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Case Challenge Free
Abhinn Aggarwal, MD; Hannah Shaheen, MD; Nida Blankas-Hernaez, MD, FAAP
Each month, this department features a discussion of an unusual diagnosis. A description and images are presented, followed by the diagnosis and an explanation of how the diagnosis was determined. As always, your comments are welcome via email at firstname.lastname@example.com.
A 6-year-old female was brought to the emergency department 6 hours after sustaining blunt trauma to the neck. She was playing outside her house when a small motorized bicycle fell on her neck. She was in mild discomfort immediately after the injury and developed significant swelling with tenderness over the following hours. She complained of pain upon swallowing and pain with movement of the neck. She had no significant medical history or prior trauma. Her vaccinations were current and no ill contacts were identified. Her growth and developmental milestones were all attained in normal stages.
On physical exam, she was afebrile. No evidence of erythema or ecchymosis was seen. She exhibited left-sided cervical swelling that was warm to the touch and tender below the left submandibular angle (Figure 1). She demonstrated limited cervical range of motion. Kernig's and Brudzinski's signs were negative. Inspection of her oropharynx showed no lesions, erythema, exudates, or edema. On palpation, a 3.5-cm × 2-cm mass was found in the left submandibular region and a 1.5-cm × 1-cm posterior cervical lymph node was palpated.
Figure 1.
A 6-year-old female with left-sided cervical swelling at the submandibular angle.
Her initial labs showed marked leukocytosis. Sonographic studies revealed an isoechoic mass in the left upper neck. Computed tomography angiography of the neck with contrast demonstrated no vascular injury. A computed tomography (CT) scan of the neck confirmed the absence of any bony fractures and revealed the diagnosis (Figures 2 and 3).
Figure 2.
A computed tomography scan of the neck (transverse view) illustrating the absence of any bony fractures and revealed the diagnosis of a traumatic fracture of the left submandibular gland.
Figure 3.
A computed tomography scan of the neck (sagittal view) showing a fracture of the left submandibular gland.
Traumatic Fracture of the Left Submandibular Gland
The CT scan of the neck revealed a traumatic fracture of the left submandibular gland, with no bone fractures. The patient was examined by the trauma surgeon in the emergency department and an ENT (ear, nose, and throat) physician on an inpatient basis. She was started on clindamycin due to significant leukocytosis and cervical adenitis. The day after admission, her leukocytosis resolved and the swelling began to decrease. The patient was treated with analgesics for pain management and a neck brace to immobilize her neck. She was discharged home the following day with instructions to complete the 7-day course of clindamycin and return to the outpatient clinic in 2 weeks for a follow-up. On her follow-up visit, the swelling and tenderness had completely resolved without any complications.
The salivary glands are exocrine glands that secrete saliva into the oral cavity via Stensen's duct and Wharton's duct. Salivary secretions facilitate mastication and swallowing, as well as the initial digestion of starches by salivary amylase.
Salivary gland injuries, although rare, can result in significant morbidity due to the delicate anatomy of the face. Of the three paired salivary glands, the parotid glands, which harbor the facial nerve and important vessels of the face, are more prone to injury compared with the sublingual and submandibular glands, as the latter two glands are located deeper within the mandibular arch.1 Because of their location, submandibular gland fractures are rare and most often associated with mandibular or zygomatic bone fractures.2,3 In the case discussed here, the blunt trauma to the neck resulted in an isolated fracture of the submandibular gland, with no complications of other glands or structures surrounding it.
Fractures of salivary glands have been reported in instances of blunt trauma or in penetrating injuries, such as in motor vehicle accidents, sports injuries, gunshot wounds, and injuries of violence.2 The cornerstone in evaluating these injuries is to thoroughly examine the site of injury and anticipate the signs and symptoms that may be included in the presentation. Proper assessment of these injuries should include a complete head and neck examination for cutaneous, skeletal, dental, vascular, nervous, and salivary duct injuries to prevent further complications and morbidity.3 Important cranial nerves to assess, based on their close proximity to the salivary glands, include the trigeminal nerve (cranial nerve V), the facial nerve (cranial nerve VII), and the hypoglossal nerve (cranial nerve XII).3
Subsequent investigations to consider include sonography and a CT scan, as well as CT angiography of the neck to assess the integrity of vasculature within the region. Lacerations of the salivary ducts usually result in the accumulation of saliva within the wound. Sialography studies examine the integrity of the ductal system and may be ordered to evaluate any ductal disruptions.3,4 Surgical repair of lacerations to the ducts should be considered immediately because they have a high risk of developing complications such as a salivary fistula, sialoceles, and mucoceles.
In the absence of cutaneous, skeletal, dental, nervous, vascular, and ductal injuries, expectant management is recommended for salivary gland injuries. Antibiotics are recommended to prevent secondary infection within the gland if at risk of infection, or to treat a concurrent infection. A study conducted by Landu and Stewart5 suggested that an anticholinergic medication is beneficial because it decreases the production and flow of salivary secretions and helps reduce the irritation within the gland. If injuries are more severe, such as ductal or vascular insults, surgical repair is recommended to prevent further complications.
Submandibular gland fractures secondary to blunt trauma are uncommon, especially in the absence of bone fractures. Despite this, they should be considered in instances of blunt or penetrating trauma to the neck. They present as slow-growing, tender submandibular masses. CT scans aid in the diagnosis by providing detailed images of the glands and surrounding structures. Sialography studies can also be used to visualize the salivary duct system. Depending on the injuries sustained, management of a submandibular gland fracture may be conservative or invasive and include immobilization of the neck, analgesia, antibiotics, anticholinergics, and surgery.
Abhinn Aggarwal, MD, is a Graduate, Windsor University School of Medicine. Hannah Shaheen, MD, is a first-year Resident in Family Medicine, McMaster University. Nida Blankas-Hernaez, MD, FAAP, is an Attending Physician, Advocate Lutheran General Hospital; and a Hospitalist/Consultant, Lurie Children's Hospital.
Address correspondence to Nida Blankas-Hernaez, MD, FAAP, Advocate Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL 60068; email: firstname.lastname@example.com.
Disclosure: The authors have no relevant financial relationships to disclose.
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Plains Area Mental Health Center is a mental health facility in Le Mars, IA, located at 180 10th Street Se, Suite 201, 51031 zip code. Plains Area Mental Health Center offers Telemedicine/telehealth and Outpatient treatment. Plains Area Mental Health Center provides Integrated dual diagnosis disorder treatment, Trauma therapy and Dialectical behavior therapy. It specializes in treatment of Seniors 65 or older, Young adults and Adults. Some other services offered by Plains Area Mental Health Center include Mentoring/peer support/consumer-run services, Integrated primary care services and Family psychoeducation.
