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Thursday, February 28, 2013

Laser Eye Surgery For Vision Corection(Near Or Far sighteness) in Pakistan


Although there are a number of laser eye surgical techniques, the most popular are Photorefractive Keratectomy (PRK) and Laser-Assisted In Situ Keratomileusis (LASIK), of which the latter is by far the superior technology.

PRK is an out-patient procedure typically performed with local anesthetic eye drops. The surgery only takes a few minutes during which an excimer laser (an extremely precise, computer-controlled ultra-violet beam of light) reshapes the cornea (the clear covering of the front of the eye) by removing microscopic amounts of tissue from the outer surface.



Prior to surgery the patient's eye is measured to determine precisely the degree of visual problem. The required corneal change is calculated and entered into the laser computer.

This procedure is available in Pakistan but with advances made in LASIK technology, especially over the past couple of years, it has become almost obsolete.

LASIK is a more complex procedure than PRK. It is performed for all degrees of myopia (near sightedness). A well-qualified surgeon uses a microkeratome knife to cut a flap in the cornea and a hinge is left at one end of this flap. The flap is folded back revealing the stroma (the middle section of the cornea). Pulses from a computer-controlled excimer laser vaporize a portion of the stroma and the flap is replaced.

Although some new lasers for eye surgery are currently being tested abroad, both PRK and LASIK are readily available in Pakistan at varying prices. LASIK is the preferred choice for most patients but an initial consultation can determine which procedure best suits an individual patient. The professional competence of the surgeon is critical.

You may be a good candidate for laser eye surgery:

* if you are at least 18 years of age and your eye prescription has stopped changing

* if you have mild to moderate myopia within the treatable range (which can be determined by your personal ophthalmologist)

* and if you have healthy eyes free of retinal problems, corneal scars and any eye disease.

In Pakistan, the fees for operation vary dramatically starting as low as Rs5,000 per eye to as high as Rs48,000 for both eyes, depending on the reputability of the clinic and doctor as well as the suitability of the patient. Although abroad some clinics offer free LASIK consultation, at most places in Pakistan there is an initial consultation fee ranging from Rs150 to Rs580.

Discomfort, if any, is minimized by the anesthetic eye drops placed in the eye prior to the procedure. However, many patients sense a scratchy feeling during the procedure and some are sensitive to light for a few days. Once the anesthetic drops’ effect wears off, the amount of discomfort varies with each individual but usually disappears within a few hours.

Most people can return to work within three days following the procedure. But this usually varies from patient to patient. Most patients resume regular activities the day following surgery.

The precision of the corneal change measurement is critical to the success of the procedure. A patient generally has to stop wearing contact lenses for several weeks prior to the surgery and the amount of time is usually determined by the doctor during initial consultation.

According to international collective results and US clinical trials, the treatment appears to be permanent. However, as people age their eyes change and re-treatment may be necessary.

Recovery time is generally minimal and typically the patient can be escorted home after 30 minutes. An improved sight is generally noticed three to five days after surgery.

Usually, the doctor operates both eyes on the same day. This should be decided after having a discussion with him.

The reputation of the surgeon, his or her experience with the procedure involved, and the condition of a patient's eyes are the more relevant factors not the country in which the clinic is located.

Risk factors:
Although the chances of complications following the procedure are relatively minimal, there are risks involved, including but not limited to the following:

Infections and delayed healing (PRK or LASIK): With PRK, there is about a 0.1 per cent chance of the cornea becoming infected, and an even smaller chance with LASIK. However, infection generally means added discomfort and a delay in healing, with no long-term effects within a period of four years.

Under-correction/Over-correction (PRK or LASIK): It is possible a patient may still need corrective lenses after the procedure to improve vision. Sometimes, a second surgery can be done to improve the result.

Flap damage or loss (LASIK only)There is a remote chance that the entire corneal flap could come off by mistake, but it is usually easily replaceable unless lost or damaged.

Distorted flap (LASIK only): Irregular healing of the corneal flap could create a distorted corneal shape, decreasing an optimal result.

Regression (PRK or LASIK): In some patients, the effect of refractive surgery is diminished over a period of time. Re-treatment is usually possible.

