Success is about hard work and not luck Essay Example for Free

Success is about hard work and not luck Essay This is the case of 74 year old male patient heavy smoker (2 packs per day) presenting to the floor of MGH for the above chief complaints. History goes back to 15 days when the patient noticed 3 successive episodes of blood with urination at morning, one hour apart, painless ,of large amount, complete stream ,also the patient recorded that he saw 2 pieces of clots after voiding at noon of same day .then the color of urine was back to normal as the patient said. there’s associated nocturia, urgency, and drippling of one month duration .also weight loss of 15 kg within 3Â  months.NO burning sensation , no pain ,no dysuria, no fever ,no flank pain,no back pain, no nausea no vomiting, no constipation ,no other system involved symptoms. The patient was admitted to MGH for further investigations. PMH : DM 25 years ago HTN 10 years ago CAD 10 years ago Medications: concor 5 mg one at morning aspicot 100 mg OD Lipitor 20 mg OD glucophage 750 mg PO BID amaryl 4 mg PO daily tritase 10 mg PO daily PSH: CABG, hemorroidectomy , left herniectomy, right hip fixation by plates and screws(duration unknown by the patient). Family history: Mother(DM,HTN,CAD) Allergy : No known drug or food allergy. Physical examination: General examination: The patient is conscious, cooperative, oriented, pale, sitting, thin , cachectic ,having foley catheter.(seen 2 days postop) Vital Signs: RR: 24/min Pulse: 64/min Temp.: 37.4 C BP: 160/90 mmhg. HEENT : pallor, no cyanosis, no jaundice, no ecchymosis, no mouth ulcers , bad oral hygiene Decreased visual acuity (presbiopia) ,arcus senilis ,diplopia No tinnitus, no vertigo (Dix hallpike test not done) Chest ex:good bilateral air entry. No rub, no crepitations, no wheezes. cardiac ex: Regular S1S2 with no murmurs. Abdomen ex: 1. Inspection: non distended symmetrical abdomen No visible pulsation or peristalsis No localized bulge Male pattern of hair distribution Umbilicus is slightly shifted downwards, no discharge No full flanks Normal subcostal angle No spider angiomas No visible veins No scars, or scaling red colored urine(in the foley’s bag) but the urine is clear due to irrigation of bladder 2.Auscultation: audible bowel sounds, no renal artery bruit 3.Palpation: soft non tender abdomen, warm, no palpable masses, Lower border of liver is not felt, upper border at 5th ICS along the MCL Spleen is not palpable Both kidneys are not palpable , no CVA tenderness. no suprapubic pain. 4.Percussion:tympanitic urinary bladder 5.DRE: not done 6.Genitalia examination: not done Lower limbs :positive pedal pulses no lower limb edema, no redness no bruises no muscular atrophy. Differential diagnosis: 1- bladder cancer 2- BPH 3- Prostatitis 4- Urolithiasis 5- Prostate cancer incidental or advanced. Investigations : Labs : CBCD, BUN, Creatinine ,electrolytes, CRP, HBA1C,FBS,LDL,HDL,triglyceride PT ,PTT ,PSA, urine analysis and culture. Imaging : CT urography(uroscan),cystoscope and urine cytology. What was done at the hospital : Item Minumum Maximum Value pre op Hemoglobin Urine analysis : normal Ultrasound of pelvis : no post residue voiding ,small thick wall, prostate is enlarged measuring 39 grams Management : Control the glucose level preop TURBT TURP to relieve obstruction with biopsy of prostate Send the samples to pathology and wait the results. If the tumor did not invade the detrusor muscle it’s superficial and managed according to grading and depth (Ta low grade TUPBT only ,T1 low grade or Ta high grade TURBT + intravesicle injection of chemotherapy , T1 high grade TUPBT and relook after 1 month) if invade the detrusor muscle : T2 = metastatic workup CT abdomen ,chest , and bone scan.then remove the bladder and do urinary divergence by neobladder or ileostomy(conduit).

Abandoning the Constitution in the Fight Against Terrorism Essay

Abandoning the Constitution in the Fight Against Terrorism    During his terms as governor of Texas, George W. Bush made it clear that he was ignorant of the Constitution by denying due process to the people he executed and refusing effective counsel to indigent inmates.   As president, Bush, terrorized by terrorists, is abandoning more and more of the fundamental rights and liberties that he-and his subordinates-assure us they are fighting to preserve. On Thursday, November 15, William Safire-The New York Times' constitutional conservative-distilled Bush's new raid on the Constitution: "Misadvised by a frustrated and panic-stricken attorney general, a president of the United States has just assumed what amounts to dictatorial power to jail or execute aliens. . . . We are letting George W. Bush get away with the replacement of the American rule of law with military kangaroo courts. . . . In an Orwellian twist, Bush's order calls this Soviet-style abomination 'a full and fair trial.' " What Bush has done by executive order-bypassing Congress and the constitutional separation of powers-is to establish special military tribunals to try noncitizens suspected of terrorism. Their authority will extend over permanent noncitizen American residents, lawfully living in the United States, as well as foreigners. The trials will be held here or in other countries-like Pakistan or "liberated" Afghanistan-and on ships at sea. The trials will be in secret. There will be no juries. Panels of military officers will be the judges-with the power to impose the death penalty if two-thirds of these uniformed judges agree. There will be no appeals to any of the sentences. (Even in regular court martials, judges must rule unanimous... ... Supreme Court (Olmstead v. United States, 1928), foreshadowed the advent of George W. Bush: "Our Government is the potent, the omnipresent teacher. For good or ill, it teaches the whole people by its example. Crime is contagious. If the Government becomes a lawbreaker, it breeds contempt for law; it invites every man to become a law unto himself; it invites anarchy. . . . To declare that in the administration of the criminal law, the end justifies the means . . . would bring terrible retribution. Against this pernicious doctrine this Court should resolutely set its face." In 1928, the Supreme Court agreed with the government's subversion of the Fourth Amendment's privacy protections-setting the initial stage for the current vast expansion of electronic surveillance by the Bush administration-and not only over suspected terrorists. The Court has another