Address: 180 10th Street SE, Suite 201, Le Mars, IA 51031
Phone #: 712-546-4624
Here are the full facility listing details on Plains Area Mental Health Center in Le Mars, IA:
Care Offered
Service Setting
Facility Type
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Emergency Mental Health Services
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Once again Taylor Congdon takes motorcycle film making to a new level. Moto is not the kind of movie you will sit back into your comfy sofa to watch. It's packed with riding footage that will have you leaning forward in your chair and you'll be wiping sweat from your brow half way in. From the moment Trey Canard rolls out of his shop to the final chapter with Cairoli being mobbed by fans and photographers, this film is riveting. With fantastic editing, an excellent soundtrack, enough POV footage to mix things up without getting dull, plus piles of creative camera angles Congdon captures the grace and beauty that is moto with slow motion, close up footage that is a treat to watch.
Footage covers MX, Etreme Enduro, free riding on some wicked trails in California and Washington and some interesting use of trials motorcycles. Riders include Trey Canard, Nathan Woods, Jessy Nelson, Steve Haughelstine, Richard Lancasater, Geoff Aaron. Congdon brings us right into their worlds with an informal modesty that is rare in the moto world. Moto the Movie is one that you will watch over and over, seeing new things each time. We've had for few weeks and have already watched it more than 5 times! The only thing we could ask for from Moto is more. Forty-three minutes is just enough to get your mouth watering!
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Through life comes challenge but by learning and determination, those challenges are sent to dust and learned from said challenge.
I am everything you've ever feared, disguised as a derpy little pony.
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A southern brony that loves to read and write. My oc Heat Wave and I are ready to explore this big huge site.
It's one thing to create/throw already-established characters in a story of some kind. It's another thing to develop those characters, regardless of the situation they're in.
Just me trying to be me.
Just a teenage gamer/writer who writes stories in his spare time...
I periodically check this. Don't like ponies anymore, if you wanna talk @ me on discord Hoops#8720
I am here only to please my fellow readers and am eager to see mlp Fim used in any artistic form and I lookforward to seeing the tallents of the internets writers brought to life
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Not an active account, only occasionally coming back to shill. Follow me at @PastaSparq on twitter or join my discord server - https://discord.gg/AAUpGRz
Just a writer who churns out stories for the people of fimfiction
I'm the Ultimate Sonorosian!
just a very shy diaper sissy who likes to rp
Darkness will always end up out lasting the light.
Today you are you! That is truer than true! There is no one alive who is you-er than you! - Theodor Seuss Geisel/Dr. Seuss
Just a man trying to make the Ultimate Who story along with his pals. Feel free to PM me if you wanna say hi.
Just a pegasister who's a huge fangirl on the inside. She follows back and would love to be your friend! (Avatar found at http://swa-oku.deviantart.com/art/Hetalia-Fan-Art-Samovar-Teatime-360787743)
I'm CreepyPastaSalad and Sensuous Sonority on YouTube, and I perform audio readings.
Bruh I can't post blogs so, imma say it here lmao. If y'all still wanna talk to me, pm me your discord XDDD
Just a huge dreamer, reader, and anime fan who wants to make friends. :3 You can always PM me too!
The Songs of The Dead are The Lamentations of The Living/// I'm literally turning into a god-damn libarby.... Fuck.
Clop stories with actual story. Not just the clop. But also clop. LOT'S and LOT'S of clop
hello my friends i Zen-Aku the god of the phantom lycanthrope's, i welcome you to my den. If you wish to join my ever growing loyal pack all you need is to follow me
Loopier than a loop on de loop de loop
Who am I to you? Who are you to me? Who are we to the world? What is the world to us? Life is a mysterious creature that you can only observe from afar, if you try to get to close it'll disappear.
Is this bio really necessary?
© MMXIX by Jesse Coffey Productions, Inc. All Rights Reserved.
I'm a brony, Whovian, casual Star Trek fan, and a film geek with a collection of DVDs and Blu-Rays that numbers into the thousands combined. I'm a nerd for all seasons.
Will I ever fully come back? Maybe. Not right now though. We vibing though. PM if ya want? Might take a bit to reply. [they/them]
Oh my.
I'm just a girl wanting to find my way in life.
Got A Feeling That Im Going Under But I Know That I Will Make It Out Alive
Writer, and editor at your disposal.
Very rare logins. To much drama in my life.
I am a Mark of Babylon. Many ponies view me as the villain. The reasons why I understand. My coat, my face, my eyes, my name, and my intention to murder. However I hope to help anyway I can.


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Block 2 from the Love and Hugs from Australia stitch-a-long has been released.
It's a gorgeous block from Libby Richardson. You can do applique or use stitchery.
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46 minutes ago


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Randeep Surjewala
Rajasthan: Complaint filed against Congress leaders says that plan to falsely accuse Union Minister with audiotape hatched at CM Gehlot's residence
Hours after a complaint was filed against Union Minister Gajendra Singh Shekhawat for conspiring to pull down its government in Rajasthan, a complaint has been filed against Congress leaders by a BJP leader for making false accusations
Congress brings in 'audio recording' drama to claim BJP is trying to buy MLAs: Did it inadvertently admit that Gehlot does not have the...
The Congress and CM Ashok Gehlot have been firmly asserting that they have a majority and the Rajasthan government is stable. The sudden audio drama and claims of a Congress MLA saying that they do not have the numbers adds new twist to the political development in the state.
Sachin Pilot & other rebel Congress MLAs approach Rajasthan HC against Speaker's disqualification notice, court grants time to amend the plea
Earlier in the day, Congress had sacked Sachin Pilot as the state chief and removed him from the Deputy CM's post
Rajasthan crisis deepens: Congress fires Sachin Pilot as Deputy CM and state Congress chief, accuses him conspiring with BJP to destabilise govt
Congress spokesperson Randeep Surjewala today announced that Congress rebel leader Sachin Pilot has been sacked as Rajasthan state Congress chief and removed from his post of Deputy Chief Minister of the state.
While Congress leaves doors open for Sachin Pilot's return, his posters removed from Rajasthan Congress office
Congress spokesperson Randeep Surjewala has urged Sachin Pilot and his followers to have discussions with the party leadership to resolves the issues
Amidst lockdown and migrant crisis, Congress spokesperson shares an image from Nepal as that of India to play politics over misery of the poor
The Congress leader from Harayana wanted to suggest that the condition of people in the 'New India', the India that is not ruled by his party anymore, is miserable.
Congress Spokesperson Randeep Surjewala scores self-goal, shares Congress-ruled Chhattisgarh migrant's image to attack Modi govt
The desire of Randeep Surjewala to change political opinion through 'poverty porn' did not last long.
Congress leaders, journalists attack Arnab Goswami after he questions Sonia Gandhi's silence over Palghar mob-lynching of Sadhus
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As Insurance premiums are due and many people are behind on their payments, states have had to adapt to the likelihood that their clients may not be able to pay their premiums. Many states have issued delays on these payments for up to 60 days. Some states have gone a step above that.
