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The financial performance of the Company for the year ended 31st March 2004 is summarised below: Rs. in millions ; Particulars Sales and other income Profit before interest, depreciation, tax and amortisation Less: - Interest - Depreciation - Amortisation Profit before tax Less: - Provision for taxation - Provision for deferred tax Profit after tax Amount b f from previous year Accumulated profit available for appropriations Provision for dividend on preference shares Provision for preference dividend tax Provision for dividend on equity shares Provision for equity dividend tax Transfer to general reserve Balance carried forward to balance sheet Year ending 31st March 2004 1605.20 234.93 Year ending 31st March 2003 1407.68 184.75.
1. Menick FJ. Reconstruction of the nose. In: Baker SR, Swanson NA, eds. Local flaps in facial reconstruction. St. Louis: Mosby p305-44 1995 ; . 2. Acosta AE. Clinical parameters of tumescent anesthesia in skin cancer reconstructive surgery. A review of 86 patients. Arch Dermatol 133 4 ; : 451-4 1997 Apr ; . 3. Ricks M, Cook J. Extranasal applications of the bilobed flap. Dermatol Surg 31 8 Pt 941-8 2005 Aug ; . 4. Kroll SS. Staged sequential flap reconstruction for large lower lip defects. Plast Reconstr Surg 88 4 ; : 620-5 1991 Oct ; . 5. Burget GC, Menick FJ. The subunit principle in nasal reconstruction. Plast Reconstr Surg 76 2 ; : 239-47 1985 Aug ; . continued from page 5 40. Schmidt JB, Raff M. [13-cis-retinoic acid: a new form of treatment for rosacea]. Wien Klin Wochenschr 94 5 ; : 1158 1982 Mar ; . 41. Krause MH, Torricelli R, Kundig T, Trueb RM, Hafner J. [Dapsone in granulomatous rosacea]. Hautarzt 48 4 ; : 2468 1997 Apr ; . 42. Bernstein JE, Soltani K. Alcohol-induced rosacea flushing blocked by naloxone. Br J Dermatol 107 1 ; : 59-61 1982 Jul ; . 43. Wollina U. The response of erythematous rosacea to ondansetron. Br J Dermatol 140 3 ; : 561-2 1999 Mar ; . 44. Bikowski JB, Goldman MP. Rosacea: where are we now? J Drugs Dermatol 3 ; : 251-61 2004 May-Jun ; . 45. Craige H, Cohen JB. Symptomatic treatment of idiopathic and rosacea-associated cutaneous flushing with propranolol. J Acad Dermatol 53 5 ; : 881-4 2005 Nov ; . 46. Wilkin J. Effect of subdepressor clonidine on flushing reactions in rosacea. Change in malar thermal circulation index during provoked flushing reactions. Arch Dermatol 119 3 ; : 211-4 1983 Mar.
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General surgery in high-risk patient Dalteparin Fragmin ; : 5, 000 units SC 8 to hours before surgery and once daily after surgery Enoxaparin Lovenox ; * : 40 mg SC 1 to 2 hours before surgery and once daily after surgery; or 30 mg SC every 12 hours starting 8 to 12 hours after surgery General surgery in moderate-risk patient Dalteparin: 2, 500 units SC 1 to hours before surgery and once daily after surgery Enoxaparin: 20 mg SC 1 to 2 hours before surgery and once daily after surgery Nadroparin: 2, 850 units SC 2 to hours before surgery and once daily after surgery Tinzaparin Innohep ; : 3, 500 units SC 2 hours before surgery and once daily after surgery Orthopedic surgery Dalteparin: 5, 000 units SC 8 to hours before surgery, then once daily starting 12 to 24 hours after surgery; or 2, 500 units SC 6 to hours after surgery, then 5, 000 units SC once daily Enoxaparin: 30 mg SC every 12 hours starting 12 to 24 hours after surgery; or 40 mg SC once daily starting 10 to 12 hours after surgery Nadroparin: 38 units per kg SC 12 hours before surgery, 12 hours after surgery, and once daily on postoperative days 1, 2, and 3, then increase to 57 units per kg SC once daily Tinzaparin: 75 units per kg SC once daily starting 12 to 24 hours after surgery; or 4, 500 units SC 12 hours before surgery and once daily after surgery Major trauma Enoxaparin: 30 mg SC every 12 hours starting 12 to 36 hours after injury if the patient is hemostatically stable For acute spinal cord injury, enoxaparin: 30 mg SC every 12 hours Medical conditions Dalteparin: 2, 500 units SC once daily Enoxaparin: 40 mg SC once daily Nadroparin: 2, 850 units SC once daily LMW low-molecular-weight; SC subcutaneous. * --Dosage for enoxaparin is expressed in anti-Xa units: 1 mg 100 anti-Xa units. --Available in Canada. Adapted with permission from Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA Jr, et al. Prevention of venous thromboembolism. Chest 2001; 119 1 suppl ; : 136S.
