Batm Ethical Case Study - 1412 Words

| A grim contradiction: The practice and consequences of corporate social responsibility by British American Tobacco in Malaysia * British American Tobacco Malaysia (BATM) was formed from he merger of Rothmans of Pall Mall (Malaysia) Berhad and Malaysian Tobacco Company Berhad on 3 November 1999. * Today, British American Tobacco Malaysia is the clear market leader with approximately 63% market share, and ranks amongst the top 25 companies on Bursa Malaysia Securities Berhad in terms of market capitalisation. * British American Tobacco Malaysia manufactures and markets high quality tobacco products designed to meet diverse consumer preferences. Their portfolio includes well-established international names such as Dunhill, Kent and†¦show more content†¦* In Islam perspective, it teaches that the hand of the giver is better than that of the receiver and the Muslims have to understand that their rewards are to be received in hereafter. * The charity that they make would be reward in terms of ‘pahala’ and all muslims are encouraged to earned as much ‘pahala’ as they can as long as they still alive in the world. * One of the verses by Allah Almighty in the Holy Quran, â€Å"Surely the men and women who give in charity and give to Allah a goodly loan, they shall receive double and for them is a noble reward†- (Quran, 57:18). So, it means the rewards would be manifold for those Muslims that give in charity regardless of small or large charity that they do. * For Christians, they are encouraged to follow in the example of Jesus Christ, who was known for helping the poor, said by Council of Churches Malaysia secretary-general Rev Dr Herman Shastri. * Besides he also said that in the early years, the Churches also set an example to help others in needed and Christians generally contributed in three ways which are within the church community, visiting poor families at their homes or setting up dedicated charities. By doing all this charitable acts, it will strengthen and enforce their devotion to God. * Hinduism states that the service to the needy is service to God and the charitable acts should be

Short Story - 1249 Words

â€Å"Oh come on Mar, its not dangerous. Theres literally nothing down here,† whispered Kai as she continued walking, and Martin sighed, slowly taking another step down. â€Å"Look, Kai, I know that you’re angry with your dad and all, but dying in a dark tunnel isn’t really the best way to get back at him† â€Å"Oh shut up, will you? Someone’ll hear us† She took a step down, out of the moonlight that was barely filtering through the long-abandoned entrance windows, and the darkness seemed to swallow her. They were in the old Park Street T Station, once a bustling station, now eerily quiet and dark. Kai had wanted to do something â€Å"rebellious† for Halloween, as she so often seemed to crave. Martin had agreed to go down to the station, as long as they†¦show more content†¦Kai slowed so that Martin could keep up, and they proceeded in a light jog so that Kai could focus on feeling for an old door or closet. Finally, after what felt like hours, but were mere minutes, Kai’s fingers hit metal, and sliding to a stop, she pulled open the door and yanked Martin inside, quickly shutting them in. Panting heavily, Martin leaned against the wall and slid down to the floor. Looking around, he saw some old buckets and shelves, and dark concrete walls, leading him to believe that they were in an old janitors closet. Kai put her finger to her lips and they both held their breath in complete silence for a few tense seconds as they listened for any sign that they had been followed. A few minutes went by with still no sound, and Kai broke the silence with a quiet laugh, â€Å"well, that was fun† Martin, however, was not laughing as he replied, â€Å"Where we are? We’re completely lost down here, and I told my mom that I’d be home by morning!† Kai sat next to Martin, and patting his arm said, â€Å"Don’t worry Mar, we know the general direction back, we’ll find it eventually. And even if we can’t find it, I’m sure someone will have to come down here at some point, right? I mean it’s Halloween, I’m sure the police are expecting kids to sneak around the T† Exasperated, Martin grabbed his backpack and held it to his face as he screamed into it. Although the screams were muffled, Kai could hear them bouncing off the walls ofShow MoreRelatedshort story1018 Words   |  5 Pagesï » ¿Short Stories:  Ã‚  Characteristics †¢Short  - Can usually be read in one sitting. †¢Concise:  Ã‚  Information offered in the story is relevant to the tale being told.  