Tuesday, April 28, 2020
The Short Summary of the Film Alexander the Great Essay Example
The Short Summary of the Film Alexander the Great Essay The Short Summary of the Film Alexander the Great is about a man called Alexander, king of Macedonia. The story tells us how Alexander conquers Asia, Egypt, part of India and how he becomes the legend ââ¬Å"Alexander the Greatâ⬠. The chosen leaders for this movie are Alexander and his father Phillip. Alexander is a man with enormous dreams since his childhood and he has been called ââ¬Å"The son of the godâ⬠. He knows and believes from the very beginning that he will create a history and become an important person for his people. Alexander is an effective and good leader in one way, but on the other hand sometimes he seems to be an ineffective leader who only searches for power and self fulfilment. ALEXANDER -Alexanderââ¬â¢s Ability and Traits Alexander has traits to be an effective leader in wars. He born as a leader and knows how to get the soldiers to follow him and trust him. He takes an interpersonal role where he acts as a leader of his men and the population of the land that he conquers. Alexander is a good planner and organiser, he know his goal and have a strategy. We will write a custom essay sample on The Short Summary of the Film Alexander the Great specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Short Summary of the Film Alexander the Great specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Short Summary of the Film Alexander the Great specifically for you FOR ONLY $16.38 $13.9/page Hire Writer He has also great ambition to do the best for himself and his people. Alexander wants to be seen as a hero, he love to manage and conquer. He is a good negotiator, as you can see in the movie for example when he and his father conquer Greece. The traits and behaviour that Alexander has is associated with derailment is that sometimes he shows very high self-esteem and He thinks that he can manage everything because of his very individualistic nature. Also he trust anyone and anything but himself. However, he needs to learn that sometimes he also needs to listen to his people and his followers to make decisions. Furthermore, another negative trait of Alexander is that he is very much impatient since he is so much fascinated by his ambitions that he couldnââ¬â¢t analyze the facts. -Alexanderââ¬â¢s Leadership Behaviours Alexander uses different leader behaviours depending on the followers. For the soldiers, he tries to motivate and recognize them and to create a culture with values and norms. He also clarifies goals and objectives for the soldiers, so everyone knows what they need to do. Alexander is also a good team builder, to be a good soldier you need to work together as a team and he displays this must behaviour. Alexanderââ¬â¢s In-groups and Out-groups Alexander has some in and out group member in one point of view. The in-group members are: His mother, his nearest friends such as such as Ptolemy, Hephaistion, and Cassander and his tutor, Aristotle. The out group members are the other soldiers from the places he conquered. However you can also take the point of view that Alexand er tried to create a positive relationship with all of the followers and create system and network through the world, as a head leader. Soldiers need to work as a network and thatââ¬â¢s why he needs to have positive relationships among all of the followers so they trust him. Alexanderââ¬â¢s Leadership Styles Alexander is task oriented and uses an autocratic leadership style. On the other hand, when he has time, he used consultation with his nearest friends, mother and his tutor, Aristotle. If we look from the perspective from Ohio State University he would be a directive/autocratic leader. Alexander also use delegation the daily business to the kings of the conquer land. In our point of view he thinks that he uses the appropriate decision style but he could use more consultants and listen to the followers rather then being very task-oriented leader. -Alexanderââ¬â¢s Sources of Power Alexander has different sources of power. He has legitimate power because of his position king of Macedonia, reward and coercive power that he can reward or punish the soldiers depending on their behaviours and ecological power because he can decide how the organization for the soldiers and the organization should look like. He has also referent power that he has charisma and the soldiers have high loyalty. -Alexanderââ¬â¢s Influence Tactics Alexander use different influence tactics to influence his people, legitimate power, rational persuasion, exchange tactic, personal appeals, inspirational appeal, and pressure tactic. Alexander is also a charismatic leader; he has the charisma both from his personality, vision and the situation. And his vision is to conquer the whole world and being the strongest. PHILIP Even though Alexander is the leading character in the movie, King Philip plays a very important role as well. Philip is a good leader in his younger ages in terms of expanding the borders of the country and giving importance to science, art, philosophyâ⬠¦etc. Additionally, he seems to be liked and respected by his public. However, in the film we come across with his old ages, accordingly a decline of his success. Therefore, he is facing problems related not only with divided Greece but also his health problems. -Philipââ¬â¢s Ability and Traits Dominance, self confidence, intelligence and internal locus of control are four personality traits for Phillip. In terms of dominance criterion, we clearly see that Philip likes to take charge of things and leading people, and he actually succeeds on this aim. He rules a broad country and commands the army. He is also highly self confident. Even if he is really sick, he believes he can go to the wars alone without taking