California, known for being one of the most difficult insurance states, has taken the stance that insurance providers should be refunding their clients. Ricardo Lara, the Insurance Commissioner has requested that providers "refund some March and April premium payments to policyholders for a range of personal and commercial lines due to COVID-19."
The notice ordered insurers to "make an initial premium refund for the months of March and April" to affected California policyholders as quickly as practicable and no later than within 120 days." Affected industries include, medical malpractice, commercial liability "any other line of coverage where the measures of risk have become substantially overstated as a result of the pandemic."[1]
These refunds come as a result of the auto insurance industry doing the same for lack of payments thanks to the wave of furloughs affected by the economy. In some fields, companies are also considering credits on what they paid in March and April. This could mean insurance companies could be having trouble making any money at this time, despite the increased demand for new insurance.
Each state has their own way of making sure people can keep their insurance in this extremely trying time. Consult your state's laws or rulings to determine what you need to do in relation to your clients' needs.
[1] https://www.businessinsurance.com/article/20200413/NEWS06/912334009/California-orders-insurers-to-pay-back-premiums-due-to-virus?utm_campaign=BI20200416MarketPulse&utm_medium=email&utm_source=ActiveCampaign&utm_campaign=BI20200416MarketPulse&utm_medium=email&utm_source=ActiveCampaign


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Swipe Right Cast: Bunny Colby, Britney Amber, Bella Rolland, Victoria Voxxx , Derrick Pierce, Ryan McLane, Lucas Frost. Everything was going perfect in Patrick and Erikas relationship until she decided that it was time that they also live together. Having just left a 7 year marriage, Patrick wants no part of that. Erika gives him an ultimatum: move in or move on. In an effort to call each others bluff, both move on to the dating app world with disastrous results. Is it enough to make Patrick swallow his pride and give in? Hot sex and smart comedy mix seamlessly in Swipe Right.
Cast: Kristen Scott, Kit Mercer, September Reign, Paris Amour It's easy to look beautiful with a full head of long, perfectly coiffed hair but only a few girls can look stunning with short hair. For the third volume of Axel Braun's acclaimed series, the legendary director picked four of the most attractive actresses in the business and used his masterful camerawork to showcase them in all their lustful beauty!
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Sometimes love is found in the most unlikely places and maybe the one that you're with isn't necessarily the one that you were destined for. Four sensual vignettes featuring an all-star cast, Sure Feels Right explores the space between compromising for what's comfortable and throwing caution to the wind for what you truly desire.
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- r)tmənt[/t]]
♦departments1) N-COUNT: usu with supp A department is one of the sections in an organization such as a government, business, or university. A department is also one of the sections in a large shop.
...the U.S. Department of Health, Education and Welfare...
He moved to the sales department.
...the geography department of Moscow University.
...the jewelry department.2) PHRASE: V inflects If you say that a task or area of knowledge is not your department, you mean that you are not responsible for it or do not know much about it.
`I'm afraid the name means nothing to me,' he said. `That's not my department.'
English dictionary. 2008.
Look at other dictionaries:
department — de‧part‧ment [dɪˈpɑːtmənt ǁ ɑːr ] written abbreviation Dept. or dept. noun [countable] 1. ORGANIZATIONS one of the parts of a large organization such as a company or university where people do a particular kind of work: • She heads the customer… … Financial and business terms
Department H — Publication information Publisher Marvel Comics In story information Type of organization Sub Department of Canadian Department of National Defence … Wikipedia
Department S — est un groupe de post punk britannique, à l existence éphémère puisqu elle ne dura que deux années : de 1980 à 1981. Malgré cette courte carrière, le groupe saura marquer les esprits avec Is Vic there ? en 1981. Promis à un bel avenir,… … Wikipédia en Français
Department — De*part ment, n. [F. d[ e]partement, fr. d[ e]partir. See {Depart}, v. i.] 1. Act of departing; departure. [Obs.] [1913 Webster] Sudden departments from one extreme to another. Wotton. [1913 Webster] 2. A part, portion, or subdivision. [1913… … The Collaborative International Dictionary of English
department — I noun agency, area, assignment, branch, bureau, categorization, category, chapter, class, classification, designation, district, division, domain, field, field of activity, jurisdiction, ministry, munus, pars, part, precinct, province, provincia … Law dictionary
Department 56 — Logo Department 56 is a manufacturer of holiday collectibles, ornaments and giftware, known for their lit Christmas village collections and their Snowbabies collection. It is owned by Enesco. Contents 1 History … Wikipedia
department — [dē pärt′mənt, dipärt′mənt] n. [ME & OFr departement < departir: see DEPART] 1. a separate part, division, or branch, as of a government, business, or school [the police department, the accounting department, the history department] 2. a field … English World dictionary
Department S — steht für: Department S (Fernsehserie) Department S (Band), eine britische Band Diese Seite ist eine Begriffsklärung zur Unterscheidung mehrerer mit demselben Wort bezeichneter Begriffe … Deutsch Wikipedia
Department — Données clés Réalisation Ramgopal Varma Scénario Ramgopal Varma Acteurs principaux Amitabh Bachchan, Abhishek Bachchan, Sanjay Duut Pays d'origine Inde Genre … Wikipédia en Français
department — ► NOUN 1) a division of a large organization or building, dealing with a specific area of activity. 2) an administrative district in France and other countries. 3) (one s department) informal an area of special expertise or responsibility. 4)… … English terms dictionary
department — mid 15c., a going away, act of leaving, from O.Fr. departement (12c.) division, sharing out; divorce, parting, from L.L. departire (see DEPART (Cf. depart)). French department meant group of people (as well as departure ), from which English… … Etymology dictionary


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By just-auto.com editorial team | 24 May 2005
GM's Opel plant in Rüsselsheim, Germany, appears to have won the battle with GM's Swedish Saab unit to build the next generation Saab 9-5 model from 2008, according to a Reuters report. Industry analysts also believe that the report is true.
The anonymous Reuters source said Trollhattan would continue to make the current versions of the 9-3 and 9-5 until 2009.
The successors to the Vectra and 9-3 will use GM's next generation Epsilon architecture, also understood to be earmarked for Rüsselsheim.
Mark Fulthorpe, an analyst with CSM Worldwide told just-auto that he believes GM is consolidating the bulk of next generation European Epsilon vehicle programmes at Russelsheim and that this now includes the next 9-5.
"There was a plan to use GM's global Zeta platform, engineered by Holden in Australia, for eventual rollout to vehicle programmes in North America and Europe, including Saab's 9-5. But the platform was over-engineered so that became too expensive, GM preferring instead to look at cheaper solutions," Fulthorpe said.
"Fortunately for GM, the next generation Epsilon architecture is flexible enough to include a wide platform option and that has been allocated for the Saab 9-5.
"With the Epsilon consolidation at Rüsselsheim from 2008, there is clearly an issue for GM in terms of what to do about Trollhattan. As things stand, it looks like it is heading for much lower volume production towards the end of the decade, perhaps becoming reliant upon niche variants only.