Ã‚  This is unlike a novel, where the story can diverge from the main plot †¢Usually tries to leave behind a  single impression  or effect.  Ã‚  Usually, though not always built around one character, place, idea, or act. †¢Because they are concise, writers depend on the reader bringing  personal experiences  and  prior knowledge  to the story. 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In the short stories â€Å"Miss Brill† and â€Å"Frau Brechenmacher attends a wedding† written by Katherine Mansfield, the themes which are relevant to real life in Miss Brill are isolation and appearance versus reality. Likewise Frau Brechenmacher suffers through isolation throughout the story and also male dominance is one of the major themes that are highlighted in the story. These themes areRead MoreShort Story and People1473 Words   |  6 Pagesï » ¿Title: Story Of An Hour Author: Kate Chopin I. On The Elements / Literary Concepts The short story Story Of An Hour is all about the series of emotions that the protagonist, Mrs. Mallard showed to the readers. With the kind of plot of this short story, it actually refers to the moments that Mrs. Mallard knew that all this time, her husband was alive. For the symbol, I like the title of this short story because it actually symbolizes the time where Mrs. Mallard died with joy. 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Case Study on Cholecystectomy for Pathophysiology- myassignmenthelp

Question: Discuss about theCase Study on Cholecystectomy for Pathophysiology. Answer: Introduction This report aims to critically analyze the case study of Mrs. Beryl Hayes, who has been admitted to the ward for a laproscopic cholecystectomy. Beryl has undergone a surgery and is now still in the hospital. She has not been discharged from the hospital as no improvement is seen in her condition, and already 3 days had already passed by after the surgery. Laparoscopic cholecystectomy is usually done to remove the gall stones from the gall bladder. This process involves two methods- Open cholecystectomy and laparoscopic cholcystectomy. This report has focused on the laparoscopic method as per the given case study. This report will be discussing about the physiology and the pathophysiology of her conditions. Assessment has been done depending on the evidence based practice. The latter part of the discussion also throws light upon the type of care that has to be provided to the patient. The report also discusses about the discharge plan that has to be prepared for the patient and help him to return to his daily activities with ease. Discussion Pathophysiology Laparoscopic cholesystectomy is usually done to remove the gall bladder. It is usually done it patients, who have developed stones or infections in the gall bladder. Normally after a cholecystectomy, a person is unable to go home, the same day, but is generally discharged after a one night stay. Post operative complications may arise which can extend the stay in the hospital. A gallstone normally consists of bile saturated with cholesterol. The hypersaturation is caused due to the greater percentage of the cholesterol concentration than its solubility. This is mainly caused due to the hypersecreation of the cholesterol metabolism (Stinton and Shaffer. 2012). Loss of balance between the crystallization promoting proteins and crystallization inhibiting proteins, leads to the formation of the cholesterol crystals with bile (Joseph et al. 2012). Mucin is a glycoprotein that is secreted by the bilary epithelial cells, which has been documented by a pronucleating protein. The lessened degradation of mucin by the lysosomal enzymes is found to be responsible for the formation of the cholesterol crystals (Reshetnyak. 