A Maya Village: The Folk-Urban Continuum Essay

The â€Å"folk-urban continuum† model elaborated by Robert Redfield continues to reappear from time to time in various guises. The concept of the continuum has been attacked as being simplistic, and overgeneralized, not least because many geographers have detected village-type communities within large cities. Redfield’s speculations about what he saw as the significant changes from the folk to the urban end of the continuum are based on studies conducted in the Yucatan during the early 1930s. It’s essential elements focus on the fact that as a community moves from the folk to the urban end of the continuum, there occur shifts from cultural intimacy and organization to disorganization. Along with this there is collective or community orientation to individualization; and the sacred to the secular. Folk cultures are borne by small, closely-integrated social units or by aggregates of such units which have already worked out satisfactory mutual adjustments. Redfield characterized the folk societies he had been studying as traditional, spontaneous, and uncritical where men follow similar lifestyles. These patterns remain clear throughout the generations. In sum, the folk society holds its traditions to heart and doesn’t question their way of life. These lifestyles are practically sacred. In modern civilization, on the other hand, the small social units are being broken down, giving place to masses of individuals who are much more loosely interrelated than the members of the former local groups and classes. In modern civilizations, culture is being reduced. Our own civilization is simply a blend of differences which he must choose. The concepts of folk religion and folk belief–at least when filtered through Redfield’s categories–are descriptive anthropological categories meant to aid in the attempt to understand the conditions and development of certain kinds of society. In part, Redfield’s concept of folk or peasant culture was meant to provide an alternative to the division of societies into primitive and modern categories. The concept relied on a distinction between â€Å"an isolated primitive community, which has for context only that community and its local and immediate culture,† and the peasant community and its culture, where â€Å"the context is widened to include the elements of the great traditions that are or have been in interaction with what is local and immediate.† Folk beliefs referred to a body of belief and practice forming part of a community’s local knowledge. As a result, they tended to occupy a region close to the cosmology and common sense of the group, rather than the domain occupied by a consciously accepted creed. Redfield wants to look at cultural change, in the ways that varying degrees of contact with â€Å"civilization† differentially affects â€Å"folk culture† throughout the Yucatan. The Chan Kom study was the first step in a project funded by the Carnegie Institution to look at the question of culture change. The project was to begin by studying † a community where folk culture was complete†. This is Chan Kom. Then, for comparison, the study was to go on to look at â€Å"communities where that culture is in disorganization or conversion into something else†. Eventually, this project would encompass four towns and would place them in a â€Å"folk-urban continuum†.

Essay about Military Justice System in the United States

When one joins the United States military, one becomes subject to a completely new justice system. While the primary purpose of the United States justice system is to dispense justice, that is not the primary reason for the creation of a separate justice system for Americas Armed Forces. The primary purpose of the militarys system is to provide the military commander with necessary tools to enforce good order and discipline. Thats why, for example, its not considered a crime to be late for work at your civilian job, but it is a crime to be late for work in the Military. The purpose then is to keep soldiers acting as soldiers so the correctional philosophy in the military has evolved in such a way to do just that. In discussing†¦show more content†¦The purpose then is to keep soldiers acting as soldiers so the correctional philosophy in the military has evolved in such a way to do just that. In discussing the UCMJ and corrections, the following topics are significant. The military justice system derives its authority from three sources, The Uniform Code of Military Justice, The Manual for Courts Martial, and Army Regulation 27-10. The UCMJ is federal law and forms the base of the military justice system. The UCMJ determines what is to be considered criminal conduct and establishes the various types of courts, and establishes the procedures to be followed in the carrying out of military justice. (FM 27-1, 1992, pg. 1-1) Counseling and Corrective Training Counseling and corrective training comprise the base for the UCMJ. With counseling and corrective training first line supervisors are able to deal with infractions of the UCMJ at their level. This allows them to mentor and mold soldiers as well as deal with that soldiers violation of the UCMJ. Counseling is documenting what article was violated, what actions can be taken against the soldiers and any thought the soldiers leader might have on the issue. Corrective training is the punishment enacted by the leader upon the soldier. According to army regulation the punishment must fit the crime. (AR 27-10, 2002, pg 4) If the soldier is late for a formation he is in violation of Article 86 of the UCMJ,Show MoreRelated Tribunals Essays1344 Words   |  6 Pages President Bushs decision to consider establishing military tribunals to prosecute accused terrorists has set off a major debate on civil liberties in the United States. Supporters argue that such a measure is a constitutional necessity to address terrorism of an unprecedented scope. Opponents claim that the tribunals would undermine the rule of law and deprive defendants of the protection provided for in the American system of justice. 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