The outcome of the British general election was a surprise and its implications are still far from clear, not least as far as Brexit is concerned. Ten days ago, on 29 April, the European Council held a brief, but very important meeting. The meeting of 29 April was however so important that it merits a more rapid appraisal than usual. The atmosphere was good. There was levity as well as ceremonial.

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Oral replacement of vitamin B by intramuscular injection of hydroxycobolamin, a form of vitamin B Folic acid deficiency can occur due to pregnancy, malabsorption syndromes or inadequate diet. Some drugs, for example phenytoin, oral contraceptives and isoniazid, can cause reduced absorption of folic acid. Oral replacement therapy with folic acid is effective. Aplastic anaemia is due to loss of haemopoietic tissue in bone marrow and therefore decreased production of red blood cells. This a common side effect of cytotoxic drugs. Effective haemoglobin synthesis and red blood cell production also depends on the action of a growth factor, erythropoietin, produced by the kidneys. In chronic renal failure lack of this growth factor results in anaemia. Replacement therapy is by intravenous or subcutaneous injection of epoetin. Increased destruction of erythrocytes, or haemolytic anaemia, occurs if erythrocytes are broken down prematurely and can be due to haemoglobin defects, abnormal enzymes, membrane defects, poisons or infections, incompatible blood, autoimmune disease or hereditary disease. Sickle cell disease and thalassaemia are examples of inherited haemolytic anaemias.

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If this is tolerated, higher concentrations can be used to provide optimum response. Since dithranol irritates normal skin, it should not be used in flexures, on the face or in skin folds. Coal tar preparations are complex and variable mixtures of hydrocarbons that have cytostatic or antimitotic actions. Crude coal tar is the most effective, but few outpatients tolerate the mess and smell. In hospitals, coal tar is often combined with ultraviolet B (UVB) radiation. There are many proprietary preparations, which are more refined and therefore more acceptable to patients, but they are less effective.

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Apart from the possibility of adverse drug reactions occurring, individuals show variation in response to drugs and this is particularly likely in the very young and the very old. In order to have an effect on the body, therapeutic, adverse or otherwise, a drug must interact with its site of action. Sites of action are known as targets for drug action and include receptors, ion channels, enzymes and carrier molecules. The phentermine 40 mg buy online of the effects that drugs can have on the body and how they produce these effects is known as pharmacodynamics. An adverse reaction is any reaction to a drug that is harmful to the patient. Side effects, unwanted effects and adverse effects are all adverse reactions; some are considered to be less serious than others, although the terms are used synonymously.

In Jacksonian epilepsy, the abnormal brain activity is confined to the motor area of the cerebral cortex. An attack consists of jerking of particular muscle groups for a few minutes phentermine 40 mg buy online no loss of consciousness. With psychomotor epilepsy, the abnormal activity is confined to the temporal lobe of the cerebral cortex resulting in brief periods of confused behaviour. It is not known what causes epileptic seizures, but suggestions include increased excitatory nerve transmission, decreased inhibitory transmission or some abnormality of the nerve cells themselves. Such abnormalities may be the result of head trauma, stroke or tumours, but in most cases, the cause is unknown.

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Prostaglandins play a role in inflammation by causing vasodilation and increased vascular permeability and in pain by sensitizing sensory nerve endings to the effects of other mediators such as bradykinin. Thromboxanes promote platelet aggregation. Prostacyclin is produced from arachidonic acid in undamaged endothelium of phentermine 40 mg buy online vessels and plays a role in preventing unnecessary blood clotting. Inhibition of COX by NSAIDs reduces rather than abolishes inflammation because the drugs do not inhibit production of other mediators of inflammation. Most patients experience some relief from pain, stiffness and swelling, but these drugs do not alter the course of the disease, prevent tissue destruction or produce remission. There are many drugs belonging to the NSAIDs group and the main differences between them are the incidence and type of side effects.

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General anaesthesia aims to achieve loss of consciousness in the patient together with loss of all sensation. Usually this is to allow surgery or manipulation of a body part. Local anaesthesia is the loss of sensation in a particular phentermine 40 mg buy online of the body while the patient remains conscious. This can allow minor surgery or other treatment of a body part. Analgesia is the absence or relief of pain. There are many reasons why analgesia is desirable.

Subcutaneous fat provides insulation and an energy store. Eczema is a localized inflammatory reaction in the skin that has several possible causes. It can be a reaction to contact with chemicals including some drugs, metals or allergens, in which case it is known as contact dermatitis. In some cases, eczema occurs without an obvious cause and is known as atopic eczema. Characteristics of eczema are red itchy epidermis and oedema of the dermis. Most often, the skin is dry and scaly, but sometimes in the early stages of eczema, the lesions weep and can become infected.

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