Halo effect (PRK or LASIK): The halo effect is the most common side effect from laser eye surgery. It refers to an optical effect that is noticed in dim light. In other words, at night, the patient sees a moon-like halo surrounding objects. This effect can often interfere with driving at night.

Incomplete procedure (PRK or LASIK): There is always the remote possibility that the computerized laser will malfunction or breakdown during the procedure. This, of course, is more of a risk with LASIK due to its more complex nature.

Monday, February 25, 2013

Oscar Winners Complete List 2013: Results From 85th Academy Awards


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Airing live from the Dolby Theater in Los Angeles, this year's ceremony is being hosted by "Family Guy" creator Seth MacFarlane. Up for Best Picture this year are plenty of 2012's biggest hits, including "Argo," "Zero Dark Thirty," "Lincoln," and "Django Unchained."
We will be updating the list of winners as soon as the show starts at 8:30 p.m. EST on ABC, so get your ballots ready! And make sure to follow our liveblog below, with analysis and updates being throughout the the night.
BEST PICTURE
"Argo"
BEST ACTOR
Daniel Day-Lewis for "Lincoln"
BEST ACTRESS
Jennifer Lawrence for "Silver Linings Playbook"
BEST SUPPORTING ACTRESS
Anne Hathaway for "Les Miserables"
BEST SUPPORTING ACTOR
Christoph Waltz for "Django Unchained"
BEST DIRECTOR
Ang Lee for "Life of Pi"
BEST ADAPTED SCREENPLAY
"Argo"
BEST ORIGINAL SCREENPLAY
"Django Unchained"
BEST ANIMATED FILM
"Brave"
BEST FOREIGN LANGUAGE FILM
"Amour"
BEST MUSIC (ORIGINAL SONG)
"Skyfall" from "Skyfall" (Music and Lyric by Adele Adkins and Paul Epworth)
BEST MUSIC (ORIGINAL SCORE)
Mychael Danna for "Life of Pi"
BEST PRODUCTION DESIGN
"Lincoln"
BEST CINEMATOGRAPHY
"Life of Pi"
BEST DOCUMENTARY (FEATURE)
"Searching for Sugar Man"
BEST VISUAL EFFECTS
"Life of Pi"
BEST MAKEUP
"Les Miserables"
BEST COSTUME DESIGN
"Anna Karenina"
BEST FILM EDITING
"Argo"
BEST SOUND EDITING
"Skyfall"
"Zero Dark Thirty"
BEST SOUND MIXING
"Les Miserables"
BEST SHORT FILM (ANIMATED)
"Paperman"
BEST SHORT FILM (LIVE ACTION)
"Curfew"
BEST DOCUMENTARY (SHORT)
"Inocente"

Friday, February 22, 2013

Stiff-Man Syndrome Pathophysiology, clinical feature, investigations and treatment


Stiff-Man Introduction

Stiff-man Syndrome is a rare disease of severe progressive muscle stiffness of the spine and lower extremities with superimposed muscle spasms triggered by external stimuli or emotional stress. Typically symptoms begin between the age of 30 and 50 and respond to benzodiazepines. EMG shows a characteristic abnormality and anti-GAD (glutamic acid decarboxylase) antibodies, which are very specific, are present in 60% of people with the disease.
Key words: Stiff Person Syndrome, Moersch and Woltman Syndrome, Anti-GAD antibody, Stiff man syndrome

History

Stiff-man syndrome (SMS) was first described by Moersch and Woltman (1956) in a case report of 14 patients seen over 27 years. A literature review by Gordon (1966) including one patient of his own and 33 from the literature more sharply delineated the characteristics of the disease and postulated that the symptoms might be due to a failure of inhibitory function. A follow-up report of the Mayo clinic experience by Lorish (1989) describing 13 patients seen over 30 years established standard criteria for diagnosing the disease. A cumulative literature review by Jankovic (1991) included 2 patients of his own and 82 others is the most recent large scale report of the disease. Effective treatment with a benzodiazepine was described by Howard in 1963.

Clinical Presentation

Epidemiology

SMS is very rare. The prevalence has not been reported however it may be as rare as 1 per 1,000,000 persons. There is no clear racial or ethnic predisposition although the disease may be more common in women than in men. Patients with SMS often have other autoimmune disease. A related disorder has been found in association with lung or breast cancer and is distinguished by the production of anti-amphiphysin antibodies.