Alexander with him. His self confidence may come from his intelligence, since he knows that he has enough capability of achieving his goals and he believes he is superior to his rivals such as the kings of other nations or commanders of other armies. Most importantly he has clear internal locus of control. He wants all control in his hands. He even believes he should rule the whole world. Accompanied with his effective behaviors, Philip has also some traits which results in derailment. Here are some of them: We can say that Philip is somewhat neurotic. This low emotional stability may occur because of his age or the complex situations he is facing with. He is also defensive, meaning he resists change. Another negative aspect of his behaviors is that he is not good at delegation. The monarchic nature of his power may prevent him to share responsibility with others. He is also very self- centered and he does not want to share the success with others. -Philipââ¬â¢s Leadership Behaviours Basically, the behaviors that Philip employs: Planning/Organizing, Motivating, Consulting, Rewarding. As a king, planning and organizing tasks are inevitable for him; and we see it from the movie in the scenes that he tries to develop strategies for his troubled country. He believes that his country should rule the world and he motivates his followers in that way. He also applies rewarding. He organizes meetings and declares the successes of soldiers who return from wars. He has some advisors around him and the famous philosopher Aristotle. He consults them and gains insights about situations around him. -Philipââ¬â¢s In-groups and Out-groups We identified two characters as examples of in-group members. They are Philipââ¬â¢s close friends/advisors and his girl friend. They clearly more influence on Philip. On the other hand, his wife Olympia seems to be an out-group member. Philip wants to send her away since he is in love with Eurydice. He is also suspicious about her loyalty. He claims she creates gossips about him saying he has gone mad. And the queen is not happy about these conditions and she feels disappointment that Philip leaves her. -Philipââ¬â¢s Leadership Style Phillip uses basically two different decision making style in the movie. The most used one is autocratic decision making. As being the leader of the public and the palace Phillip makes decision alone without asking Alexander, the Queen, the soldiers and his friends. On his own Phillip investigates the conquests, wars, and the future of Macedonia and decides what should be done. After that he tells people what he decided and what would they do. -Philipââ¬â¢s Sources of Power Firstly, he has position power. He has legitimate power because he is the king and the leader of the public and the palace. Since Phillip can reward people for appropriate behavior and punish them for noncompliance he has both reward and coercive power. He has great information power because he has control over access and distribution of the information. He control over the physical environment and organization of the work so he has ecological power. Secondly, he has personal power: Due to his specialized knowledge and skills he has great expert power. -Philipââ¬â¢s Influence Tactics Phillip use legitimating tactics, inspirational appeal by arousing emotions, consultation -He only consults with his consultant in the palace. He never asks something to the public-, and pressure tactics including coercion, intimidation, and push behavior to influence the soldiers, the public, and the palace. Phillip is also a charismatic leader; his charisma emerges depend on different sources such as his personality, leadership skills, followership, and the situation. Because of his charisma he has great impact on people especially on the soldiers. Followersââ¬â¢ Characteristics As we watched the movie again and again, we discovered unimaginable leadership characteristics of Alexander the great at each time; however, finally we understood that only good followers can make a great leader. The question in this point is ââ¬Å"who is a good follower? A good follower is one who understands, supports, and works for the leaderââ¬â¢s vision and challenges the leaderââ¬â¢s decisions that are misguided or unethical. By taking this definition as the base we determine several followers that made Alexander one of the greatest leaders ever seen. These are Macedonian great generals such as Hephaestion, Permenion, Coenus, Antigonus, Polyperchon, Crateros, Perdiccas, Attalus, Philotas, Cleitus , Pausanius, and Leonnatus. Among these Permenion and Hephaestion were the most valuable and the closest, respectively, to Alexander the great. Hephaestion grows up with Alexander and share his entire secret. Besides being a soldier, engineer and diplomat, he corresponds with the philosophers and actively supports Alexander in his attempts to integrate Greeks and Persians. Permenion, one of the most experienced warriors, is the main general in command of the army. Alexander does not make any decision without him. During the battles he can create innovative strategies and always is seem to be unbeatable. In the Gaugamela battle, while Alexander commands the right part of the army, Permenion fights in the left of the army and solely commands the entire left part. Alexander is great with these followers, without them he is just a person who has high passion to win, to create a unique empire in Europe and Asia. When Macedonians are in India, Alexander speaks to his army and tried to persuade them to march further into India but Coenus makes him to change his opinion and return. The main reason of this return is the unwillingness of the generals. However, we never forget that without a leader followers cannot succeed. Just after the Alexander death the whole empire is divided into four parts by the followers.
