Tuesday, June 30, 2009

Schoolarship

SCHOOLARSHIP ( UNDER TEST and AS DRAFT)
There are lots of individuals or NGO's which are working in social sector. Education is the most important factor for the development of people. Education is most donated sector all over the world. Specially country like Nepal which lacks basic need of life. There are lots of people who never saw the school. We are getting million and million of dollar for education. We can see lots of programme which are running by local organisation. During my work as I worked most of time as individual I met some nice people who beleive me and they also agree to help poor childreans who want to study. So they made me as mediam to help them There are nealy 10 students who are getting partial schoolship for study. In this blog I am going to write their details. I will also write details about the persons who help to get better life to some of Nepali students.

Monday, June 22, 2009

HELP ME TO GET HELP

Friends from Sankhu- Want to Earn Dollar on free time?
Online Earning is really easy. We all can earn by giving sometime on net. All we need a computer and internet connection. Online earning is the product of new technology. We all want to use internet and today is the age of information and technology. So we all use internet and in the same time we can also help our friends by seeing their ads.
All we need lots of friends who really think seriously about online earning. We need to make big circle of friends. Who help others to get help self.

Process
All you need a gmail account first. If you already have gmail account then you can start bloggging.. To make a blog account you can go to www.blogspot.com you can use you gmail user name password to creat account. After creating blog account you try to make a simple blog or website. It is really simple. You can write about anything. Try to put some interesting things so that lots of people will visit your page. After creating blog you can create adsense account. It is also easy step. Go to Adsense and again you can use same gmail ID for user name and password. In form you have to put web address. which you created on blogspot. You account will approved with in 3 days. After you get adsense account you can get advertise from google adsesne. You can put those advertisement on your blog and you can easily publish post.. You refer your blog among your friends. When your friends see you blog and clicks on advertisement on your blog you will earn money.. So it is really simple step. If you need any help you are most welcome...

Know About Sankhu

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Thursday, June 18, 2009

First Day I am trying

Finally now I again trying to do something best to earn online by the help of google adsense.. I will update my site after i get account from google.. Online Earning really nice to see lots of people making money which is unable to earn by normal job. I am still trying to get the ways of making money. Today I did some steps that will help me to make some money.
In most of cases there is problem of language and computer knowledge. Most of people don't know how the adsense works?. There are lots of site which always shows they pay but most of them do not pay anything. When I first try to do adsense I had no idea about it. After 2 years I got little idea. But it is not as easy as it described.. But I need to earn at anyway. So think anyone who want to earn little on net. It is best way if we can get anything on net..






Online Earning

Thank you for visiting my site. This is Anup Shrestha from Nepal. This is my story about how filling when I have free time I always try to make some money.. I went from a low-paying dead-end job with terrible hours to making good money working from my home computer. This resulted in less stress, a higher income and, best of all, more time to spend with my family.

I always try to earn money. And I know lots of people who make money. so I also try lots of time in internet. I hope from now I will make money instead of earn.. We never can earn enough money unless we start make money....




Saturday, June 13, 2009

GI system- Anatomy

INTERACTION BETWEEN HUMAN BODY AND DRUGS
Introduction



Drugs are the substance that are used to treat a disease. These are chemical substances derived from different sources (living or non- living things) which are sued to alter the functions of living/ bacterial tisseus by reacting with them.
Uses of drugs
Drigs are used for:
1. Diagnosis of diseases
2. Prevention of diesases
3. Treatment of diseases.


This chapter deals with the relationship between drug and the human body; the mechanism of drung' action, uses of drugs and the body's response to drugs.
Drugs are prepared in laboratories and experimented so that they are free of unacceable toxic substances which can harm the clients. Then only they are approved for use of human. The study of action of drug in man is called clinical pharmacology.

Clinical Pharmacology can be divided into two brances.
1. Pharmacokinetics.
Means what the human body dees to drungs it is the study of the movement of drugs in the body.

2. Pharmacodynamics
Means what a drug does to the human body. The knowledge about pharmacokinetics and pharmacodynamics is essential to know how the drugs are used for the best advantade of the patient.

Protein Binding

Most drugs bind to proteins, either albumin or alpha-1 acid glycoprotein (AAG), to a greater or lesser extent. Drugs prefer to be free, it is in this state that they can travel throughout the body, in and out of tissues and have their biological effect. The downside of this is that they are easy prey for metabolising enzymes.