Clinical features

Although most often the disease begins insidiously and progresses over years, in some cases symptoms can develop over weeks. The first symptom is usually a persistent progressive stiffening of the back or a limb which may be worse under pressure e.g. crossing a busy street. A sensation of aching or stiffness may be noted. This progresses with time and is described as stiffness, rigidity, hypertonia or increased tone. Additionally patients experience spasms of the involved muscles which are characterized as severe, tremendous, intense and painful. The examiner may feel there is a volitional component. When stiffness and spasms are present together patients have difficulty ambulating and are prone to unprotected falls i.e. falls like a tin soldier. When in spasm the muscles are hard to palpation and may produce abnormal joint position: extension or contraction. Spasms may be triggered by sudden noise, touch, electrical shock, passive or volitional movement and are typically relieved by sleep. The onset of stiffness may less commonly begin in the face and arms however the spine and legs almost invariably become involved with time. An increase in the normal curvature of the lumbar spine or hyperlordosis is common. In the GAD antibody positive form of Stiff-man syndrome there is a strong association with other autoimmune diseases such as diabetes, hyperthyroidism, hypothyroidism, pernicious anemia and vitiligo. Often before the diagnosis is established people are considered for psychiatric evaluation because symptoms wax and wane over time and are apparently worsened by heightened emotional states. Patients with SMS have been described at fearful, afraid and depressed; it is important to consider the impact of the symptoms of SMS on the patientís overall well-being.

Pathophysiology

The symptom complex of SMS suggests a derangement of physiology mediated by spinal cord reflexes however the specific mechanism of disease has not been defined. Stiffness, spasms, pain, trigger response and falls could all result from failed modulation of spinal cord reflexes. The neurons controlling these functions use gamma-aminobutyric acid (GABA) as a neurotransmitter and are called GABAergic neurons. GAD (glutamic acid decarboxylase) is an enzyme which produces GABA and is localized to the synaptic nerve terminal. GAD is the protein antigen that is specifically bound by the anti-GAD auto-antibodies found in approximately half of SMS patients.
First described by Solimena and coworkers in 1988, at high titer anti-GAD autoantibodies are almost exclusively associated with SMS. Sporadic reports of association with cerebellar ataxia, type I (autoimmune) diabetes and autoimmune polyendocrine syndrome have been made. At low titer anti-GAD antibodies are found in type I diabetes; pancreatic beta cells, like GABAergic neurons, express GAD. Although the presence of high titer anti-GAD antibodies is highly specific for SMS, the role that the humoral immune system plays in pathogenesis of this disease is unclear. It is not known whether the antibodies have a causative role or are the consequence of a process that leads to impairment of neurotransmission.

Diagnosis

Antibody testing

While the absence of antibodies in the serum does not rule out SMS, the presence of anti-GAD autoantibodies strongly supports that diagnosis (99% specific by immunocytochemistry). There are several ways to measure anti-GAD antibodies: immunocytochemistry and Western blotting were the first methods used. Immunocytochemistry allows the detection of antigens in tissue section whereas Western blotting visualizes protein antigens which have been separated by size. ELISA and radioimmunoassay (RIA) use antigen specific binding to attach enzyme linked or radioactively labeled substrates to the antibodies in serum. Developed more recently ELISA and RIA have the advantage of quantitatively assessing the amount of anti-GAD antibody a patient has produced.

Physical exam

Central to evaluation for SMS is a detailed history and neurological exam. The cardinal symptoms are essential to the diagnosis of this disease and isolated laboratory results do not stand alone. The symptoms of stiffness, rigidity or increased tone, spasm or pain are identified by the patient and physician together. The areas of involvement may include the face, neck, abdomen or arms but more typically the legs or lumbar spine are involved. The response to medications is important in discriminating other causes of stiffness e.g. Parkinsonís disease and spasticity. Evaluation may include tests to rule out other causes of stiffness such as multiple sclerosis or transverse myelitis.

