Government of Nepal

Ministry of Communications and Information Technology

Minimum Wages Fixation Committee


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By: A. Porgan, M.B. B.CH. B.A.O., M.B.B.Ch., Ph.D.

Assistant Professor, Dartmouth College Geisel School of Medicine

Hints and tips for the exam Venousexaminationofthelowerlimbisfairlystraightforwardandislikelytoappearasthesepatientshavea chronicillnessandareplentifulinnumber women's health questions to ask your doctor cheap provera 5mg overnight delivery. Ifyou manage to complete your examination in good time pregnancy flu shot buy generic provera line, Examinations: 15 Vascular (venous) 75 (a) Figure 15 women's health issues statistics buy 5mg provera amex. Describing the edges of an ulcer Descriptive term Punched-out Pathology Full-thickness skin death Relatively quick onset Healing ulcer Shallow Infection at ulcer site Damages subcutaneous tissue Edge is growing quickly Slow growth at the edge women's health center lansdale pa buy provera 10 mg on line, telangiectasia in ulcer Likely cause Arterial Neuropathic Rarely syphilis Venous Infection Carcinoma Basal cell carcinoma Picture Flat, sloping Undermined Heaped/everted Pearly rolled Hints and tips for the exam Theulcerexaminationstationmaybeencounteredas amedical,surgicalordermatologycaseinfinals. Find out about function/activities of daily living Beforeattendingtotheulcer,remembertoinspectthe patientandthesurroundings. Be clear and systematic in your description of the ulcer Thekeytothisstationisinthedescriptionoftheulcer, and that is where most of your marks can be gained. When you embark on describing the ulcer, be sure to use the correct terminology, as in most cases it is likely beaspotdiagnosis. Use theinternet(when not on the wards) to look up and describe pictures of ulcers with a friend. Tobeginwith,commentonthesiteoftheulcerasa distance from a bony landmark or obvious point of reference. Thedistribution of an ulcer may give you a clue to its cause so it is importanttomentionthistoo. The larger an ulcer,thelongeritwilltaketohealandthemorelikely it will be to become infected. The edge of an ulcer is one of its most defining characteristics(atleastforfinals! Itcanallowyouto showtheexamineryouareawareofthediagnosisand also the pathological processes underway within the ulcer(seethetableabove). Afterthankingthepatient,remembertocoverthem appropriately and complete your examination, tailoringanyfurtherexaminationtoyourmostlikelydiagnosis,suchasanexaminationoftheperipheralnerves ifaneuropathiculcerisfound,oraperipheralvascular examination if arterial or venous insufficiency is the suspectedaetiology. Hereisoneexampleofdescribinganulcer: There is a single lesion 1cm above the left nostril. To answer this question, be sure to include community-basedservicesinyouranswerinaddition toconservative,medicalandsurgicalmanagement. Know your muscle groups the following muscles are responsible for the movementselicitedwithintheshoulderexamination. The hand imitates holding an empty can for full internal rotation and imitates holding a full can with thumbs up for external rotation. Thisaction creates impingement of the structures of the greater tuberosity of the humerus against the coracohumeral ligament. This demonstrates impingement of the long head of the biceps, supraspinatusorinfraspinatus. Sulcus sign the arm is gently pulled downwards, creating an observableenlargedsubacromialspaceandacleardeep skinsulcus. Load shift sign Anterior or posterior dislocation can be detected by grippingthehumeruswithonehandandgraspingthe scapulawiththeotherhand. Theinjuredshoulderjoint will shift more with movement than it does on the normalside.


