tips for your Writing Test!!!!!

• Do write in paragraphs. Focus on one idea in each paragraph and introduce it with a topic sentence. The rest of the paragraph should explain, expand on,support or illustrate the idea.

• Similarly, in Task 2, make sure that you structure your essay with an introduction, a body and a conclusion. The introduction should not be too long, and the conclusion should be a summary of the key points and your nal viewpoint.

• Don’t simply copy words from the question paper. Use your own words to paraphrase the question, and make sure you demonstrate the breadth of your vocabulary.

• Don’t use bullet points or note form: you need to write in complete sentences.

Reference: http://www.ieltspractice.com/?utm_source=Guide1&utm_medium=btm_website&utm_campaign=StudyGuide

Latest Updates In Nurses: Pediatric Pneumococcal Infections

Streptococcus pneumoniae  colonizes the upper respiratory tract of healthy individuals and is one of the most frequent causes of bacterial infection in children. Pediatric infections caused by this pathogen include otitis media (OM), sinusitis, occult bacteremia, pneumonia, meningitis, osteomyelitis, septic arthritis, pericarditis, and peritonitis.

Essential update: New recommendation says high-risk children should receive pneumococcal conjugate vaccine

A new recommendation from the American Association of Pediatrics states that children between the ages of 6 and 18 years with immune deficiency disorders and other high-risk conditions such as HIV, sickle-cell disease, or cerebrospinal fluid leaks should receive a single dose of PCV13. These children should receive the vaccination regardless of prior vaccination status. Also, if these children did not receive PPSV23 previously they should receive a dose of this vaccine no less than 8 weeks after their dose of PCV13. Recommendations for children aged 5 years and younger remain the same.

Signs and symptoms

Children with pneumococcal infections usually have a temperature higher than 102°F, along with symptoms of specific infections, as follows:

• OM – Otalgia, upper respiratory symptoms, vomiting
• Sinusitis – Headache, facial tenderness (much less frequent than in adults), symptoms of upper respiratory tract infection lasting for 10 days or longer
• Occult bacteremia – Fever without a localizing source in children aged 2-24 months
• Pneumonia – Cough; chest pain, shortness of breath, or respiratory difficulty; malaise and poor appetite
• Meningitis – Stiff neck, vomiting, headache (older children); high fever (>103°F), lethargy, irritability, poor feeding, inconsolable crying^[2]

Physical findings include the following:

• OM – Bulging, erythematous, or yellow tympanic membrane with poor mobility and purulent fluid seen behind the membrane
• Sinusitis – Tenderness to palpation over maxillary or frontal sinuses, nasal discharge of any color, swollen nasal turbinates
• Bacteremia – None, besides fever (≥102°F) and tachycardia associated with the fever
• Pneumonia – Crackles or decreased breath sounds in the area of lobar consolidation on chest auscultation, with egophony in patients with severe consolidation and dullness to percussion; retractions, tachypnea, or both
• Meningitis or other central nervous system (CNS) infection – Ill appearance; nuchal rigidity (may not be present before age 4 months); altered mental status with poor responsiveness (patient may present in comatose state); other neurologic abnormalities possible (eg, cranial nerve deficits, ataxia, weakness); poor perfusion and signs of shock in patients with concurrent pneumococcal sepsis

Diagnosis

The following laboratory studies are indicated in patients with pneumococcal infections:

• White blood cell (WBC) count and differential
• Antigen tests (cerebrospinal fluid [CSF], urine)
• Gram stain (CSF, synovial fluid, pleural fluid)
• Culture (blood, CSF, pleural fluid, middle ear effusion, synovial fluid)

Specific testing recommendations for particular clinical syndromes are as follows:

• OM or sinusitis – Tympanocentesis and bacterial cultures of middle ear fluid if chronic OM is refractory to antibiotics
• Sinusitis – Culture of sinus fluid if sinusitis is refractory to antibiotics
• Occult bacteremia – Culture of blood (≥2 mL)
• Pneumonia – Blood culture; sputum cultures are difficult to obtain from children, and results may be falsely positive
• Meningitis (suspected) – Lumbar puncture with CSF analysis (cell count, protein levels, glucose levels, Gram stain, culture; antigen tests are needed only in cases of antibiotic pretreatment); blood culture
• Osteomyelitis or septic arthritis – Surgical biopsy or joint aspiration; culture of fluid or bone; blood culture

Imaging studies that may be helpful include the following:

• Chest radiography
• Computed tomography (CT) of the head (often unnecessary)
• Magnetic resonance imaging (MRI) of the head

Management

Antibiotic therapy and supportive care are indicated. The key to successful antibiotic therapy is achieving drug concentrations in the affected area of the body that are several times higher than the minimal inhibitory concentration (MIC) for S pneumoniae.

Recommendations for particular clinical situations include the following:

• OM or sinusitis (initial treatment) – Amoxicillin for 5-10 days (otitis media) or 10-21 days (sinusitis)
• OM or sinusitis that does not improve with standard-dose amoxicillin – High-dose amoxicillin, amoxicillin-clavulanate, cefuroxime, or ceftriaxone (IM)
• Pneumonia (outpatient) – Amoxicillin for 10 days
• Pneumonia (inpatient) – IV ceftriaxone until clinical improvement, then 10 days of outpatient treatment; in critical illness, addition of vancomycin should be considered
• Other invasive pneumococcal diseases – A third- or fourth-generation parenteral cephalosporin (ceftriaxone, cefotaxime, cefepime); in critical illness or the absence of clinical improvement, addition of vancomycin should be considered
• Meningitis – Ceftriaxone or cefotaxime; meropenem may be an alternative in cases of ceftriaxone resistance; vancomycin is always added until susceptibilities are known; rifampin may be added after 24-48 hours of improvement is not noted or the relevant MIC is high
• Penicillin allergy (OM, sinusitis, outpatient treatment of pneumonia) – Azithromycin (or other macrolide), clindamycin, cefuroxime (if there is no cephalosporin allergy), or cefprozil
• Penicillin allergy (inpatient treatment of pneumonia or other invasive infections) – IV ceftriaxone (if there is no cephalosporin allergy); alternatively, IV clindamycin or meropenem; vancomycin may be considered if the patient is severely ill and microbial susceptibility is unknown

Streptococcus pneumoniae colonizes the upper respiratory tract of healthy individuals and is one of the most frequent causes of bacterial infection in children. Common infections caused by this pathogen include otitis media (OM), sinusitis, occult bacteremia, pneumonia, and meningitis. Pneumococci may also cause osteomyelitis, septic arthritis, pericarditis, and peritonitis. See the image below.

Reference: http://emedicine.medscape.com/article/967694-clinical