Acute Onset Of Refractory Hypertension - 1270 Words

INTRODUCTION: Acute onset of refractory hypertension in an otherwise young, healthy patient should immediately raise suspicion for secondary (non-idiopathic) etiologies. This case represents a scenario of secondary hypertension due to Cushing’s syndrome stemming from an ectopic ACTH-producing bronchial carcinoid tumor in a young, active duty sailor. PATIENT PRESENTATION: A 23 year-old otherwise healthy African American active duty male admitted directly from Endocrinology clinic for expedited work-up of suspected Cushing’s syndrome. Patient had been treated by his primary care provider for acute-onset hypertension, but had escalated rapidly to use of three antihypertensive agents within 6 months. Other than tobacco dependence (1/3 pack per day), patient had no known pertinent personal or family medical history. Patient was referred to Endocrinology due to refractory hypertension (190/100s on three agents) and signs of truncal obesity (30 lbs despite active lifestyle), moon facies, buffalo hump and violaceous striae concerning for Cushing’s syndrome. He also reported symptoms of generalized fatigue, limb weakness, lower extremity edema, easy bruising, nocturia, insomnia, and irritability. Patient was found to have elevated ACTH (252-290) with non-suppressible cortisol levels upon dexamethasone suppression testing at 1-mg (32.7) and 8-mg (37.56). Adjunctive studies included thyroid function tests, renin:aldosterone ratios, plasma metanephrines, 24-hour urineShow MoreRelatedAtrial Fibrillation: Causes, Pathophysiology and Treatment1498 Words   |  6 PagesThe anaesthetist must take into consideration the physiological and pharmacological implications of this common arrhythmia. In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of whichRead MoreSymptoms And Treatment Of Acute Coronary Syndrome1231 Words   |  5 PagesAcute Coronary Syndrome Megan Kehn Nursing 250 Delta College Disease Process Research has demonstrated that thrombus formation from an abrupt rupture of atherosclerotic plaque, which equates to diminished or complete termination of blood flow through the coronary artery, is the most common cause of an acute coronary event (EBP guidelines). 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The Kite Runner by by Khaled Hosseini Blinded by Guilt

The Kite Runner: Blinded by Guilt A person’s childhood is the foundation that paves the way for the rest of one’s life. Memorable events can trigger certain emotions in a child and, as a result, change the nature of that person as an adult. Set in the 1970s in California, the novel The Kite Runner by Khaled Hosseini is told in flashbacks as the reader follows the main character through his resolutions to lifelong conflicts. The novel traces Amir’s mixed feelings of love and jealousy towards his best friend Hassan. Although they each came from different economic and social classes, they grew up in the same household facing hardships, resent, and deceit together. The two boys reach a turning point when the neighborhood bully savages†¦show more content†¦He had guilt and remorse for what he put Hassan through, but felt powerless to stop himself. Because his father’s burning words made Amir doubtful, he opposes it in the end when he stands up to Assef. The metaphors in The Kite Runner follows Amir to California where his bed is his guilt and it must be laid in every night. Amir reminisces about his past and states, that was a long time ago, but its wrong what they say about the past, I’ve learned, about how you can bury it, because the past claws its way out(1). Amir looks back on what he has once witnessed long ago, and it is haunting him, making him feel guilty and ashamed. Amir is clearly an emotionally unstable person, but his resentment towards Hassan is increased because of his own haunting guilt. The guilt that seems to be terrorizing Amir is caused by his experience of watching the rape of Hassan in the alley. Amir is so guilty that he can no longer be close to Hassan. Amir says, Id hear Hassan shuffling around the kitchen in the morning, hear the clinking of silverware, the whistle of the teapot. Id wait to hear the door shut and only then I would walk down to eat(87). Amir has trouble facing his guilt. Amirs gu ilt shows that what he had done was wrong. After Amir’s graduation, Baba says that he wishes Hassan were here and Amir feels as if A pair of steel hands closed around my wind pipe at the sound of Hassans name(134). Amir was feeling guilt so great it was choking him when Baba saidShow MoreRelatedThe Kite Runner By Khaled Hosseini1621 Words   |  7 Pageswouldn’t typically have from the outside looking in. They counteract the stereotypes that outsiders procreate of something that they have never intimately experienced. Keeping that in mind, my classical nomination is the Bestseller The Kite Runner by Khaled Hosseini. Hosseini wrote this historical novel in 2001 while completing his residency at Cedars-Sinai Medical Center in Los Angeles, California. Much of the historical content was based off his childhood experiences living in Afghanistan. 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Khaled Hosseini’s prized novel, The Kite Runner, reveals the controversy that surrounds the relationship of two central characters, Amir and Hassan. Both have fathers who share a long history. Amir and Hassan grow up together and appear, on the surface, as close friends. Yet, there are various instances that foster doubt in regards to the authenticity of Amir’s feelings towards Hassan. For all intents and purposes, Hassan proves time and time again to be a faithful companion. Hosseini uses

Importance of Information Security In E Commerce Free Sample