Electromyography

Electromyography (EMG) is an important diagnostic tool in evaluating patients for SMS. The typical pattern of continuous low frequency firing of normal motor units or continuous motor unit activity (CMUA) is found simultaneously in agonist and antagonist muscles of the affected region. This abnormal firing pattern is abolished by centrally and peripherally acting agents (general anesthesia, intravenous diazepam, neuromuscular blockade). The EMG findings of SMS may be subtle in patients who are fully treated for the symptoms of SMS.

Genetics

The disease has not been described in members of the same family and there is no known genetic predisposition. An association with human leukocyte antigen (HLA) type has been described.


Treatment

There are several important features specific to the treatment of this disease. Although there seems to be a strong autoimmune link, immunomodulating therapies have yet to produce consistent results. Anecdotal reports of response to prednisone, immunoglobulin or plasmapheresis have appeared. The most consistently effective therapy is benzodiazepines. These drugs produce symptomatic relief and discontinuation often leads to reemergence of symptoms. Other drugs which modulate the function of GABAergic neurons are employed with variable efficacy. Physical therapy may exacerbate spasms in some patients and should be used carefully in those for whom passive motion may be a trigger of spasm. The course of the disease is variable; there are reports of patients with SMS who respond well to medication and are able to exercise vigorously. Abrupt withdrawal of therapy may be harmful.

Wednesday, February 6, 2013

'Argo' wins top prize at Screen Actors Guild awards



LOS ANGELES: "Argo" won the Screen Actors Guild award for best cast ensemble on Sunday, the top prize at the annual Hollywood ceremony.

The film about the Iran hostage crisis starred Ben Affleck, John Goodman, Alan Arkin and Bryan Cranston.

The Screen Actors Guild, made up of about 100,000 actors working in the United States, handed out trophies for the best performances on film and television at a dinner in Los Angeles. --AGENCIES
 

Witch-hunting movie 'Hansel & Gretel' wins box office



REUTERS: A grown-up "Hansel & Gretel" grabbed the weekend box office title, pulling in $19 million in U.S. and Canadian ticket sales with its reinvention of the fairy tale characters as fierce bounty hunters.

"Hansel & Gretel: Witch Hunters" knocked last weekend's winner, low-budget horror flick "Mama," into second place. "Mama" earned $12.8 million from Friday through Sunday, according to studio estimates, followed by "Silver Linings Playbook" with $10 million.

CIA drama "Zero Dark Thirty" came in fourth with $9.8 million.

Jeremy Renner and Gemma Arterton star in "Hansel & Gretel" as crossbow-wielding adult siblings who travel the world taking out evil witches. MGM and Viacom Inc's Paramount Pictures produced the action comedy for about $50 million. Paramount had predicted opening weekend sales in the high-teens or low $20 million range.

Don Harris, Paramount's president of distribution, said the film performed well despite the very cold temperatures and snow that hit the eastern United States.


"We are pleased that we were on our number on a worldwide basis. It looks like we are on or exceeding our numbers but we did get dinged with the weather on Friday," he said in an interview.

"The impact of the weather was certainly more than I had predicted."

"Mama" features Jessica Chastain as a woman forced to take care of two orphaned nieces who have been living in the woods. The $15 million production has now earned $48.6 million at U.S. and Canadian theaters through two weekends.

Chastain also stars in "Zero Dark Thirty" in an Oscar-nominated role as a dogged CIA agent searching for al Qaeda leader Osama bin Laden. The best picture nominee, which has sparked debate over depictions of torture, has grossed $69.9 million since its release in late December.

"Silver Linings Playbook" stars Bradley Cooper as a former mental patient trying to rebuild his life with the help of a young widow played by Jennifer Lawrence. Total sales for "Silver Linings" reached $69.46 million. The movie, Cooper, Lawrence and co-star Robert De Niro are all nominated for Oscars.

New crime thriller "Parker" finished in fifth place, taking in $7 million at domestic theaters. The film is based on a series of novels by Donald E. Westlake and stars Jason Statham as a thief seeking revenge against a crew that double-crossed him. Jennifer Lopez plays a woman who helps with his mission.

"Movie 43," a film with an ensemble of Hollywood directors and stars, was in seventh place, according to Hollywood.com, very close behind "Django Unchained."