"Last year Saab made 128,000 units at Trollhttan. That could be heading down to an annual production level of around 40,000 units," Fulthorpe said.
"But if it becomes a niche variant plant it could become vulnerable on cost grounds as GM may eventually decide to simply consolidate all next generation Epsilon Saab niche variants at Rüsselsheim also when the current Epsilon variants and the Cadillac BLS (also current Epsilon and due to start production at Trollhattan early in 2006) runout.
"There again, the downside there is losing the perceived 'Swedishness' of the Saab brand if no Saabs at all are made in Sweden - so GM may be willing to bear the extra manufacturing costs of keeping Trollhattan going, even at much lower volume, anyway.
"One possibility that could throw Trollhattan a major lifeline is that it could be offered a future small Saab - dubbed '9-1' - based on GM's Delta architecture [used for the Opel/Vauxhall Astra]. Such a vehicle would be mainly aimed at Europe, so Trollhattan's exposure on the weak dollar would perhaps be considerably reduced in such a scenario," Fulthorpe added.


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An installment loan for bad credit is a kind of loan that is typically paid back over a few scheduled payments that can endure anywhere from 3 months to 7 years. Optimum loan quantities range from lender to lender, but some get up to $40,000. Popular amounts are $2,000, $5,000 and as much as $10,000.
For people having a low credit rating, getting authorized for loans could be challenging. There are lots of lenders available to you loans that are offering bad credit happily. Installment loans for bad credit could be a choice that is wise.
Installment loans provide reasonable interest that is fixed and organized monthly premiums predicated on loan terms, loan quantity and APR. A normal installment that is monthly avoid stressful balloon re payments related to other forms of loans such as for example short-term pay day loans.
The conditions and terms of installment loans additionally are more versatile, making them an even more available choice for a client with bad credit.
Installment loans for bad credit are usually more short-term than likewise organized signature loans. The duration of installment loans is as brief as ninety days or will last up to 7 years. Quantities including $2,000 up to as much as $40,000 could be lent, depending on the loan provider. Monthly obligations consist of both major and interest, enabling you to chip away during the sum that is principal time 1.
Why you ought to select an Installment Loan over a quick payday loan
On this website we'll explain why you need to select an installment loan for bad credit more than a pay day loan, and we'll show you lenders who we start thinking about to be the ideal in the market.
Installment Loan for bad credit benefits when compared with payday advances
- Greater loan quantities, typical amounts consist of $2,000 to $5,000 or more
- Longer repayment plans – better to repay
- Reduced monthly payments (in the event that you choose a lengthier loan term)
In 2020 the rise in popularity of online installment loans for bad credit increased, and today progressively lenders are getting off payday advances and tend to be rather providing loans that are installment clients. Installment loans are merely better to repay. Unlike payday advances where you've got one balloon that is huge due by the next paycheck, installment loans offer you the selection to have much much longer loan terms in order to have smaller monthly obligations. For all Us americans, this is a much safer choice than paying out one huge lump sum payment by their next paycheck.
Two options for Bad Credit Loans
How many available loans is nearly endless, therefore we've created two lists: one list for borrowers with bad or good credit rating that requires an installment loan, and also the other for borrowers that want to get a short pay day loan. The requirements are few and easy to meet, but the interest rates are higher compared to loans offered to those with better credit for borrowers with low credit score. Borrowers with good credit will have significantly more requirements to meet up (a number of that are tough to get), but, consequently, could have better interest levels and certainly will conserve additional money in the long haul.
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Regrettably, there are not any "guaranteed installment loans for bad credit, without any credit check and instant approval, " BUT different loan providers do have various needs. This means, even though one lender states no to your application for the loan, often there is an opportunity another loan provider will say yes.
Installment Loans for Bad Credit explained
If you'd like a fast and simple solution to get money, an online installment loan for bad credit might be simply the thing for your needs. With loans no more than $1000, $1500, as well as $2000, and perhaps up to $5,000 or $10,000, installment loans will be the real strategy to use. Numerous loan providers accept a diverse variety of credit ratings, which means you very possible have to be able to qualify, even with a credit that is low.
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Have you thought to a pay day loan alternatively?
For decades people looking for a turnaround that is quick money went to payday loan providers. The issue with pay day loans, but, could be the lump that is large you're likely to fork over on your next paycheck. Lots of people can't manage it, and can get caught in period after period of indebtedness.
Luckily, it doesn't need to be like that. Installment loans in many cases are unsecured, meaning you don't need certainly to offer any collateral that will be good. Numerous loan providers additionally utilize what exactly is called an alternative solution credit check, they just request a pay stub. What this means is no credit check at major credit agencies. Additionally loan providers in place of doing a tough pull on https://speedyloan.net/installment-loans-pa your own credit file, that will be then listed for 2 years and dings your score, they could simply perform a pull that is soft. Better still, some installment lenders just need evidence of earnings within the application procedure.
Another perk with installment loans? You'll frequently get day deposit that is same. You may want to fulfill a couple of demands and that can boost your opportunities by pulling together your documentation that is supporting before use. That expedites the whole procedure so you may get your money at the earliest opportunity.
Payback your loans that are payday Installment Loans for Bad Credit
Pay day loans have balloon re re payments during the end that numerous borrowers are not able to pay for. Instead of paying over time, you must set your very own rate at saving a big sum of money over a brief period of the time. Installment loans don't try this, and so are a lot easier to address throughout the payment procedure. Although monthly obligations are based from the loan quantity, APR ( the attention rate for a complete 12 months), and selected loan term, these are typically almost always more manageable compared to a pay day loan.
It must be not surprising, then, that a lot of borrowers that have applied for both forms of loan vastly prefer installment loans over payday advances. The strain of payday advances simply is not here with installment loans. Plus, you can test various payment choices through the application procedure to ensure that you choose terms that fit your monthly spending plan. You are able to frequently get pre-approved without any check that is hard your credit history.


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Procedure for cardioversion-defibrillation
- Instrument for maintaining airway patency.
- Electrocardiograph.
- The device of artificial ventilation of lungs.
- Drugs and solutions required for the procedure.
- Oxygen.
- The patient should be in a position that allows, if necessary, intubation of the trachea and closed heart massage.
- Reliable access to the patient's vein is mandatory.
- Turn on the power supply, turn off the defibrillator synchronization switch.
- Set the scale to the desired charge( approximately 3 J / kg for adults, 2 J / kg for children);charge the electrodes;grease the plate with a gel.
- It is more convenient to work with two hand electrodes. Set the electrodes on the front of the chest:
- One electrode is placed above the zone of cardiac dullness( in women - outside of the apex of the heart, outside the breast), the second - under the right collarbone, and if the electrode is dorsal, then under the left scapula.
- Electrodes can be located in the anteroposterior position( along the left edge of the sternum in the region of the 3rd and 4th intercostal spaces and in the left subscapular area).