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Outlaw hormones, had become less an organ of thought than an instrument registering, minute by minute, varying degrees of its own suffering." Kraepelin noted that "the eye becomes dull." Norman Endler's wife reports that she could see the depression in his eyes. My friends say the same thing. They also can look at a photo of me and judge whether I was depressed at the time it was taken. When depressed I walk hunched over and sit in a slouch. How desperate does depression make a person? Kay Redfield Jamison describes it in An Unquiet Mind as "a pitiless, unrelenting pain that affords no window of hope, no alternative to a grim and brackish existence, and no respite from the cold undercurrents of thought and feeling that dominate the horribly restless nights of despair." Mixed State: Manic Mind, Depressed Body My first psychiatrist, Dr. Gottstein, had a name for why, at the age of 17, I felt so awful. The unwelcome houseguest is called the mixed state, and mine liked to linger. Bipolar disorder manifests itself in many mood and energy combinations. There are shallow depressions and manias lasting a few weeks and then at other points deep depressions and manias lasting longer. The so-called mixed state occurs when manic and depressive traits occur in combination. In fact, research in 2005 reported that up to The so-called mixed 40% of admissions to hospitals for state occurs when manic bipolar disorder were characterized and depressive traits by mixed states. I find mixed states occur in combination. the most uncomfortable aspect of bipolar disorder for myself in part because they are hard to escape. However, the research says the hardest mood state to break is a severe depression.
Ow molecular weight LMW ; heparin products such as FRAGMIN dalteparin ; , LOVENOX enoxaparin ; , and INNOHEP tinzaparin ; offer effective prophylaxis against and treatment of deep vein thrombosis. These products also help prevent ischemic complications in unstable angina and non-Q-wave myocardial infarction. LMW heparin has a much longer duration of action than the more traditional form of heparin unfractionated ; , so A more recent error led to its effects are active in the death of an elderly Failure to the body for up to 24 woman who had a hisclearly communihours. It also has a tory of atrial fibrillamore predictable cate the drugs given in tion, hypertension, therapeutic effect the ED led to starting and constipation. than unfractionated Lovenox and warthe heparin infusion heparin, so less labfarin were prescribed too soon after the oratory monitoring is upon admission. After Fragmin dose. required for dosing. a colonoscopy was But without safeguards, scheduled, warfarin was unintended concomitant discontinued and a heparin use of these two forms of heparin infusion was ordered. But can occur, potentially causing seri- Lovenox was not discontinued. The ous patient harm, even death. order for the heparin infusion was never sent to the pharmacy because In one reported case, a patient with the solution was stocked on the unit. unstable angina died from internal The patient's aPTT was greater than bleeding after he received Fragmin 90 seconds several hours after she in the emergency department ED ; , received both heparin and Lovenox. and then a thrombolytic and IV The heparin infusion was decreased, heparin immediately upon admis- but by morning, the patient had sion to a cardiac care unit after an developed internal bleeding and she acute myocardial infarction was con- died despite immediate discontinuafirmed. Failure to clearly communi- tion of both heparin products. See cate the drugs given in the ED led to check out! for recommendations on starting the heparin infusion too how to avoid these serious errors and tipranavir.