The film is a series of interconnected short movies following a washed-up producer as he pitches hilarious and insane story lines featuring some of the biggest stars in Hollywood, including Hugh Jackman, Seth MacFarlane, Kate Winslet and Dennis Quaid. Privately held Relativity Media produced the film for about $6 million.

"Mama" was distributed by Universal Studios, a division of Comcast Corp, Sony Corp's, movie studio released "Zero Dark Thirty." "Parker" was released by independent studio FilmDistrict. The Weinstein Co distributed "Silver Linings Playbook." --AGENCIES

Oscar producers aim to cut out the boring parts



CALIFORNIA: The producers of the Academy Awards have good news for those watching at home: They re trying to cut out the boring parts.

Oscar producers Craig Zadan and Neil Meron say they watched 40 years of past ceremonies to finds ways to keep the show moving at a brisk pace. They say they are looking to nip and tuck unnecessary moments that can turn the show into a marathon.

At an annual lunch honoring Oscar nominees, Zadan and Meron said they identified time-consuming segments that might run only 15 or 30 seconds but which collectively can bog down the show. In some years, the Oscars have run to a ponderous four hours or more.

"You start adding up those 30 seconds, and you have an accumulation of time that you can use for entertainment. So that s what we re doing. We re learning a lot about the things that we don t need in the show," Zadan said. "The main goal is to honor the nominees and the winners. And then beside that, there s a lot of pregnant pauses that you get in the show.

We ve scooped out a lot of those pauses and created more time for performance and entertainment." Zadan and Meron said they have moments planned that should appeal to all ages and interests, including performances by Adele, Norah Jones and Barbra Streisand and a tribute to the James Bond franchise.

They also are working closely with Oscar host Seth MacFarlane, creator of "Family Guy" and last summer s comedy hit "Ted" who is known for edgy, potty-mouthed humor. The producers said they re not worried that they will need an emergency switch to censor MacFarlane.

"There s no oversized red button" to bleep the broadcast if MacFarlane goes too far, Meron said. "Seth is Seth, and we love him."

Among those attending the Oscar lunch were acting nominees Denzel Washington, Sally Field, Anne Hathaway, Hugh Jackman, Naomi Watts, Jessica Chastain, Jennifer Lawrence, Bradley Cooper and Robert De Niro.

Also on hand was Ben Affleck, who missed out on acting and directing nominations for his CIA thriller "Argo" but does share a best-picture nomination as a producer on the film.

Affleck said he s thrilled with the awards attention the film has gotten and that he is not sweating his snub as director.

Since he got left out of the directing field on Oscar nominations morning, "Argo" has gone one to dominate other Hollywood awards, including the top prize for Affleck at Saturday s Directors Guild of America honors. "Argo" now has established itself as the Oscar favorite among the nine best-picture contenders, a rarity since films hardly ever win the main award if they are not nominated for best director.

"I just feel so incredibly honored to be nominated as a producer for this movie. To be here at the big party," said Affleck, who shared a screenplay Oscar with Matt Damon for 1997 s "Good Will Hunting" but had not been nominated again until this season.

"There are nine amazing movies, any of which could win, any of which would deserve to win if they did. I don t get into worrying too much about who got what and who didn t get what. I mean, I ve had many, many, many, many, many, many years watching from home."

About 160 nominees attended the lunch, an annual rite leading up to Hollywood s big night. The 85th annual Oscars air live Feb. 24 on ABC.

At the lunch, stars discussed other rites of awards season, such as what to wear Oscar night and how to deal with the stress of it all.

Chastain, a best-actress nominee for the Osama bin Laden manhunt thriller "Zero Dark Thirty," said she expects to have a nice breakfast, with calming music and candles, on Oscar morning.

Best-actress rival Lawrence, nominated for the lost-souls romance "Silver Linings Playbook," said her family is pretty matter-of-fact about her Oscar success, using it a reason to party.

"The night of the Oscars, everybody just gets wasted and has a blast," said Lawrence, who dressed for comfort two years ago when nominated for "Winter s Bone" but is thinking style this time around. "This year, I m like,  No, suck it up. Wear a corset.  So yeah, I m going to go for fashion this time."

Lawrence s "Silver Linings Playbook" co-star Cooper, a best-actor nominee, expects to be doing the reverse of his character, who s recovering from a stay in a mental hospital with help from his parents. Cooper said he figures he ll be minding one of his own parents before the Oscars.