Friday, March 20, 2020
HIV in South Africa Essays
HIV in South Africa Essays HIV in South Africa Essay HIV in South Africa Essay HIWAIDS In south Africa South Africa has more people with HIWAIDS than any other country in the world. Over 5,700,000 South Africans are living with HIV/AIDS, which is 12% of the population of South Africa (Banerjee 63). The adult population with HIV/AIDS is 18. 1%. South Africa continues to struggle in regards to dealing with this disease. In 2007, only 28% of people with AIDS received anti-retroviral treatment (Central Intelligence Agency 1). This number has improved from 2004 however, when only 4% of people with AIDS received anti-retroviral treatment. AIDS continues to be a huge problem to the South African population. In 2007, around 280,000 South Africans died of AIDS. Thats about half of all South African deaths that year (Mid-year Population Estimates, 1). There is still great mystery as to why South Africa is so affected, especially compared to other African countries that have greater poverty. However, it is known that South Africa has made mistakes in regards to how to prevent the spread of HIV. As clarified through explanations of the prevalence of the disease, what affects economic growth and whats being done to stop the spread, economic development in South Africa is isturbed greatly by the continuous rise in HIV/AIDS. It is estimated that 10. 9% of all South Africans have HIV/AIDS. HIV is most common among female adults under the age of 40. Not much is being done to help limit the spread of HIV. Slightly more than 50% of sexually active South Africans have ever had at least one HIV test (Sub- Saharan Africa). South Africa is struggling with regards as to how they should treat the spread of HIV. What has worked best at limiting the spread of HIV has been the ability for South Africa to help educate people in regards to how to prevent HIV. Knowledge about HIV/AIDS is lowest among people older than 50 years (Banerjee 63). In 2008, more than half of South Africans with HIV reside in the most popular provinces: the KwaZulu-Natal and Gautleng provinces (Sub-Saharan Africa, 1). This just shows that some areas seem to have greater availability of resources, since areas of poverty and education vastly range from different provinces.. Expenses related to HIV/AIDS are equivalent to 4% of all salaries in South Africa. The cost of HIV/AIDS include: costs associated with greater absenteeism, reduced productivity, increased urnover, and healthcare costs (Central Intelligence Agency). To counteract these problems, two main campaigns were enacted: Soul City (a television drama for adults) and Soul Buddyz (a television series for teenagers) (Booysen, 1). While these two campaigns were effective at first, there was unfortunately a decrease in quality on condoms, creating a loss on effectiveness in HIV prevention in the 21st century. It seems as though South Africa has no successful plan in regards to effectively stopping the spread of HIV. In 1983, AIDS was first diagnosed to two patients in South Africa. By 1986, there were 46 AIDS diagnoses. In 1990, 1% of South Africans had AIDS. In 1999 the fgure had reached 10%. Now, its estimated that 6 million people currently have HIV/AIDS in South Africa (Booysen 1). A major reason as to why there was still so much of a continuation of the spread of HIV/AIDS in South Africa came from the fact that there was much AIDS denialism in South Africa. The president improve HIV/AIDS treatment was damaged by the attitude of many figures in the government when the health minister incorrectly claimed that a diet of lemon, garlic, nd olive oil could cure the disease (Booysen 1). There is hope that in the near future, there will be greater availability of resources to prevent HIV/AIDS. South Africa has the potential to turn around the amount of future diagnoses, for they have the industrial power to create affective ways for educating people as to how one becomes HIV+, and what one can do to prevent the disease from spreading. Bibliography Banerjee, AbhiJit V. , and Esther Duflo. Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty. New York: PublicAffairs, 2011. Print. Central Intelligence Agency. The World Factbook. OpenGov, n. d. Web. 12 Nov. 2013. . Mid- year Population Estimates. Statistics of South Africa. User Information Services, n. d. web. 12 NOV. 2013. . Sub-Saharan Africa: AIDS Epidemic Update Regional Summary. Joint United Programs on AIDS. World Health Organization, n. d. Web. 12 Nov. 2013. . Booysen, F. R. Geldenguys,J. P. Marinkov, M. The Impact of HIV/AIDS on the South African Economy: A Review of Current Evidence. Univ ersity of the Free State. Department of Economics, n. d. Web. 12 Nov. 2013.