2012). The Loss of motility of the gall bladder muscular wall and excessive contraction of thee sphincter is also responsible for the formation of gall bladder crystals. The hypo motility of the muscular walls generates bilestasis for an extended peri od of time, including a lessened reservoir function. As the bile cannot flow, it leads to the accumulation of bile and a higher chance of stone formation. Improper filling and a higher percentage of hepatic bile diverted from the gall bladder to the bile duct can be caused due to the hypomotility (Pasternak et al. 2013). Sometimes Gallstones are made up of bilirubin. It is a chemical that is produced due to the breakdown of the red blood cells. Infection in the bile tract and an increased level of enterohepatic cycle of bilirubin can lead to the formation of bilirubin stone formation. Bilirubin stones are often called as the pigmented stones (Joseph et al. 2012). As the pressure on the gall bladder increases, the organ becomes larger in size, the blood supply decreases and repeated inflammation leads to acute cholecystitis. Cholecystitis may also give rise to gall stone pancreatitis which is a life threatening condition (Joseph et al. 2012). Sometimes the gall blader can be infected with microorganisms. An inflamed gallbladder can lead to gas gangerene and suffer from necrosis, which can ultimately lead to sepsis (Joseph et al. 2012). Patient assessment It is required to assess the secondary body function after the surgery, which includes a head to toe format. Any problem in any of this assessment may lead to adverse conditions. CNS- acute cholecystitis can lead to anoxic brain injury. With the severity of the condition it can lead to an elevated brain natriuretic peptide level. CVS Color- straw colored urination. Normally, the T-tube may drain up to 500 mL in the first 24 hours after surgery; drainage decreases to less than 200 mL in 2 or 3 days, and is minimal thereafter. Drainage may be tinged with blood initially, which can change to brown. Excessive drainage immediately (after 48 hours, drainage greater than 500 mL is considered excessive). Pulse- 125 (elevated pulse rate), which can be due to the trauma and fear for the pain post surgery. Blood pressure- 110/60, which signifies her blood pressure quite normal. Respiratory rate- 26, which is the standard RR for elderly patients like Ms Beryl. Chest pain- No chest pain had been reported, although patients might have chest pain due to aspiration and the respiratiory distresses in elderly patient like Ms .beryl. Cap refill- Prolonged cap refill time. A prolonged cap refill time in patient may signify shock and decreased rate of peripheral perfusion. Prolonged cap refill time may indicate peripheral artery disease. Abdominal- Abdominal muscles may ache, flatulent, bloating. Continuous bile flow in the upper intestinal tract can lead to esophagitis and gastritis. Diarrhea and colicky lower abdominal pain may result (Marker et al. 2012). Renal condition- No change has been observed in the arterial blood flow and the renal blood flow. If proper assessment is not done then acute renal failure may occur following laparoscopic surgery. Skin- The patient might experience severe itching; she will have three incisions in her stomach, skin remains itchy and dry. The wound must be kept clean and dry to prevent any infection. Regular dressing is required to avoid any infections. Infections may lead to fever and can increase the risks especially in the elderly patients (Kortram et al. 2012). Social/ family- A proper post operative care by the family can help to bring down the complications. The post operative period requires care as the patient cannot do intensive activities on her own, so it is important to provide him with support. Extensive physical exercise is not permitted as it can increase the complications. Prioritization of care Doctors are not responsible for the post operative care that has to be provided after cholecystectomy (Philibert, Nasca, Brigham and Shapiro. 2013). Nursing plans- To monitor effective breathing patterns- Breathing patterns may be ineffective, this can be due to pain, muscular impairment. The patient sometimes suffers from Tachypnea, holding breath. It is essential to observe the ausculate breath sounds, respiratory depths, to show how to splint incision to the patient. The patient should be provided support in the abdomen while coughing. To observe the color and the characteristics of the discharge- changing of the dressings when required, to change dressings, application of montegomery straps, proper disposal of the ostomy bags (cubas et al. 2012). Checking of the T- tubes and incisional drains, note the consistency and color of the stool, maintenance of the T tube in a closed collection system to prevent skin irritation and reduce the risk of contamination, sufficient tubing should be allowed to permit free turning facility (Yokoe et al. 2012). The vital signs should be monitored, mucous membrane should be