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Kerala, a State in the Republic of India, has 14 districts or administrative divisions. The major cities are Thiruvananthapuram, Kochi and Kozhikode. There are three airports in the state which provide international and domestic connections.
One of India’s most literate and socially advanced, the people of Kerala enjoy a unique cosmopolitan viewpoint, which is reflected in their spirit of tolerance and catholicity of outlook. This can be attributed to Kerala’s composite culture to which several lands and races from across the world have contributed significantly.
Through the ages, Kerala has demonstrated a remarkable ability to adapt to new traditions and values in almost every sphere of human thought and endeavour. This positive response to changes and challenges is what sets the Keralan people as well as the society apart.
Keralites have a high degree of awareness and political consciousness. In the field of education too, Keralites hold a unique position. The literacy rate for women is one of the highest in all of Asia. Which is perhaps why the women in the State enjoy a privileged status both within the family and society.
(Continued at : http://www.keralatourism.org/pictures/ )Kerala, a State in the Republic of India, has 14 districts or administrative divisions. The major cities are Thiruvananthapuram, Kochi and Kozhikode. There are three airports in the state which provide international and domestic connections. One of India’s most literate and socially advanced, the people of Kerala enjoy a unique cosmopolitan viewpoint, which is reflected ...
Jaundice, (also known as icterus, attributive adjective: icteric) is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae (whites of the eyes), and other mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Typically, the concentration of bilirubin in the plasma must exceed 1.5 mg/dL ( > 35 micromoles/L), three times the usual value of approximately 0.5 mg/dL, for the coloration to be easily visible. Jaundice comes from the French word jaune, meaning yellow.
The conjunctiva of the eye are one of the first tissues to change color as bilirubin levels rise in jaundice. This is sometimes referred to as scleral icterus. However, the sclera themselves are not “icteric” (stained with bile pigment) but rather the conjunctival membranes that overlie them. The yellowing of the “white of the eye” is thus more properly termed conjunctival icterus. The term “icterus” itself is sometimes incorrectly used to refer to jaundice that is noted in the sclera of the eyes, however its more common and more correct meaning is entirely synonymous with jaundice.
It was once believed persons suffering from the medical condition jaundice saw everything as yellow. By extension, the jaundiced eye came to mean a prejudiced view, usually rather negative or critical. Alexander Pope, in “An Essay on Criticism” (1711), wrote: “All seems Infected that th’ Infected spy, As all looks yellow to the Jaundic’d Eye.” Similarly in the mid-19th century the English poet Alfred Lord Tennyson wrote in the poem Locksley Hall: “So I triumphe’d ere my passion sweeping thro’ me left me dry, left me with the palsied heart, and left me with a jaundiced eye.”
When a pathological process interferes with the normal functioning of the metabolism and excretion of bilirubin just described, jaundice may be the result. Jaundice is classified into three categories, depending on which part of the physiological mechanism the pathology affects. The three categories are:
Category Definition Pre-hepatic The pathology is occurring prior to the liver. Hepatic The pathology is located within the liver. Post-Hepatic The pathology is located after the conjugation of bilirubin in the liver.
Pre-hepatic jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia, spherocytosis, thalassemia and glucose 6-phosphate dehydrogenase deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as hemolytic uremic syndrome, can also lead to coloration. Defects in bilirubin metabolism also present as jaundice, as in Gilbert’s syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population)and Crigler-Najjar syndrome.
In jaundice secondary to hemolysis, the increased production of bilirubin, leads to the increased production of urine-urobilinogen. Bilirubin is not usually found in the urine because unconjugated bilirubinn is not water-soluble, so, the combination of increased urine-urobilinogen with no bilirubin(since, unconjugated)in urine is suggestive of hemolytic jaundice.
Laboratory findings include:
- Urine: no bilirubin present, urobilirubin > 2 units (i.e., hemolytic anemia causes increased heme metabolism; exception: infants where gut flora has not developed).
- Serum: increased unconjugated bilirubin.
- Kernicterus is associated with increased unconjugated bilirubin.