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2. Baseline anti-Xa level measurement IU kg 3. Tinzaparin administration 175 IU kg ; prior to HD Tinzaparin dose IU kg Injection site Abdomen Thigh Other Administration Self-administered includes family member friend administering ; Nursing-administered Hospital status Inpatient Outpatient 4. Time of starting HD session t 0 ; Heparin should NOT be used during dialysis for this study. Was heparin was used during HD session? Y Time post tinzaparin injection h ; 1 2 Time of anti-Xa blood sampling 24 h clock.
Could draw or use a computer by holding a pencil between his teeth, and attended regular classes at Satchel Ford Ele mentary School in Columbia, South Carolina, where the Able family lives. He has a go-cart, lots of friends who play with him every day, and an award on the wall in his room for a draw ing he made of the Statue of Liberty. "The Lady" is all torso, with short little legs and hardly any arms. Why did the Ables name their boy David? "Because he will have so many giants to slay in his lifetime, " said Cecelia. True. But he also will have something his biblical namesake did not--the help of family and friends in slaying those giants. Will David's rearing place "undue burdens" upon the Ables? No doubt about it. Will they face medical bills and perhaps an uncertain future for their little giant slayer? Indeed. But has that deterred them from doing what is right? Absolutely not. And who, by their lifetime commitment, has been blessed? David has been blessed, because he lives amidst a family that loves and cares for him. His brother Patrick has been blessed, because he has been taught, by example, altruistic love and self-sacrifice. Daniel and Cecelia Able have been blessed, because they have had to learn what selflessness is-- the same kind of selflessness God forever has displayed through His love for His creation. Those around them have been blessed, because they have seen firsthand what agape love is all about. And I have been blessed, because a little boy with no arms and no legs has reminded me that the love of God is more important than being able to hold a dog or walk along the seashore. In the midst of the controversy over medical ethics--a con troversy that is unlikely to be resolved anytime soon--perhaps we should be reminded that this world never was in tended to be our final home Hebrews 11: 13-16 our time here is temporary James 4: 14 ; . With God's help, we can tri umph over whatever comes our way Romans 8: 35-39; Psalm 46: 1-3 ; , and understand that whatever befalls us in this world is "not worthy to be compared with the glory which shall be revealed" Romans 8: 18 ; . - 207 and tobi.
Tion occurs without apparent pathology, raise interesting questions regarding the underlying mechanisms of resistance. Adrenal steroids act by binding to and transforming specific intracellular receptors that then direct the transcriptional regulation of specific target genes 14, 15 ; . Two intracellular adrenal steroid receptor subtypes, termed type I and type II, have been identified in mammals 16, 17 ; . The type I receptor binds the endogenous adrenocorticoids aldosterone ALDO ; , corticosterone CORT ; , cortisol, and the sex steroid progesterone with high Kd, 1.0 nm ; and nearly equal affinity 16, 18 ; . Binding specificity for this receptor subtype is thus a function of extrinsic mechanisms, including most notably the glucocorticoid-inactivating actions of the enzyme 11 -hydroxysteroid dehydrogenase 11 HSD ; , rather than of its intrinsic pharmacological characteristics 19 ; . The type I receptor and 11 HSD are coexpressed in high concentrations in the kidney and colon, tissues in which mineralocorticoids regulate ion equilibrium and blood volume 20, 21 ; , and in discrete regions of the central nervous system, where they mediate cardiovascular and blood pressure regulation and salt appetite 22 ; . Type I receptors are also expressed in high density in the hippocampus HC ; , where, in the absence of 11 HSD, they function as high affinity receptors for glucocorticoids. In contrast to the type I receptor, the type II receptor displays a lower binding affinity Kd, 10.0 nm ; but higher intrinsic selectivity for glucocorticoids 16 ; . The pharmacological profile of the type II receptor is therefore consistent with that of a specific glucocorticoid receptor. The type II receptor displays a wide.