Tuesday, March 3, 2020
Elementary Physical Science Fair Project Ideas
Elementary Physical Science Fair Project Ideas Trying to find the topic for a science fair project can be almost as challenging as the project itself. Helping a child decide on a project that doesnt involve huge expense, constant supervision or the danger of burning down the house need not be an impossibility. Elementary school level projects should be not only informative but quick and fun. Great projects usually answer a question, rather than a general demonstration or display. Remember that the project is your childs, let them have fun with it. Here is a list of ten ideas to help get past the difficult first step. Fly a kite.Making a kite is fun and easy. Adding a tail to the kite adds stability. Does a longer tail make the kite fly better? Try different lengths of tail or vary the number of tails.Parachutes - Throwing things for science. Make parachutes with garbage bags and fishing line. See if larger parachutes are better than smaller parachutes. Are square parachutes better than round ones? Long strings better than short strings?Swinging Pendulums.Make a simple pendulum from a string and fishing weight. How does varying the length of the string affect the period? Add more weight and see what that does.Musical Glasses.Running your finger around a wine glass to make a tone is always entertaining. Does the tone change if you use different liquids in the glass? Check to see if changing the amount of liquid changes the tone.Balloons and Static Electricity.If you rub a balloon against your hair or a wool sweater, you can generate enough static electricity to stick the balloon to a wall. How many rubs does it take to this? Do fuller balloons take more or less rubbing? Does the type of hair matter? Spaghetti Bridge.One piece of spaghetti is easy to break. Bundling several pieces together can support a lot of weight. Make bundles of spaghetti to make beams that span two chairs or tables. Hang a cup from the middle of the spaghetti beam and add fishing weights or bolts until the beam breaks. Is your bridge stronger if you bind the spaghetti with thread, glue, tape or rubber bands? Try different pastas. Is flat spaghetti stronger than round?Electromagnets.You can make a simple electromagnet with a lantern battery, copper wire and a nail. Wrap the wire around the nail several times and connect the ends to the battery terminals. Use the magnet to pick up iron filings. Increase the number of windings and see how the amount of filings your magnet picks up changes.Buoyancy with eggs.If you put an egg into a jar of water, the egg will sink. If you add salt to the water, the egg will start to float. How much salt does it take to float an egg to the top of the water? What if you used suga r instead of salt? Watt about light bulbs?Light bulbs come in several styles, sizes and wattages. What does the wattage mean? Do higher watt bulbs run hotter? brighter?Battery Battle.All battery makers claim their battery lasts longer. Why not see for yourself? Are more expensive batteries better? Does one brand stand out?How Strong Is It?Test the strength of trashbags, grocery store bags, or plastic wrap.Whitest of Them All.Which tooth whitener is best at removing stains and whitening? You can stain tile or another material with coffee, tea, berries, smoke, etc., then compare the whitening power of different toothpastes. Try something similar for laundry detergents or bathroom cleaners.Haircolor ColorfastnessGrab a human hair wig and dye different areas with the same color of haircolor, except different brands. Wash the wig and see which color lasts. Do any of the colors change in unexpected ways? Dont dont have a human hair wig? Try wool or another animal hair.