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Form a word with cardi and -gram: / / (root) (suffix) Summarize the rule that applies in this frame womens health 95825 buy provera visa. Build a medical word with enter + cyst + -plasty: / / / / Summarize the word building rules that apply in forming the above term menopause 30s purchase 5 mg provera mastercard. It is not necessary for you to know the meanings of all suffixes yet because these terms and definitions will be reviewed again women's health & family services proven 5mg provera. What is important now is that you understand how to identify the component parts (root women's health fertility problems cheap provera online, combining form, suffix) of a word. For example, in the term pancreat/itis, pancreat is the ; itis is the. Many prefixes found in medical terminology also are found in the English language. Form a new term meaning small cell by changing the prefix macro- to micro-: /. When it is part of a word, the prefix is not highlighted, but a slash separates it from the next element, as in hyper/tension. By changing the prefix, post/operative pst-P-r-tv after you alter the meaning of the word. In addition, you can find pronunciation guidelines on the inside back cover of this book. We recommend you complete the flash-card activity before starting the Word Elements Chapter Reviews. Then, in the exercise below, underline one of the items within the parentheses to complete each sentence. The breve above a vowel is used to indicate the (short, long) vowel pronunciations. When i is at the end of a word (to form a plural), it is pronounced like (eye, ee). When e and es form the final letter or letters of a word, they are commonly pronounced as (combined, separate) syllables. If you are not satisfied with your level of comprehension, review the pronunciation guidelines (on the inside back cover of this book) and retake the review. When you see gastr/o in a medical term, you will know the term refers to the stomach. The following sections introduce common surgical, diagnostic, and pathological suffixes as well as plural suffixes. Some of these elements have already been introduced in previous frames, but they are reinforced below. Surgical Suffixes Common suffixes associated with surgical procedures, their meanings, and an example of a related term are presented in the table that follows. If you are not satisfied with your level of comprehension, review the surgical suffixes and their meanings. If you are not satisfied with your level of comprehension, review the diagnostic suffixes and their meanings. First, study the suffix as well as its meaning and practice pronouncing the term aloud. To build a working vocabulary of medical terms and understand how those terms are used in the health-care industry, it is important that you complete these exercises. If you are not satisfied with your level of comprehension, review the pathological suffixes and their meanings.

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There will be no exchange, loaning or borrowing of tools, equipment or manpower between the Department of Environmental Quality and the Contractor. The Asbestos Consultant selected by the Contractor shall be experienced and knowledgeable about the methods for asbestos air sampling and be able to select representative numbers and locations of samples. Sampling locations with at least (one exceedance** [Fence Property Boundary Conceptual Site and Geographic Area Boundaries! Joseph Street Lansing, Michigan 48917 Bids must be submitted electronically through the Buy4Michigan website at Project Scope of Work: the Work, Interim Response Activities, includes, but is not necessarily limited to: Planning, site preparation, site health and safety, clearing, and dewatering. Drainage ditch improvement to restore channel capacity and prevent overflowing onto the newly placed cap. The Bidder must figure its Base Bid on the specified, or Addendum-approved, materials and equipment only. No "or equal" or substitution proposals will be permitted after Bid opening, except as provided in the General Conditions. I authorize the Michigan Department of Treasury to verify that the business has or has not met the criteria for a Michigan business indicated above and to disclose the verifying information to the procuring agency. Bidder shall also indicate one of the following: Bidder qualifies as a Michigan business (provide zip code: ) Bidder does not qualify as a Michigan business (provide name of State: ). Principal place of business is outside the State of Michigan, however service/commodity provided by a location within the State of Michigan (provide zip code: ( ). For each nominated Subcontractor, the Bidder shall enter, if applicable, whether the Subcontractor is a minority, woman or handicapped owned business in the spaces provided for that purpose. The Bidder also shall furnish the amount of the Subagreement that the Bidder, directly or through another higher tier Subcontractor, anticipates awarding to each nominated Subcontractor. Failure by the Bidder to comply with this Subcontractor nominating requirement may render the Bid as not conforming in all material respects with the requirements of the Bidding Documents. Pursuant to the Bidding Documents, the Bidder shall not remove, replace or add a nominated Subcontractor except for good cause. Before Contract Award, any removal, replacement or addition of a nominated Subcontractor shall be responsive to the requirements of the Bidding Documents only to the extent it permits the timely evaluation of the newly nominated Subcontractor. Since the requirement to nominate Subcontractors for the listed Divisions, Specification Sections and/or trades survives the award of the Contract, any Subcontractor nominated for any listed Division, Specification Section and/or trade for the first time after Contract Award and who is objected to by the Owner, for good cause, shall be replaced at no increase in Contract Price and/or Contract Time. The requirement to make a definite nomination of Subcontractors or to state that the Bidder intends to self-perform that classification, and to clarify any omissions or ambiguities in this List of Subcontractors, applies to any Bidder remaining or wishing to remain in contention for the award. This listing requirement is not intended to create any express or implied duty or obligation to the Bidder or the nominated Subcontractors by the Owner or Professional. No change in Contract Price or Contract Time, "or equal" or substitution or modification of the Contract Documents (including addition, deletion or other revision) releases the Surety of its obligations under this Section 00610 Performance Bond. The Surety expressly waives notice of any such change in Contract Price or Contract Time, "or equal" or substitution or modification of the Contract Documents (including addition, deletion or other revision). This Performance Bond must be solely for the protection of the Owner and its successors, legal representatives or assigns. It is the intention of the Contractor and Surety that they must be bound by all terms and conditions of the Contract Documents (including, but not limited to General Conditions and this Performance Bond). 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