- Electrodes can be located in the anterolateral position( in the interval between the clavicle and the 2nd intercostal space along the right edge of the sternum and above the 5th and 6th intercostal space, in the region of the apex of the heart).
- To minimize the electrical resistance in electropulse therapy, the skin under the electrodes is degreased with alcohol or ether. In this case, gauze pads are used, which are well moistened with isotonic sodium chloride solution or special pastes.
- The electrodes are pressed against the chest wall tightly and with force.
- Perform cardioversion-defibrillation.
- Discharge is applied at the time of full exhalation of the patient.
- If the type of arrhythmia and type of defibrillator allow, the discharge is given after synchronization with the QRS complex on the monitor.
- Immediately before the discharge, it should be ensured that tachyarrhythmia is maintained, which is the subject of electropulse therapy!
- Recommended parameters for cardioversion-defibrillation in adults:
- For supraventricular tachycardia and atrial flutter, a sufficient discharge of 50 J is sufficient for the first exposure.
- Atrial fibrillation or ventricular tachycardia requires a discharge of 100 J for the first exposure.
- In the case of polymorphic ventricular tachycardia or ventricular fibrillationfor the first exposure, a discharge of 200 J is used.
- If the arrhythmia is maintained, with each subsequent discharge, the energy is doubled up to a maximum of 360J.
- The interval between attempts should be minimal and only needed to assess the effect of defibrillation and recruitment, if necessary, of the next digit.
- If 3 discharges with increasing energy did not restore the heart rate, then the fourth one - the maximum energy - is applied after the administration of the antiarrhythmic drug shown in this type of arrhythmia.
- Immediately after electropulse therapy, you should evaluate the rhythm and, in case of its recovery, register an ECG in 12 leads.
- Lidocaine - 1.5 mg / kg intravenously, struino, repeat after 3-5 minutes. In the case of restoration of blood circulation, continuous infusion of lidocaine at a rate of 2-4 mg / min.
- Amiodarone - 300 mg intravenously for 2-3 minutes. If there is no effect, you can repeat the intravenous administration of another 150 mg. In the case of restoration of blood circulation, continuous infusion during the first 6 hours 1 mg / min( 360 mg), in the next 18 hours, 0.5 mg / min( 540 mg).
- Procainamide is 100 mg intravenously. If necessary, repeat the dose after 5 minutes( up to a total dose of 17 mg / kg).
- Magnesium sulphate( Cormagnesin) - 1-2 g intravenously for 5 minutes. If necessary, the administration can be repeated after 5-10 minutes.(with tachycardia of the "pirouette" type).
- Antiarrhythmic drug - discharge 360 J - adrenaline - discharge 360 J - antiarrhythmic drug - discharge 360 J - adrenaline, etc.
- You can apply not 1, but 3 times the maximum power.
- The number of digits is unlimited.
- If inefficiency resumes general resuscitation measures:
- Produce an intubation of the trachea.
- Provide venous access.
- Enter adrenaline by 1 mg every 3-5 minutes.
- You can inject increasing doses of epinephrine 1-5 mg every 3-5 minutes or intermediate doses of 2-5 mg every 3-5 minutes.
- Instead of adrenaline, intravenous vasopressin 40 mg once can be administered.
In case of scheduled cardioversion the patient should not eat for 6-8 hours, to avoid possible aspiration.
Because of the painful procedure and the presence of fear in the patient, general anesthesia or intravenous analgesia and sedation( eg, fentanyl at a dose of 1 μg / kg, then midazolam 1-2 mg or diazepam 5-10 mg, elderly or debilitated patients - 10 mg promedola).With initial respiratory depression, non-narcotic analgesics are used.
When carrying out cardioversion-defibrillation, it is necessary to have at hand the following set:
Procedure for conducting electrical defibrillation:
With the continuation of ventricular fibrillation, antiarrhythmic drugs are used that reduce the defibrillation threshold.
After the introduction of the drug for 30-60 seconds, general resuscitation is carried out, and then the electropulse therapy is repeated.
In cases of unrecoverable arrhythmias or sudden cardiac death, it is recommended to alternate the introduction of drugs with electropulse therapy according to the scheme:
- Changes in the biochemical analysis of blood.
Increases in the activity of enzymes( AST LDH.CFK) are associated mainly with the influence of cardioversion-defibrillation on skeletal muscles. Activity CF CFK increases only with multiple discharges of high energy.
Electro-pulse therapy
Electro-pulse therapy or cardioversion is a term applied to any process that eliminates an abnormal heart rhythm. Despite the fact that there are many different types of abnormal heart rhythm, cardioversion is easiest to cure atrial fibrillation or simply AF.
Atrial fibrillation, the upper chambers of the heart are rapidly shaking - or "fibrillated" - about 400 times per minute. This chaotic electric rhythm, although limited by the upper chambers of the heart, atria, usually has an adverse effect on the lower chambers, the ventricles, and causes a rapid and uneven pulse. In some patients, atrial fibrillation is completely asymptomatic, while others may complain of severe palpitations or palpitations, dyspnea or fatigue.
There are various forms of electropulse therapy;The most common of these is electrical cardioversion, often referred to as "DC" or "DC cardioversion," which involves the delivery to the heart of a specialized form of a safe, medically impulse, either through the chest wall or through a small temporary wire insertedin the heart through a vein. In other cases, electropulse therapy may take the form of a drug administered in the form of an injection or orally, in order to restore the heart rate within a few minutes, hours, or days.
If electrical cardioversion is used to treat atrial fibrillation, the procedure is usually performed in the clinic in one day, and the patient should not eat anything for 6 hours before the procedure. Before an electrical impulse, a short-acting sedative or a short general anesthetic is injected intravenously to the patient to prevent any discomfort.
Patients usually wake up soon after the procedure, and a little later, after a brief observation period, which is also usually a recovery period, they are released home the same day.
For a few days after cardioversion, patients may feel minor skin irritation and muscle pain if the procedure is performed through the chest wall. On the other hand, if the procedure for cardioversion or electropulse therapy was carried out using a wire inserted into the heart, there may be a small bruise at the point where the wire entered the vein( for example, on the arm, neck or leg), but usually there is no skin irritation orpain in the muscles.
It is important to stop driving the car and not make important decisions within about 24 hours after the procedure of electrical cardioversion, so that the sedative action is completely over.
Although it is possible to restore normal cardiac rhythm by using electrical cardioversion in approximately 90% of patients during this procedure, unfortunately, only half of these patients will have a normal rhythm until next year. If atrial fibrillation recurs, it makes sense to conduct additional procedures for electropulse therapy with an additional correction of the heart rate or rhythm or without it. A doctor can usually give his patient personal advice, if it happens that he will again have atrial fibrillation after the initially successful procedure of electropulse therapy.