"I m sure the day of, I ll be calming my mother down," Cooper said. "She still doesn t know what to wear, so I ll be a caretaker that day."

Hathaway, a supporting-actress nominee for the musical "Les Miserables," said she hasn t given any thought yet to what she ll wear on Oscar night.

"Yeah, I need to get on that, don t I?" Hathaway said. "It was the Super Bowl. I couldn t think about dresses with all that delicious fried food around."

If the Oscar producers really want to keep the show moving, they might seek advice from De Niro, a supporting-actor nominee for "Silver Linings Playbook."

Meeting with reporters, seven-time nominee, two-time winner De Niro was asked how big a deal the Oscars are to him now. The notoriously terse De Niro lived up to his reputation with a five-word answer.

"It s still a big deal," he said, and moved on to the next question.

'No big red button' for Oscars host MacFarlane


LOS ANGELES: The producers of this year's Oscars show said Monday they have no "big red button" to press in case boundary-pushing host Seth MacFarlane oversteps the mark.
They voiced confidence in the "Family Guy" creator as more than 160 nominees attended a traditional Oscar luncheon in Beverly Hills, three weeks before the February 24 show, the climax of Tinseltown's annual awards season.
MacFarlane, also creator of foul-mouthed big-screen teddy bear Ted, is seen as an edgier choice of host for the Academy Awards than previous years, in what could be an attempt to target a younger demographic.
But Neil Meron, co-producing the show with Craig Zadan, said the pair of them were working closely with MacFarlane and were confident they won't have any surprises.
"There's no oversized red button," he said. "I mean, Seth is Seth, and we love him." The Oscars show, watched on TV around the world, usually airs with a few seconds' delay, in case of expletives or other inappropriate surprises.
Zadan added: "Also, we're working together on the show, so he's one of the few hosts who has been in every production meeting. He's been there every day, and we're working on the show together.
"So as he's writing it, we're part of the process of him saying, 'Is this good? Is this funny? Is this not funny?' So we have been collaborating with him on that, so we're not going to be surprised by anything.
"We're working as a team. We're totally cool about it."
They were speaking as nominees attended a luncheon in their honor at the Beverly Hilton hotel, put on every year by the Academy of Motion Picture Arts and Sciences.
Daniel Day-Lewis, tipped for best actor Oscar for his presidential "Lincoln" performance, and Jessica Chastain, best actress frontrunner for Osama bin Laden manhunt movie "Zero Dark Thirty," were among the 17 of the 20 acting nominees present.
Ben Affleck, whose Iran hostage drama movie "Argo" has picked up the top prize in a series of awards shows so far, turned up despite the perceived Oscars snub, which saw him missing from the best director nominees.
Other filmmakers there included Kathryn Bigelow, who was also left off the Academy's directors shortlist for "Zero Dark Thirty," and Steven Spielberg, whose "Lincoln," won the most Oscar nominations, with 12 nods.

First Steve Jobs movie gets red carpet premiere





PARK CITY, Utah: The first movie about Apple's legendary co-founder got a warm reception at its world premiere on Friday, just 15 months after Steve Jobs' death.
"jOBS," starring "Two and a Half Men" actor Ashton Kutcher as the tech and computer entrepreneur who revolutionized the way people listen to music and built Apple Inc into an international powerhouse, got a red carpet roll-out at the Sundance Film Festival ahead of hitting U.S. theaters on April 19.
"jOBS" chronicles 30 defining years of the late Apple chairman, from an experimental youth to the man in charge of one of the world's most recognized brands. It is the first of two U.S. feature films about Jobs, who died in 2011 at age 56.
"Everybody has their own opinion about Steve Jobs, and they have something invested in a different part of his story. So the challenge is to decide what part of his story to tell, and not disenfranchise anybody," director Josh Stern told Reuters ahead of the screening.
"Hazarding a guess and venturing into too much speculation is always dangerous, especially with a character who is so well-known," Stern added.

