Un-English Expressions

A watch is slow or fast, not goes behind or in front.
Don’t say: My watch goes two minutes behind.
Say: My watch is two minutes slow.

Un-English Expressions

Make a blunder, not do a blunder.

Don’t say: I did one blunder yesterday.

Say: I made one blunder yesterday.

British Vs American – Is the word or thing different?

When an American says suspenders where a Briton would use braces, there is a real difference in vocabulary – but both people are talking about the same thing. Here the choice is fairly simple. If you are a speaker of British English writing for British readers, you would normally use the word braces. If you are writing for American readers who will understand the British word, it is probably best to do the same thing – to use the word that comes most naturally to you.

But does the same rule apply to words such as expressway and motorway? Are they really identical? Expressways tend to be across or into cities, whereas motorways are usually trunk roads between towns or regions. If you were a British speaker writing or speaking of an American highway, it would probably be better to use the American word.

Things can get more complicated. It is often hard to decide whether the difference is one of vocabulary or reality. An American bar is not quite the same as a British pub; the New York subway is not really identical to the London underground. So what should a British person in New York say or write? Would you choose underground or subway? If you are talking about underground railway systems in general, you might prefer to use the word you are most familiar with – underground. If you are talking about the New York system in particular, it would probably be more appropriate to talk about the subway.

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Clinical feature of Leishmaniasis – A manuscriptedit.com analysis

Cutaneous leishmaniasis has broad spectrum of clinical manifestations, so,  it is often compared with  leprosy. Cutaneous  ulcers can be localized or diffuse type, wet or dry ulcer depending on the  species and host factors. The  initial lesions can appear immediately after a bite, or several months of infection. The lesions are usually painless and over weeks to year time some lesions may resolve spontaneously without any therapeutic agent

Mucocutaneous leishmaniasis

The incubation period ranges from 1-3 months, the primary lesions may  be limited to cutaneous and mucosa,  appearing as a painful erosion.

Visceral leishmaniasis

Kala azar is the Indian name for visceral leishmaniasis. The term means “black disease,” which is a reference to the characteristic darkening of the skin that is seen in patients with the disease. Many subclinical cases go unrecognized . Malnutrition has been shown to contribute to the development of clinical disease. Onset can be insidious or sudden, it can be  asymptomatic , self-resolving disease to fulminating  disease. In endemic areas, it is suspected in a patient with persistent, irregular, or remittent fever; leucopenia, splenomegaly, lymphadenopathy and weight loss.

Examination

Cutaneous leishmaniasis initially starts as small, red papule up to 2 cm in diameter. Over several weeks, the papule becomes dark brown and forms  crust in the center while advancing edge of the  ulcer is active  with raised edges and surrounding dusky red and edema. The ulcers can be moist or covered  with dry  crusted scab depending on the stage of activity. After about 3-6 months the ulcers usually heals leaving a raised border. Regional lymphadenopathy, satellite lesions, and subcutaneous nodules can be present .Lesions are found on the  exposed areas of skin like extremities and face. Systemic signs are usually absent.

Mucocutaneous leishmaniasis can be single or multiple. The mucosal lesions can progress to involve the entire nasal mucosa and the hard and soft palates. Without treatment, the entire nasal mucosa and palates may become deformed with ulceration and erosion of the nasal septum, lips, and palate. The disease attacks cartilaginous areas but spares the bony structures. Other findings include gingival edema, periodontitis, and adenopathy.

Visceral leishmaniasis presents with bouts of fever with hepatosplenomegaly ,wasting,  weakness darkening of skin, ymphadenopathy. severe anemia.

Risk factors

• • Children are at greater risk than adults.
  • Malnutrition enhances the severity of disease.
  • Persons with AIDS are at a greater risk (100-1000 times) of developing visceral leishmaniasis.
  • Incomplete therapy give rise to recurrence of leishmaniasis.
  • Bite of one infected sandfly is sufficient to cause the disease, since a sandfly can ingest more than 1000 parasites per bite.

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