Hepatocellular (hepatic) jaundice can be caused by acute hepatitis, hepatotoxicity, and alcoholic liver disease. Cell necrosis reduces the liver’s ability to metabolize and excrete bilirubin leading to a buildup of unconjugated bilirubin in the blood. Other causes include primary biliary cirrhosis leading to an increase in plasma conjugated bilirubin. Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age. Rat fever (leptospirosis) can also cause hepatic jaundice. In hepatic jaundice, there is invariably cholestasis.
Laboratory findings depend on the cause of jaundice.
- Urine: Conjugated bilirubin present, urobilirubin > 2 units but variable (except in children). Kernicterus is a condition not associated with increased conjugated bilirubin.
Post-hepatic jaundice, also called obstructive jaundice, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct, and pancreatic cancer in the head of the pancreas. Also, a group of parasites known as “liver flukes” can live in the common bile duct, causing obstructive jaundice. Other causes include strictures of the common bile duct, biliary atresia, ductal carcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi’s syndrome.
In complete obstruction of the bile duct, no urobilinogen is found in the urine,since bilirubin has no access to the intestine and its in the intestine that bilirubin gets converted to urobilinogen to be later released into the general circulation. In this case, presence of bilirubin(conjugated) in the urine without urine-urobilinogen suggests obstructive jaundice, either intra-hepatic or post-hepatic.
The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from bile pigments. However, although pale stools and dark urine are a feature of biliary obstruction, they can occur in many intra-hepatic illnesses and are therefore not a reliable clinical feature to distinguish obstruction from hepatic causes of jaundice.
Patients also can present with elevated serum cholesterol, and often complain of severe itching or “pruritus” because of the deposition of bile salts.
No single test can differentiate between various classifications of jaundice. A combination of liver function tests is essential to arrive at a diagnosis.
Table of diagnostic tests Function test Pre-hepatic Jaundice Hepatic Jaundice Post-hepatic Jaundice Total bilirubin Normal / Increased Increased Conjugated bilirubin Normal Increased Increased Unconjugated bilirubin Normal / Increased Increased Normal Urobilinogen Normal / Increased Increased Decreased / Negative Urine Color Dark(urobilinogen) Dark (urobilinogen + conjugated bilirubin) Dark (conjugated bilirubin) Stool Color Normal Pale Alkaline phosphatase levels Normal Increased Alanine transferase and Aspartate transferase levels Increased Conjugated Bilirubin in Urine Not Present Present
(more at: http://en.wikipedia.org/wiki/Jaundice)
Milte Hi Aankhein, Movie – Babul Chhod Babul Ka Ghar, Movie – Babul
1. Raw horse meat is a popular food in Japan.
2. Sometimes the trains are so crowded railway staff are employed to cram passengers inside.
3. For many Japanese couples Christmas is celebrated like Valentine’s Day in the western world.
4. Poorly written English can be found everywhere, including T-shirts and other fashion items.
5. More than 70% of Japan consists of mountains, including more than 200 volcanoes.
6. Mt. Fuji, the tallest mountain in Japan, is an active volcano.
7. Religion does not play a big role in the lives of most Japanese and many do not understand the difference between Shintoism and Buddhism.
8. A nice musk melon, similar to a cantaloupe, may sell for over $300US.
9. There are four different writing systems in Japan, romaji, katakana, hiragana, and kanji.
10. Coffee is very popular and Japan imports approximately 85% of Jamaica’s annual coffee production.
11. Japan’s literacy rate is almost 100%.
12. Sumo is Japan’s national sport, although baseball is also very popular.
13. Sumo wrestlers eat a stew called Chankonabe to fatten up. Many restaurants in the Ryogoku district of Tokyo serve this nabe (Japanese word for stew).
14. Many of the western style toilets in Japan have a built-in bidet system for spraying your backside.
15. When you use the restroom in some one’s home, you may need to put on special bathroom slippers so as not to contaminate the rest of the home.
16. Noodles, especially soba (buckwheat), are slurped loudly when eaten. It is often said slurping symbolizes the food is delicious, but the slurping also serves to cool down the hot noodles for eating.