assessed, signs of bleeding should be observed. The IQ, including the drainage frm the NG tube and the wound should be assessed properly. All the laboratory signs should be monitored properly (Doenges, Moorhouse and Murr. 2014). Post operative pain can be assessed and monitored and painkillers can be given consulting with the physician. Opoids can be given for moderate to severe pains. Fir the patients who have a high risk in pulmonary disease epidural LA and the opoids in combination can be administered (Bercy et al. 2013). Should check the risk of aspirations- Before any surgery, general anesthesia is used. It relaxes the muscles of the body and suppresses the sensation of pain. It can lead to aspiration as the person does not remain conscious to swallow or gag. Should help the patient to move and take measures against unintentional falls in elderly patients (Bercy et al. 2013). It should be kept in mind that the presence of the surgical incisions may lead to increased pain due to movement; therefore the patient becomes reluctant to any movement. Thus the patient should be encouraged to make movements. Several other factors are also there that has to be monitored. Discharge Plan Prescribe pain medicine- Application of the NSAIDs, to decrease the swelling and the pain, stool softener or laxatives to avoid constipation, iron tonics. It should be kept in mind that the NSAIDs can cause kidney problems or bleeding in the stomach, so a doctor should always be consulted with (Regimbeau et al. 2014). Surgical wounds should be looked upon carefully; the wounds should be kept dry and clean. Shower is permitted after 24 hours from the surgery. Easily digestible food has to be taken followed by enough fluids. Low fat foods should be consumed for about a month, as the gall bladder had a part in the digestion of the fat, so the body needs to be given some time to digest fat without the gall bladder (Dumphy et al. 2015). Plenty of liquids should be taken to prevent dehydration and to facilitate proper bowel movement and to prevent constipation. Avoid intense exercises or activities post operation. Need to provide a follow up within next two weeks from the surgery. Contact the healthcare provider if one has got fever, nausea, pain which is not relieved by the medicines, one has a sign of redness or welling around the incision or blood or puss is leaking out of the incision, having constant constipation or diarrhea, a doctor should also be contacted with if signs of vomiting persists, bowel movements are pale or black or bloody (Naoman et al. 2013). A medical help is also needed if the person is coughing up blood, feeling lightheadedness, having chest pain or the arms and the legs are feeling warm, tender and painful. Return to work is only permitted as soon as the pain is controlled and one feels comfortable to go outside. For some it is 5-7 days after the surgery (Philbert et al. 2013). Conclusion Laparoscopic cholecystectomy has decreased the risks of the open surgery and can be managed easily with a proper management and a proper discharge plan. It has become the preferred treatment for cholecystitis. Laparoscopic method reduces the risk of surgery and helps the person to return back to its normal activity within a very small time, unlike open surgery. In spite of that patients often encounter with problem which can be avoided by providing proper medications and holistic care approach. Proper assessment of the patient, monitoring if the signs and symptoms and providing proper pharmacological and evidence based nursing care can bring about improvement in the deteriorating condition of the patient. From this report it can be understood what interventions can be done for Mr. Beryl to improve her conditions. References Berci, G., Hunter, J., Morgenstern, L., Arregui, M., Brunt, M., Carroll, B., Edye, M., Fermelia, D., Ferzli, G., Greene, F. and Petelin, J., 2013. Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones. Cubas, R.F., Gmez, N.R., Rodriguez, S., Wanis, M., Sivanandam, A. and Garberoglio, C.A., 2012. Outcomes in the management of appendicitis and cholecystitis in the setting of a new acute care surgery service model: impact on timing and cost.Journal of the American College of Surgeons,215(5), pp.715-721. Doenges, M.E., Moorhouse, M.F. and Murr, A.C., 2014.Nursing care plans: Guidelines for individualizing client care across the life span. FA Davis. Dunphy, L.M., Winland-Brown, J., Porter, B. and Thomas, D., 2015.Primary care: Art and science of advanced practice nursing. FA Davis. Joseph, M., Phillips, M.R., Farrell, T.M. and Rupp, C.C., 2012. Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution.Annals of surgery,256(1), pp.1-6. Kortram, K., van Ramshorst, B., Bollen, T.L., Besselink, M.G., Gouma, D.J., Karsten, T., Kruyt, P.M., Nieuwenhuijzen, G.A., Kelder, J.C., Tromp, E. and Boerma, D., 2012. Acute cholecystitis in high risk surgical patients: percutaneous cholecystostomy versus laparoscopic cholecystectomy (CHOCOLATE trial): study protocol for a randomized controlled trial.Trials,13(1), p.7. Markar, S.R., Karthikesalingam, A., Thrumurthy, S., Muirhead, L., Kinross, J. and Paraskeva, P., 2012. Single-incision laparoscopic surgery (SILS) vs. conventional multiport cholecystectomy: systematic review and meta-analysis.Surgical endoscopy,26(5), pp.1205-1213. Naumann, D.N., Quinn, M., Sivanesan, S., Farooq, U., Hendrickse, C.W. and Bowley, D.M., 2013. Preventing readmissions: are we doing enough?.British Journal of Healthcare Management,19(7), pp.348-353. Pasternak, A., Gil, K., Matyja, A., Gajda, M., Sztefko, K., Walocha, J.A., Kulig, J. and Thor, P., 2013. Loss of gallbladder interstitial Cajal?like cells in patients with cholelithiasis.Neurogastroenterology Motility,25(1). Philibert, I., Nasca, T., Brigham, T. and Shapiro, J., 2013. Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?.Annual review of medicine,64, pp.467-483. Regimbeau, J.M., Fuks, D., Pautrat, K., Mauvais, F., Haccart, V., Msika, S., Mathonnet, M., Scott, M., Paquet, J.C., Vons, C. and Sielezneff, I., 2014. Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial.Jama,312(2), pp.145-154. Reshetnyak, V.I., 2012. Concept of the pathogenesis and treatment of cholelithiasis.World journal of hepatology,4(2), p.18. Stinton, L.M. and Shaffer, E.A., 2012. Epidemiology of gallbladder disease: cholelithiasis and cancer.Gut and liver,6(2), p.172. van Baal, M.C., Besselink, M.G., Bakker, O.J., van Santvoort, H.C., Schaapherder, A.F., Nieuwenhuijs, V.B., Gooszen, H.G., van Ramshorst, B., Boerma, D. and Dutch Pancreatitis Study Group, 2012. Timing of cholecystectomy after mild biliary pancreatitis: a systematic review.Annals of surgery,255(5), pp.860-866. Yokoe, M., Takada, T., Strasberg, S.M., Solomkin, J.S., Mayumi, T., Gomi, H., Pitt, H.A., Gouma, D.J., Garden, O.J., Bchler, M.W. and Kiriyama, S., 2012. New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo Guidelines.Journal of hepato-biliary-pancreatic sciences,19(5), pp.578-585.

Investigating Vitamin C free essay sample

Vitamin C is found in green vegetables, fruits, and potatoes. It is essential for a healthy diet. The chemical name for vitamin C is ascorbic acid. Ascorbic acid is a good reducing agent and therefore it is easily oxidised. Methods for the detection of vitamin C involve titrating it against a solution of an oxidising agent. Where to start There are several oxidising agents that can be used and a commonly used one is 2,6-dichlorophenol-indophenol or DCPIP. You need to standardise this against a known concentration of vitamin C. This means finding out how much DCPIP reacts with a known amount of vitamin C. You can check the end point colour by testing a small amount of vitamin C with the DCPIP and observe the disappearance of the blue colour. The end point is usually a pink colour that persists for about 15 seconds or longer. Practical Techniques You will need to find out about the technique of titration and how to make up accurate solutions. We will write a custom essay sample on Investigating Vitamin C or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Possible Investigations  · Investigate the reliability of this method at different concentrations and under different conditions. You may also find slightly different procedures for the DCPIP analysis – are they more accurate/easier?  · Investigate other analytical agents such as iodine and Nbromosuccinimide. How do they compare to DCPIP?  · Investigate the stability of ascorbic acid under different conditions such as temperature, light and air/oxygen.  · Investigate the amount of vitamin C in foodstuffs and the effect of cooking them.  · It has been shown that vitamin C can interfere with the blue-black colour of the starch iodine complex. The vitamin C can turn it from blue-black to colourless. Investigate the possibility of using this reaction to determine vitamin C concentration.