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Although other actors are not explicitly invited, any individual or institution that approaches or writes to the Ministry by any means, announcing an intention to participate in the negotiating meetings, is included in a database and receives information about and invitations to the meetings. This happens because when the sector has not been taken into account in decision-making on very important issues it has responded with significant pressure -through press statements. Apart from the decisions taken at the start of the 1990s and the creation of a free trade area within the Andean Community was an exception in that regard ; , the Ministry tends to engage in an intense round of negotiations with the business sector. Once negotiations begin, the business associations and companies are called to general meetings so that the purpose and strategic issues of the negotiations can be explained to them. As mentioned earlier, this is not a formally regulated mechanism but it has been used throughout the last ten years of negotiations. Once the first invitation has been issued to business groups and companies, the Ministry holds an intensive round of meetings with the business sector. Using the "room next door" consultation mechanism, selected representatives of business groups accompany the official delegations and await the public official's request for consultation. At the end of each day, the government's technical team meets with the representatives of the business sector to update them on the negotiations. Upon their return they present the results to members of the private sector. The Foreign Trade Ministry is studying the possibility of playing a more decisive role in inviting and promoting the participation of "private sector" actors in the FTAA negotiations. It has contemplated issuing public invitations and publishing announcements in the press. The negotiators customarily use the working material distributed in the discussions with the "private sector". These official documents are not widely distributed but are usually provided if a request is made. The reasons for this reserve have to do with the concern that the other party to the negotiations might gain access to the documents, thereby weakening the country's bargaining position. Another reason is that the documents are not definitive and hence their indiscriminate distribution could spur false public expectations. Finally, it is assumed that the average person would find it difficult to understand the texts. As regards the role of the officials, it is worth noting that the business organizations consulted believe that they are well prepared, and that they are aloof from the preferences of certain associations.
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On October 28, the Boston Globe stated, "Pigs can fly and impossible dreams can come true, the Boston Red Sox have won the World Series." Like many other Boston fans, I was caught up in the sports world's equivalent of the Berlin Wall falling. After reflecting, though, my beloved Red Sox didn't win because of a miracle or because they reversed an alleged curse, they won because they played fundamental baseball. Like this incredible team, your Club's leadership team can be successful by focusing on fundamentals in the Toastmasters Distinguished Club Program DCP ; . As we approach the halfway point of our year, I have a few questions for you; Where is your Club in terms of achieving success in the DCP? Are you at least halfway towards your goals in the areas of educational achievements and membership? If not, do you have a plan in place to get there? To help you answer these questions, you will want to be sure to attend at least one of the Winter Toastmasters Leadership Institute TLI ; sessions. Our District sets the standard for Leadership Training and our cadre of facilitators will provide you with your required training in a fun-filled atmosphere. During our TLI events, you will learn skills to help you take your Club to "World Class" status. Not only will you receive world-class training, you will get a first look at two new District 3 programs; the XCL award and the Set a Date Campaign. Cyndi, Mick and I look forward to not only seeing you at one of our five TLI events this winter, but also seeing each one of you earn the President's Distinguished Club award before June 30. After all, if the Red Sox can win it all, so can your Club - by focusing on the fundamentals and tolmetin.
Therapy reduces all-cause mortality even in patients with massive ileofemoral thrombi ; . Furthermore, the risk of intracranial hemorrhage is greater with thrombolytic therapy than with unfractionated heparin therapy. Treatment of PE Anticoagulation is the mainstay of treatment for PE. Because of the risks of hypoxemia and hemodynamic instability associated with PE, close monitoring and supportive therapy are necessary. Therefore, outpatient treatment of PE is not advised. Unfractionated heparin most commonly is used to treat patients with PE, although LMW heparin also is safe and effective.9 Only enoxaparin and tinzaparin have received formal FDA approval for use in the treatment of PE.
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POSSIBLE ASSOCIATION BEtween venous thromboembolism VTE ; and the use of antipsychotic agents was first suggested in the 1950s after the introduction of phenothiazines.1 Since then, several case studies2-4 have supported the notion of an increased risk of VTE with conventional antipsychotic agents. Recently, Zornberg and Jick5 documented a 7-fold increase in the risk of idiopathic VTE among users of conventional antipsychotic agents who were younger than 60 years and free of major risk factors. A similar thromboembolic effect of conventional antipsychotic agents has been observed also among individuals with risk factors for VTE.6 Atypical antipsychotic agents represent a newer class of drugs characterized by a distinct pharmacologic and clinical profile. They are more effective for the treatment of negative symptoms and confer a lower risk of extrapyramidal adverse effects compared with conventional agents.7 To date, information on the and toradol.
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