Question: Information security and buyer protection and the challenge of data protection are expanding in degree and trouble. While online businesses have since a long time ago expected to shield their clients' security and private data, changes in information transforming and plans of action present new dangers and new regulations. As part of your report, you are required to assess different protection and security issues experienced by customers and online businesses, including security strategies by which these issues are currently being addressed. Answer: Introduction Privacy and security in the realm of e commerce are the two critical factors of concern that determine the course of online business. E commerce security is considered to be a small part of the wider dimension of information security framework. There are two main areas of focus namely computer security including all kinds of internet thefts and data security that pertains to privacy issues of personal data (Udo, 2001). The security of e commerce is the highly visible form of security component affecting daily routine of the payment interactions and transactions. The thesis developed in the study would dwell deeper into the dynamic dimensions of e commerce security namely authenticity, confidentiality, non repudiation, integrity, privacy and availability (Ghosh, 1998). Hence, the realm of e commerce security is an essential requirement for all the managements and technical domains for effective transactions over the internet. The study would discuss about some of the pertinent securit y issues that are posing threat to the privacy of the customers. The security issues are also discussed with some technical jargon used. Another area of discussions would be the measures that can be taken to prevent this threat and risk over e commerce in the form of information security. The study would also discuss some of the major laws that support the cause of business management and online transactions. Threats to e commerce The main security crunches and the relevant issues pertain to verifying the identity of the person involved in business transactions and ensuring correct and timely delivery of messages without tampering. Networks at both the ends of customers and business vendors are at risk with hackers demanding ransoms to reveal credit card information (Ghosh, 2001). But the conflict of ease of use versus the security is heavier on the side of convenience. The virus attacks against the software Microsoft Outlook that there have been quick proliferation of these viruses and worms (Hassler, 2002) throughout the internet network. All the sites that are directly, or remotely associated with e commerce site must adequately arrange security services due to widespread attacks of Distributed Denial of Service. Code Red worm and NIMDA have successfully penetrated the system and have leaked sensitive security information (Awad, 2004) without the permission of the customers. Viruses and Trojan horse program s are main threats to the client server model of e commerce websites. Viruses are naturally disruptive but Trojan horse programs facilitate breaking into the system in addition to permit the attacks of data integrity. Therefore, Trojan horses are serious threats that remotely control some of the programs and are difficult to resolve. Spamming is another security threat that is sending of unconsolidated email threats (Belanger, 2002) and mailers to individuals leading to situations of email bombing. Hackers also place software agents to get into the system. The unauthorized access security measure is the illegal access into the system with active and passive modes. The passive mode is overhearing of some communication or overlooking some transactions while active mode refers to modification of the information or intended changes in the message. It also includes forms of masquerading that is to send messages in a fake form in the terms of spoofing. Hackers also take advantage of the o perating system security holes. Theft and fraud cases also overpower the e commerce world of online business. In technical terms, there are some other attacks such as smurf attacks (These are ICMP attacks where a large number of IP packets are send with fake source address quickly using up networks bandwidth and easing up breach to the required destination), teardrop attack (sending of distorted fragments with oversized and overlapping payloads along with a bug leading to improper handling of fragments and crashing them ultimately), phlashing (this is a form of permanent denial of service damaging the system to a greater extent that would require reinstallation of even the hardware and sometimes making it completely unusable) and brute force attacks (to defeat a cryptographic scheme), phishing attacks (it is a criminally fraudulent process to acquire sensitive information in e communication mainly targeting online auction sites, bank customers, service providers and online retailers ), social engineering (manipulating people by pretexting, phone phishing, baiting with Trojan horse, interactive voice recording) (Sindre, 2005). Social engineering is an open area of research nowadays with various mental models and motivations. The management of software is also another pertinent issue with the e commerce security guidelines and policies. There have to be balance among all the domains of data on e commerce websites and without the accomplishment of this equilibrium, e commerce security will remain as an issue of concern and a problem of all the times. There can be numerous measures that can be taken in order to mitigate the risks associated with the e commerce security and threats. Encryption in the form of public key or private key can be used to secure