17. Japan is the world’s largest consumer of Amazon rain forest timber.
18. Vending machines in Japan sell beer, hot and cold canned coffee, cigarettes, and other items.
19. When moving into an apartment it is often required to give the landlord a “gift” of money equal to two months’ rent.
20. There are around 1,500 earthquakes every year in Japan.
21. In Japan it is not uncommon to eat rice at every meal, including breakfast.
22. Average life expectancy in Japan is one of the highest in the world. Japanese people live an average of 4 years longer than Americans.
23. Japan is the largest automobile producer in the world.
24. The Japanese language has thousands of foreign loan words, known as gairaigo. These words are often truncated, e.g. personal computer = paso kon. The number of foreign loan words is steadily increasing.
25. Tsukiji market in Tokyo is the world’s largest fish market.
26. Although whaling is banned by the IWC, Japan still hunts whales under the premise of research. The harvested whale meat ends up in restaurants and supermarkets.
27. In the past men might shave their heads to apologize.
28. In the past women in Japan might cut their hair after breaking up with a boyfriend.
29. Tokyo has had 24 recorded instances of people either killed or receiving serious skull fractures while bowing to each other with the traditional Japanese greeting.
30. The first novel, The Tale of Genji, was written in 1007 by a Japanese noble woman, Murasaki Shikibu.
31. The term karaoke means “empty orchestra” in Japanese.
32. In a Sumo training “stable” the junior rikishi Sumo wrestlers must wash and bathe their senior sumo wrestlers and make sure their hard to reach places are clean.
33. Contrary to popular belief, whale meat is not a delicacy in Japan. Many Japanese dislike the taste and older Japanese are reminded of the post-World War II period when whale meat was one of the few economical sources of protein.
34. Rampant inbreeding of dogs has resulted in one of the highest rate of genetic defects in the world for canines.
35. Raised floors help indicate when to take off shoes or slippers. At the entrance to a home in Japan, the floor will usually be raised about 6 inches indicating you should take off your shoes and put on slippers. If the house has a tatami mat room its floor may be rasied 1-2 inches indicating you should to take off your slippers.
36. Ramen noodles are a popular food in Japan and it is widely believed extensive training is required to make a delicious soup broth. This is the subject of the movies Tampopo (1985) and The Ramen Girl (2008).
37. On average, it takes about 7-10 years of intensive training to become a fugu (blowfish) chef. This training may not be needed in the future as some fish farms in Japan are producing non-poisonous fugu.
38. Ovens are not nearly as commonplace as rice cookers in Japanese households.
39. Geisha means “person of the arts” and the first geisha were actually men.
40. It was customary in ancient Japan for women to blacken their teeth with dye as white teeth were considered ugly. This practice persisted until the late 1800’s.
41. In ancient Japan, small eyes, a round puffy face, and plump body were considered attractive features.
42. Some traditional Japanese companies conduct a morning exercise session for the workers to prepare them for the day’s work.
43. In Japan non-smoking areas are difficult to find in restaurants, including family restaurants. Many of Japan’s politicians have interest in the tobacco industry so anti-smoking laws are almost non-existent. If you are planning a trip to Japan you may want to think twice if you are sensitive to cigarette smoke.
(source : http://www.facts-about-japan.com/interesting.html)
- A man was riding a bus, minding his own business, when the gorgeous woman next to him started to breastfeed her baby.The baby wouldn’t take it, so she said: “Come on, eat it all up or … I’ll have to give it to this nice man here.”Five minutes later, the baby was still not feeding, so she said,”Come on, honey. Take it or I’ll give it to this nice man here”A few minutes later, the anxious man blurted out: “Come on, kid. Make up your mind! I was supposed to get off four stops ago!”
(contributed by : A Mohan Rao on 31.03.2011)A man was riding a bus, minding his own business, when the gorgeous woman next to him started to breastfeed her baby. The baby wouldn’t take it, so she said: “Come on, eat it all up or … I’ll have to give it to this nice man here.” Five minutes later, the baby was still not feeding, ...