Before any procedure for electropulse therapy of atrial fibrillation, a doctor or nurse must ensure that the patient has a minimal risk of blood clots that can result from less effective cardiac contractions caused by atrial fibrillation. To this end, the patient's blood is checked - it should be sufficiently diluted due to the drug warfarin, which should be taken 3-4 weeks just before the procedure of electropulse therapy.
Sometimes, if a patient has atrial fibrillation for less than 48 hours, his doctor may recommend a specialized ultrasound examination of the heart - known as transesophageal echocardiography, or "T.OE."- to establish whether it is safe to use electropulse therapy without first resorting to the use of warfarin.
Electroimpulse therapy
See also in other dictionaries:
Electropulse therapy -( cardioversion of the urine, countershank) Some of the arrhythmias based on the impact on the myocardium discharge of the high-voltage capacitor, which leads to the depolarization of the entire myocardium and interrupts the pathological circulation in it of the wavesexcitement. .. The Big Medical Dictionary
Cardioversion, Therapy Electro-pulse( Countershock) is a method of restoring the normal rhythm of heartbeats in patients with enlarged heart and arrhythmia. The controlled current of direct polarity synchronized with the R wave of the electrocardiograph is passed through the electrodes fixed to the chest. ... .. Medical terms
CARDIVERSITY, THERAPY, ELECTROPULSE -( countershock) method of restoring the normal rhythm of heartbeats in patients with enlarged heart and arrhythmia. Controlled current of direct polarity synchronized with R wave of electrocardiograph is passed through electrodes,. ... .. Explanatory dictionary on medicine
EIT - electropulse therapy electronic test table electron-ion technology. .. Dictionary of abbreviations of Russian
Treatment - I Treatment( lat, curatio;Therapeia) system of measures aimed at restoring health, preventing complications of the disease and eliminating painful manifestations of the disease. Among them are activities aimed at. ... .. Medical encyclopedia
Atrial fibrillation -( Greek arrhythmia lack of rhythm, irregularity, synonym: atrial fibrillation, atrial fibrillation, complete arrhythmia) cardiac rhythm disorder characterized by frequent and usually irregular excitation of atrial myocardial fibers.as well as. ... .. Medical encyclopedia
THERAPEUTIC PRESERVATION - honey. Atrial fibrillation( MP) fast irregular atrial rhythm with a frequency of atrial depolarization of 350 700 per 1 min. Clinical characteristics of atrial fibrillation. Etiology • Rheumatic heart diseases( up to 48% of all cases of MP) • IHD. ... .. Directory of diseases
CARDIVIRES - honey. Cardioversion cupping of tachyarrhythmias by a defibrillator discharge synchronized with the least vulnerable phase of the ventricular systole( usually 20-30 ms after the apex of the R wave).In contrast to ventricular fibrillation( VF), with. ... .. Directory of diseases
INSULT - - acute violation of cerebral circulation. According to the nature of the lesions, ischemic stroke is formed, which is caused by insufficient blood supply( ischemia) of the brain, and hemorrhagic stroke, or spontaneous( non-traumatic) intracranial. ... .. Encyclopedic Dictionary of Psychology and Pedagogy
MYOCARDIAL INFRASTRUCTURE - honey. Myocardial infarction( MI), acute focal necrosis of the cardiac muscle due to absolute or relative deficiency of coronary blood flow. More than 95% of cases in the basis of MI is atherosclerosis of the coronary arteries, complicated. ... .. Handbook of diseases
ARITHMIA - - violations of the rhythm of the heart. They can complicate the course of such serious diseases as myocardial infarction, cardiosclerosis, acute myocarditis, valvular rheumatic heart diseases. There are the following basic violations of rhythm and conductivity: sinus. ... .. Collegiate Dictionary of Psychology and Pedagogy
- Heart rhythm disturbances. EI Chazov, VM Bogolyubov. Heart rhythm disturbances are a frequent complication in various diseases. The proposed monograph presents a synthesis of the latest data on pathogenesis, clinic and treatment of rhythm disturbances. .. More info Buy now for 336 руб
- Emergency therapy. Directory for doctors. A. P. Golikov, A. M. Zakin. The manual describes the main techniques of intensive care and resuscitation: external massage and heart defibrillation, artificial respiration, intubation of the trachea, heart puncture, pericardium, pleura,. .. More info Buy for 192 руб
- Diagnosis and treatment of heart rhythm disturbances. A manual for doctors. Yakovlev. The book presents modern data on heart rhythm disturbances. The questions of clinical electrophysiology of the heart, nomenclature, classification and electrocardiographic criteria are considered. .. More info Buy for 157 RUR
Other books by request «Electroimpulse therapy» & gt; & gt;
- Postconversion arrhythmias, and above all ventricular fibrillation.
Ventricular fibrillation usually develops in cases of discharge in the vulnerable phase of the cardiac cycle. The probability of this is low( about 0.4%), however, if the patient's condition, type of arrhythmia and technical capabilities allow, synchronization of the discharge with the R-wave on the ECG should be used.
If ventricular fibrillation occurs, a second discharge of 200 J is immediately applied.
Other post-conversion arrhythmias( eg, atrial and ventricular extrasystoles) are usually short-lived and do not require special treatment.
- Thromboembolism of the pulmonary artery and a large circle of blood circulation.
Thromboembolism is more common in patients with thromboendocarditis and with long-term atrial fibrillation in the absence of adequate preparation with anti-coagulants.
- Respiratory depression.
Disturbances of respiration are the result of inadequate premedication and anlhesia.
To prevent the development of respiratory disorders should be a full oxygen therapy. Often, with developing respiratory depression, it is possible to cope with the help of verbal commands. Do not try to stimulate breathing with respiratory analeptics. Serious violations of breathing show intubation.
- Skin burns.
Skin burns result from poor contact of electrodes with the skin, use of repeated discharges with high energy.
- Arterial hypotension.
Arterial hypotension after cardioversion-defibrillation is rare. Usually, hypotension is not expressed and does not last long.
- Pulmonary edema.
Pulmonary edema occurs occasionally 1-3 hours after recovery of the sinus rhythm, especially in patients with long-lasting atrial fibrillation.
- Changes in repolarization on the ECG.
Changes in repolarization on the ECG after cardioversion-defibrillation are multidirectional, non-specific and can last several hours.
Cardioversion-defibrillation( electropulse therapy)
Cardioversion-defibrillation( electropulse therapy-EIT) - represents the over-current action of a direct current of sufficient strength to cause depolarization of the entire myocardium, after which the sinoatrial node( pacemaker) resumes controlheart rhythm.
Distinguish between cardioversion and defibrillation.
- Cardioversion.
Cardioversion is the action of direct current synchronized with the QRS complex. For various tachyarrhythmias( except for ventricular fibrillation), the effect of direct current should be synchronized with the QRS complex, becauseIn case of exposure to a current before the peak of the T wave, ventricular fibrillation may occur.