As you would expect, more highly bound drugs have a longer duration of action and a lower volume of distribution. Generally high extraction ratio drugs' clearance is high because of low protein binding and, conversely, low extraction ratio drugs' clearance is strongly dependent on the amount of protein binding.

Why is this important? If a drug is highly protein bound, you need to give loads of it to get a theraputic effect; as so much is stuck to protein. But what happens if another agent comes along and starts to compete with the drug for the binding site on the protein? Yes, you guessed it, the amount of free drug is increased. This is really important for drugs that are highly protein bound: if a drug is 97% bound to albumin and there is a 3% reduction in binding (displaced by another drug), then the free drug concentration doubles; if a drug is 70% bound and there is a 3% reduction in binding, this will make little difference.

The drugs that you really need to keep an eye on are: warfarin, diazepam, propranolol and phenytoin. For example, a patient on warfarin is admitted with seizures, you treat the patient with phenytoin, next thing you know - his INR is 10.

The amount of albumin does not appear to be hugely relavent. In disease states such as sepsis, the serum albumin drops drastically, but the free drug concentration does not appear to increase


Degree of ionisation

This is really important with regard to local anaesthetics. The essential fact to know is that highly ionized drugs cannnot cross lipid membranes (basically they can't go anywhere) and unionised drugs can cross freely. Morphine is highly ionised, fentanyl is the opposite. Consequently the latter has a faster onset of action. The degree of ionisation depends on the pKa of the drug and the pH of the local environment. The pKa is the the pH at which the drug is 50% ionised. Most drugs are either weak acids or weak bases. Acids are most highly ionised at a high pH (i.e. in an alkaline environment). Bases are most highly ionised in an acidic environment (low pH). For a weak acid, the more acidic the environment, the less ionised the drug, and the more easily it crosses lipid membranes. If you take this acid, at pKa it is 50% ionised, if you add 2 pH points to this (more alkaline), it becomes 90% ionised, if you reduce the pH (more acidic) by two units, it becomes 10% ionised. Weak bases have the opposite effect.

Local anaesthetics are weak bases: the closer the pKa of the local anaesthetic to the local tissue pH, the more unionised the drug is. That is why lignocaine(pKa 7.7) has a faster onset of action than bupivicaine (pKa 8.3). If the local tissues are alkalinised (e.g. by adding bicarbonate to the local anaesthetic), then the tisssue pH is brought closer to the pKa, and the onset of action is hastened.

ADVERSE REACTIONS TO DRUGS

An adverse reaction to a drug has been defined as any noxious or unintended reaction to a drug that is administered in standard doses by the proper route for the purpose of prophylaxis, diagnosis, or treatment. Some drug reactions may occur in everyone, whereas others occur only in susceptible patients. A drug allergy is an immunologically mediated reaction that exhibits specificity and recurrence on re-exposure to the offending drug.



Classification of adverse reactions to drugs
Reactions that may occur in anyone

Drug overdose -Toxic reactions linked to excess dose or impaired excretion, or to both
Drug side effect - Undesirable pharmacological effect at recommended doses
Drug interaction - Action of a drug on the effectiveness or toxicity of another drug

Reactions that occur only in susceptible subjects

Drug intolerance - A low threshold to the normal pharmacological action of a drug
Drug idiosyncrasy - A genetically determined, qualitatively abnormal reaction to a drug related to a metabolic or enzyme deficiency.
Drug allergy - An immunologically mediated reaction, characterised by specificity, transferability by antibodies or lymphocytes, and recurrence on re-exposure
Pseudoallergic reaction - A reaction with the same clinical manifestations as an allergic reaction (eg, as a result of histamine release) but lacking immunological specificity


Incidence

Adverse reactions to drugs are very common in everyday medical practice. A French study of 2067 adults aged 20-67 years attending a health centre for a check up reported that 14.7% gave reliable histories of systemic adverse reactions to one or more drugs. In a Swiss study of 5568 hospital inpatients, 17% had adverse reactions to drugs. Fatal drug reactions occur in 0.1% medical inpatients and 0.01% of surgical inpatients. The main drugs implicated are antibiotics and non-steroidal anti-inflammatory drugs. Adverse reactions to drugs occurring during anaesthesia (muscle relaxants, general anaesthetics, and opiates), although less common (1 in 6000 patients receiving anaesthesia), are life threatening, with a mortality of about 6%.

Numerous mechanisms have been implicated in adverse reactions to drugs. However, these mechanisms are not fully understood, which may explain the difficulty in differentiating drug allergy from other forms of drug reactions and in assessing the incidence of drug allergy, evaluating risk factors, and defining management strategies.