The film, co-starring Josh Gad and Dermot Mulroney, begins with Jobs the dreamer, the poet and the occasional drug user in college, and his initial ideas for Apple Computers, before his vision took on a life of its own.
Much of the drama is based around the early 1980s, and Jobs' ideologies for the Apple Lisa and Macintosh computers, which ended up performing poorly for the company and led to Jobs being fired.
Kutcher's Jobs is seen as the rock star of the tech world, admired but misunderstood in his early days as he constantly tried to think outside of the box and bring a notion of "cool" to his brand.
The audience on Friday warmly applauded the film following the screening.
In a question-and-answer session after the screening, Kutcher took to the stage to talk about his preparations of mastering Jobs' posture, hand gestures and eccentricities, saying his "painstaking research" included watching more than 100 hours of footage of the Apple innovator.
Notably missing from the film are details about Jobs' personal life - his court settlement with the mother of his first child features only in the backdrop of the 1980s, a time when he struggled to gain support from the Apple board for his visions.
Stern told the audience that he deliberately stayed away from the CEO's personal life, saying the film was "not about getting mired in some of the soap opera" of Jobs' life.
Kutcher, 34, told Reuters on the red carpet before the screening that he was honored to play Jobs but also terrified because of the former Apple chairman's iconic status.
"To be playing a guy who so freshly is in people's minds, where everywhere you go you can run into people who met him or knew him or had seen a video of him ... that's terrifying because everyone is an appropriate critic," Kutcher told Reuters.


Measles symptoms ,sign and treatement

Measles is a very contagious (easily spread) illness caused by a virus.

Causes, incidence, and risk factors

The infection is spread by contact with droplets from the nose, mouth, or throat of an infected person. Sneezing and coughing can put contaminated droplets into the air.
Those who have had an active measles infection or who have been vaccinated against the measles have immunity to the disease. Before widespread vaccination, measles was so common during childhood that most people became sick with the disease by age 20. The number of measles cases dropped over the last several decades to almost none in the U.S. and Canada. However, rates have started to rise again recently.
Some parents do not let their children get vaccinated because of unfounded fears that the MMR vaccine, which protects against measles, mumps, and rubella, can cause autism. Large studies of thousands of children have found no connection between this vaccine and autism. Not vaccinating children can lead to outbreaks of a measles, mumps, and rubella -- all of which are potentially serious diseases of childhood.

Symptoms

1.Symptoms usually begin 8 - 12 days after you are exposed to the virus. This is called the incubation period.
2,Symptoms of prodormal phase may include (3cs)
  • conjuctivitis


  • Cough
  • Fever
  • Light sensitivity (photophobia)
  • Muscle pain
  • 3.  Rash(Maculopapular rash)
    • Usually appears 3 - 5 days after the first signs of being sick
    • May last 4 - 7 days
    • Usually starts on the head and spreads to other areas, moving down the body
    • Rash may appear as flat, discolored areas (macules) and solid, red, raised areas (papules) that later join together
    • Itchy






  • Runny nose
  • Sore throat

                                                    Measles Facial Look

  • Tiny white spots inside the mouth (Koplik's spots)...present in prodormal period



 Tests   

  • Measles serology
  • Viral culture (rarely done)

Treatment

There is no specific treatment for the measles.
The following may relieve symptoms:
  • Acetaminophen (Tylenol)
  • Bed rest
  • Humidified air
Some children may need vitamin A supplements. Vitamin A reduces the risk of death and complications in children in less developed countries, where children may not be getting enough vitamin A. People who don't get enough vitamin A are more likely to get infections, including measles. 

1lac unit for child below 1 year And 2 lac unit above 1 year child

Complications

Complications of measles infection may include:
  • Bronchitis
  • Encephalitis (about 1 out of 1,000 measles cases)
  • Ear infection (otitis media)
  • Pneumonia

Prevention

Routine immunization is highly effective for preventing measles i.e Measles Vaccine(or MMR) At 9 month By SC injection because before 9 month maternal antibodies Prevent Against Infection .People who are not immunized, or who have not received the full immunization are at high risk for catching the disease.



Taking serum immune globulin 6 days after being exposed to the virus can reduce the risk of developing measles, or can make the disease less severe.and vaccine is given 6 week after immunolobulin.

Key words:
measles , measles rash,Maculopapular rash, kopliks spot, conjunctivitis,immunization, serum imuno globulin ,complications,encephalitis,pneuminia,