The effect of direct current without synchronization with the QRS complex is called defibrillation. Defibrillation is performed with ventricular fibrillation, when there is no need( and there is no possibility) of synchronizing the effects of direct current.
In the presence of impaired hemodynamics( Morgani-Adams-Stokes attack, arterial hypotension and / or acute heart failure), defibrillation is performed immediately, and if it is stable, after attempting to stop with medication if it is ineffective.
Electroimpulse therapy is performed according to vital indications with progressive deterioration of hemodynamics or in routine order with inefficiency of drug therapy.
Electroimpulse therapy is performed according to vital indications with progressive deterioration of hemodynamics or in routine order with ineffectiveness of drug therapy.
All the ambulance brigades and all departments of medical institutions must be defibrillated, and all health workers should have this method of resuscitation.
- Safety instructions for use with the
- defibrillator. Eliminate the possibility of grounding the personnel( do not touch the pipes!).
- Avoid touching others around the patient during discharge.
- Ensure that the insulating part of the electrodes and hands are dry.


text: June 23, 2019 Does the Leinart family hold the largest private collection of Mercury Engines? If you're ever driving through Connecticut and spot a truck with a license plate that reads "MERC," that's Walter and Maureen Leniart. There's a chance their truck will also be pulling a boat, or perhaps hauling an outboard engine, because ... Read More


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Just a quick update, as it feels like an eternity since I last wrote on here.
I now finally have a stable unit; there was a flickering issue that lead to the Powerboost 1000C going up in a puff of smoke... It turned out it was caused by the HDMI panelmount port!
I have re-jigged my wiring whilst troubleshooting and also introduced a thermal fuse and the 12v converter, so now the powerboost 500C is powering my USB hub, and the 12v step up converter is powering my screen. The 12v converter is taking power directly from the batteries via the 'BAT' out pins on the powerboost. I have ordered another 1000C to put in as charging takes an eternity with the 500c's 500mA charging rate. The 1000C will allow me to charge twice as fast!
I am now in need of assistance with my python scripting, however...
Over on my Github (https://github.com/CraigHissett/PiVidPlayer) I have started writing my scripts. Trouble is I can't seem to get how to integrate OMX player into my script and make it work.
Does anyone have experience with the pyOMXPlayer library or have any alternative ways of playing videos from Python?


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A chilling new Ministry of Defense (MoD) report circulating in the Kremlin today echoing the warning just issued by renowned futurist Gerald Celente (whom the New York Post wrote about: "If Nostradamus were alive today, he'd have a hard time keeping up with Gerald Celente") declaring "You are going to see violence like we have never seen before this summer…You are going to see police against the people, and it's going to become more militarized as it becomes more violent…If we don't unite for peace and restore freedom, America is dead", states that due to the assessment made by MoD intelligence analysts that the United States will erupt into a full-scale civil war during the September-October time period, President Putin has ordered Russian military forces to conduct an historic and unprecedented over 15,500 combat drills during the summer training period.
A time period assessment of when civil war hostilities will break out in America these MoD analysts based on numerous factors, to include this past week's stunning US military preparations being made for war—such as the US Army designating this week the three day time period between 30 June-2 July to hire with at least $2,000 bonuses 10,000 additional troops, who will immediately be deployed for training at the massive Fort Benning military base already housing over 120,000 combat forces belonging to the US Army—is a military base where President Donald Trump has combined infantry and armor training for the US Army—and whose 10,000 new combat forces that have just been hired by the US Army this past week, will be trained and readied to be deployed in 10-14 weeks.
A deployment into the United States that MoD analysts assert will be made by President Trump using a series of federal laws known as the Military Reconstruction Acts—which were passed by the US Congress after the American Civil War, in the 1860s, to restore order in rebellious States—set up 5 military districts governed by US Army generals to rule over them until normal law and order was restored—are still in force federal acts, and after the US Congress repealed this act's Habeas Corpus provision in 1867, it eliminated the United States Supreme Court's jurisdiction over them—and is all occurring as socialist mobs in Washington D.C. have now begun marching by the thousands chanting blood libel against the Jews, who were unleashed yesterday when shockingly the socialist Democrat Party in the US Senate blocked a resolution condemning mob violence…


text:
how can i be good gay man in world?
i am belieeve in buddha that gayest man ever living
how i can be like buddha good man
4 Answers
- Big MamaLv 610 months ago
What does being a "good gay man" mean? You have sex with multiple partners? You have a wonderful partner? You have great sex? You're content with yourself? You're a good person?
- Mx_intersex_folxLv 710 months ago
By being a good person
- 𝓒𝓸𝓼𝓶𝓲𝓬 𝓓𝓻𝓮𝓪𝓶𝓮𝓻Lv 710 months ago
Follow the dharma and be the best homo you can be.
- reme_1Lv 710 months ago
Please get some help with your English writing so we can understand you better. Just be a good person. You do not need to copy anyone. Do what is right. Help others. Try not to hurt anyone. Just be a good person.
Still have questions? Get answers by asking now.


text:
pH Scale for Acids and Bases
pH scale and pOH scales differentiate between neutral, acidic, or basic in pure or distilled water solution on the basis of the relative concentration range of ionic hydrogen and hydroxyl ion in acid and alkaline chemistry. Sorensen define these term known as pH and pOH scale or chart for measuring the concentration of hydrogen and hydroxyl ion in the pure water solution of acid and alkaline. Therefore, the acidity and basicity level chart of acid and base measure by pH scale value in pure or distilled water solution. The calculation of the concentrations of hydrogen ion and hydroxyl ion in pure water not much convenient and meaningful because this shows the low-value of the dissociation constant.
Hence Sorenson measure the neutral, acidic, or base properties of solution in pure or distilled water in terms of pH level chart value of acid and alkaline. Therefore, pH = – log (CH+). When a solution having hydrogen ion concentration range 10-1 M to 10-14, then the pH range of said solution 1 to 14. Hence acidity of the solution in terms of hydrogen ion is more convenient.
pOH Scale Value for Alkaline Solution
In learning chemistry, the concentration value of hydroxyl ion define the pOH scale of the basic or alkaline solution as that of the pH of the acid solution. Therefore, pOH = – log (COH–). When the acidity of a solution goes down 100 fold, the pH goes up by two units.
- Therefore, the solution of pH = 1, has hydrogen ion concentration 100 times greater than that of 3.