the arrangements in the process of transactions. An algorithm is a key for encoding and decoding the message (Ford, 2000). The process of key protects the contents of the message and the associated technology of digital signatures can prove the true identity of the authorized sender too. In other terms, it is a digitally signed certificate for electronic identification. There are certain laws in UK pertaining to electronic signatures like Electronic Communications Act of 2000. Digital signatures are replaced by electronic signatures and are validated by the government. This directive focuses over guidelines for use of electronic signatures, establish a legal criteria for the implementation of these signatures. UK Regulation of Investigatory Powers Act monitors the powers of the po lice authorities to intercept any kind of electronic message that is seeming to be dangerous. The police authorities may also demand for encryption keys if necessary (Thomson, 1998). The data Protection Act of 1998 gives out eight principles to control data either personal or of government use. The controls common for security of data and other information are information security policy document, reporting security credentials, business continuity management, allocation of information for security responsibility, and information for security of education and training (Alter, 2001). There are some other guidelines that can be followed by the customers to safeguard their online transactions and the pathway of e commerce. They must ensure that they are shopping at secure web sites having an https in the header indicating secure. The company can be researched prior to ordering the goods and the services. It is quite essential to read the privacy codes and security policies of the web site and look for a membership in web based program. The customers need to be aware about the presence of cookies on a website and can block them if desired and on the other hand they must be prepared about the behavioral marketing that is being adopted by various e commerce websites nowadays. The mode of payment via the means of credit card is the most secure one out of other means as it is protected under Fair Credit Billing Act (Joshi, 2001). The copies of the orders must be saved or printed for future correspondence purpose and the tracking information or the shipping facts must be paid attention to. In case there is any kind of merchant side cancellation, return or any kind of complaint handling, the policies of the websites must be checked. A single use card number can be used all the times in case of transactions and every time while handling the card number, virtual keypad should be used. Customers and business experts must understand the sales responsibility and should have a knowledge about the taxes that have to be paid online. The dynamic pricing strategies should also be used in the favor of online services requested by the users. The need of the hour is to protect the e commerce websites from the common mistakes done by the people handling them and the hackers who are having a keen eye over the whole network and the end points of the network. Conclusion E commerce industry hence is facing a challenging future in terms of risks and security threats. The criminals of internet and e commerce are becoming more sophisticated for the attacks and deceptions over the e commerce gateway. Awareness about all the potential risks and execution of multi layered protocols for security purpose and strong authentication for encryption and other preventive and corrective measures will ensure a bit of a compromise for the risks and safeguard the net for the future use of e commerce pathway. It is also essential to educate the consumers of e commerce website to dwell into the security architecture of the system. Orientation programs and training programs need to be conducted for the staff for enhancing the security awareness for the internet. Financial audit groups and IT services within the domain of e commerce (Siau, 2001) should form an alliance to implement security measures at business level. References 1. Udo, G. J. 2001, Privacy and security concerns as major barriers for e-commerce: a survey study, Information Management Computer Security, vol. 9, no. 4, pp. 165-174.2. Ghosh, A. K. 1998, E-commerce security: weak links, best defenses, Wiley.3. Ghosh, A. K., Swaminatha, T. M. 2001, Software security and privacy risks in mobile e-commerce, Communications of the ACM, vol. 44, no. 2, pp. 51-57.4. Hassler, V. 2002, Security Fundamentals for E-commerce, info, vol. 4, no. 2, pp. 49-50.5. Awad, E. M. 2004, Electronic commerce: From vision to fulfillment.6. Belanger, F., Hiller, J. S., Smith, W. J. 2002, Trustworthiness in electronic commerce: the role of privacy, security, and site attributes, The Journal of Strategic Information Systems, vol. 11, no. 3, pp. 245-270.7. Sindre, G., Opdahl, A. L. 2005, Eliciting security requirements with misuse cases, Requirements engineering, vol. 10, no. 1, pp. 34-44.8. Ford, W., Baum, M. S. 2000, Secure electronic commerce: building the infrastruc ture for digital signatures and encryption, Prentice Hall PTR.9. Thomson, M. E., von Solms, R. 1998, Information security awareness: educating your users effectively, Information management computer security, vol. 6, no. 4, pp. 167-173.10. Alter, S. 2001, Information systems: foundation of e-business, Prentice Hall PTR.11. Joshi, J. B., Aref, W. G., Ghafoor, A., Spafford, E. H. 2001, Security models for web-based applications, Communications of the ACM, vol. 44, no. 2, pp. 38-44.12. Siau, K., Lim, E. P., Shen, Z. 2001, Mobile commerce: Promises, challenges and research agenda, Journal of Database Management (JDM), vol. 12, no. 3, pp. 4-13.