- Same way, when hydroxyl ion concentration will go down by two units then pOH goes from 13 to 11.
pH Scale Chart of Acid and Alkaline Solution
Now we can proceed to differentiate between neutral, acidic, and basic solutions on the basis of relative concentrations of hydrogen and hydroxyl ions in water. When the concentration level based on the pH value of the neutral, acidic, and alkaline pure water solution, it defines the pH and pOH scales chart.
pH Level of Neutral Solution
A neutral solution is one where the concentrations of hydrogen and hydroxyl ions are equal.
or, -log (CH⁺) = -log (COH⁻) = -log (10-7) M
Agin from the definition
pH = -log (CH+) and pOH = -log (COH–)
∴ pH = pOH = 7
Therefore, the pH and pOH range of neutral water solution having the same value of 7.
pH Level of Acidic and Alkaline Solution
An acidic solution has the concentration of hydrogen ion greater then hydroxyl ion.
or, CH+ > 10-7 M and COH– < 10-7 M
∴ pH < 7 and pOH > 7
Therefore, for an acidic pure water solution pH range one to less than seven and pOH range greater than seven to fourteen. In alkaline or basic solution, the concentration of hydrogen less than hydroxyl ion.
or, COH– > 10-7 M and CH+ < 10-7 M
∴ pOH < 7 and pH > 7
Value of the Ionic Product of Pure Water
Water molecule ionizing weakly to form conjugate acid hydrogen and base hydroxyl ion in solution. Thus there will always be an equilibrium between hydrogen and hydroxyl ions in the water molecule.
At this equilibrium for dissociation of water will have its own equilibrium constant value.
k = (CH+ × COH–)/CH2O
or, k × CH2O = CH+ × COH–
where CH₂O = concentrations of water and CH⁺ and COH⁻ = concentration of hydrogen and hydroxyl ions. But in any dilute aqueous solution, the concentration of water = 55.5 moles/liter, can be taken as a constant.
∴ k × CH₂O = Kw = CH+ × COH–
where Kw = ionic product of water.
Chemical reactions in which absorbed a specific heat by the system from the surroundings are known as endothermic reactions in thermodynamics. A specific heat absorbed from the surroundings for ionization of water. Thus it is an endothermic reaction.
H2O → H+ + OH– +13.7 kcal
Therefore, according to Le-Chatelier's principle, increasing temperature will facilitate dissociation and giving higher values of Kw.
Measuring pH and pOH Scales of Pure Water
The product of hydrogen and hydroxyl ion has constant having the value 10-14.
or, – log (CH+ × COH–) = – log (10-14)
or, – log (CH+) – log (COH–) = 14
Again from the definition
– log CH⁺ = pH and -logCOH⁻ = pOH
∴ pH + pOH = 14
Acidity Scale of Pure Water
The concentration of hydrogen and hydroxyl ion or acidity scale in pure water has been determined by the ionic product of water. Ionic product of pure water =14 and the concentration of hydrogen and hydroxyl are the same.
pKw = pH + pOH =14
or, Kw = CH+ × COH– =10-7 × 10-7 = 10-14
Therefore, the above relation measure the pure water pH level and the concentration of hydrogen ion and hydroxyl ion in the neutral solution which is inversely proportional to each other. To maintain constant Kw, if hydrogen ion concentration increases 100 fold than hydroxyl ion concentration decrease 100 fold.
For 0.01 m sulfuric acid
Sulfuric acid is a dibasic acid. Molarity of sulfuric acid = 2 × molarity of the sulfuric acid solution. Thus acidity scale 0.1 m and 0.2 N sulfuric acids are the same. Thus, pH of 0.1 or 0.2 sulfuric acids = – log (0.2) = 0.699.
For 0.02 M HCl Solution
Hydrochloric acid is a strong electrolyte and completely dissociated in the solution.
∴ CH+ = CHCl = 0.002 = 2×10-3 M
For HCl 0.02 M HCl = – log CH+
= – log (2×10-3)
= (3 – log2) = 2.7
For 0.02 m Acetic Acid Solution
Acetic acid is a weak organic acid and the concentration of hydrogen ion in 0.02 m acetic acid
∴ For 0.002 CH3COOH = – log (CH+)
= -log (2 × 10-4) = 3.7
Measuring pH and pOH Scale and Acidity
Nitric acid, sulfuric acid, hydrochloric acid in pure solution are completely dissociated and regarded as an almost equally strong acid. But the mathematical measuring of pH scales provides the negative value when the concentration of hydrogen ion exceeds 1 M. Therefore, measure pH and pOH scale value for such polar solution avoided because these solutions are not likely to dissociate fully. The concentration of such strongly acid solution is expressed best in terms of molarity rather than pH.


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It looks like James Holmes is getting a life sentence for each victim of the Aurora, Co shooting. He also gets additional time as well. It's always surprised me when people get multiple life sentences for crimes. I understand that they have to stand trial for their crimes but… at what what point is giving a punishment for more than lifetime really fit the crime. They can not divy up each year to each family member of the victim. The verdict should be death/life/term. By term I mean for lesser sentences that do not require life or death. But a life sentence should be cut and dry and to the point.
Home » Social Issues » Aurora, Colorado shooting ruling.
Aurora, Colorado shooting ruling.
Tags: Aurora, Aurora Shooting, colorado shootings, james holmes, life sentenceBy Jeff Mackey in Social Issues on .
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Too many managers are flouting the principles of good performance management, as despite being rated as poor performers, they are still being rewarded by their employers according to new research published 3 June 2015 by the Chartered Management Institute (CMI) and XpertHR.
Data from the National Management Salary Survey 2015, which for the first time recorded performance ratings alongside pay, shows that rewarding poor performance is widespread within organisations, as nearly a third (30%) of all managers ranked as underperforming were handed a bonus in 2014.
Looking at the top of organisations, the salary and performance data reveals that of those senior managers and directors whose performance was rated as 'not meeting expectations', almost half (45%) received a financial bonus. The average bonus paid to underperforming senior managers stood at £8,873.
Data from the survey, taken from 72,206 employees in 317 UK organisations, also shows that managers' salaries are on the rise. Pay increased by 3% on average in the past year – the biggest annual increase since 2012 – compared to a 2.7% increase the previous year. The average salary across all executive levels now stands at £38,328. The average bonus pay-out for all managers was £8,836, rising to £44,687 for directors.
Ann Francke, chief executive of CMI, commented:
"Too many managers are reaping the rich rewards of their positions despite being poor performers. This unacceptable discrepancy between pay and performance is even more widespread among the ranks of senior managers. Unfortunately, it seems to be a lot easier to reward poor performance than to face the awkwardness of having difficult conversations with underperforming staff.
"Change must start at the top with CEOs' pay, as there's plenty of scope at that level to bring pay and performance more in line. To improve performance, managers must be prepared to have honest conversations with their staff and provide regular feedback and coaching. Managers should also have clear targets and be measured against them. Organisations and their employees will only benefit from a culture in which pay closely reflects performance."
Mark Crail, Content Director at XpertHR, added:
"Another reason so many low performers get bonuses is that there is often a culture of rewarding past glories. The biggest and most significant indicator of whether someone will get a bonus this year is whether or not they got one last year. The longer that goes on, the more people come to rely on the money and the harder it is to stop paying it. In those circumstances, employers really should think about whether it would be better to address the level of basic pay rather than finding spurious reasons to add on an arbitrary annual bonus that has little basis in performance."
Download the full National Management Salary Survey 2015