Sunday, February 16, 2020
How to improve the poor customer service rating Research Proposal
How to improve the poor customer service rating - Research Proposal Example This research will help readers take corrective action in relation to customer satisfaction and improve their customer service rating. The increased use of Interactive Voice Response Systems (IVRs) has hindered personal interaction between consumers and the service providers, leading to dissatisfaction and discontentment of consumers. Therefore, there is a need to rectify this problem and divert to more consumer interactive models of customer service. The goal of this investigate is to provide an interactive customer service model that will increase customer service and in turn increase customer satisfaction and service ratings. Case studies have shown that by eliminating the barrier between customers and service providers, the customers feel more appreciated and better served. It has also been proven that this increases customer retention rates. This will be done by adopting a face to face sale of companyââ¬â¢s products to consumers, a process that will be very interactive through product sampling, answer query session and feedback about the product. The customer will be able to interact personally with the service provider and ask questions about the product i.e. how it works, what ingredients have been used to make it, what its limitations are, how long the product will serve the customer among other questions the customer might have. This solution will also enable the customer feel well served since his/her complains/concerns will be handled immediately without the hustle of having to follow up through phone calls. By eliminating barriers, more customer interactive model will be adopted that will hel p accomplish the first objectives of this research, i.e., to make customer service interactive and also the second objective by ensuring that customers are satisfied with services provided. Most customers are not satisfied with the service they
Sunday, February 2, 2020
The Borzoi College Reader, Seventh Edition Essay
The Borzoi College Reader, Seventh Edition - Essay Example As matter of fact, the multiple reasons of immigration, assumed to be as many as the immigrants themselves, fall under similar themes that determine the immigrantââ¬â¢s life and how they are treated by the natives. Poverty has triggered a significant percentage of immigration. The poor move from places with low endowment of resource to seek better lifeââ¬â¢s in other places. However, no matter how promising these new places are, they donââ¬â¢t guarantee immigrants full satisfaction. Immigrants have continued to live filthy lives despite being in high status location. Mankind has developed a capitalistic nature, with every individual struggling to maximize his self-satisfaction. Literally, no one cares about the immigrants but instead take advantage of their vulnerability to attain self-development. Native humiliate immigrants; enslave them following the fact that, they are their financial supporters. This mistreatment corrupts he immigrants mind, creating a negative attitude towards the new environment. Racism in US has evolved, developed and even worsened due to immigration of black Africans to the whitesââ¬â¢ territories in search for better hosting. The intercultural interaction br ings confusion, the definition of satisfaction is altered and hence most immigrants have remained in these cruel and anti-social environments so long as they receive some financial compensation. Good life, fair treatment and kindness and other social norms are no longer a priority and immigrants adapt cruelty. To quote ââ¬Å"if we lived in Canada we could play outdoors every day in the sunâ⬠¦ sun is bad for you. Everything our parents said was good is badâ⬠(298). Regions differ, socially and economically. Economic and social reasons significantly influence immigration. People move to acquire better healthcare, better education, and access auxiliary services as well security. The impact is
Saturday, January 25, 2020
Dilutional Hyponatremia During Intrauterine Adhesion
Dilutional Hyponatremia During Intrauterine Adhesion Severe dilutional hyponatremia in a patient during hysteroscopic of intrauterineà adhesion : A case report YE Yuzhu, LIN Lina Abstract Hysteroscopy is a minimally invasive procedure for the patients of intrauterin adhesion, but may result in potentially disastrous complication labeled transurethral resection of the prostate (TURP) syndrome. Excessive absorption of large scale of distension media under high inflow pressure by openings of venous channels in endometrium, the large volume of transfusion fluid that is beyond the modulation ability of body may produce the most dangerous situation of severe hyponatremia, hypervolemia and hypoosmolality. The consequence of hysteroscopy is mainly determined by the type of distension medium, irrigation pressure,condition of endometrium, preoperative catheterization, type of electrode system and duration of the surgery. A case of hysteroscopic resection of intrauterine adhesion in which severely symptomatic hyponatremia and hypervolemia happended with epidural anesthesia is presented. Key words: Hysteroscopy, hyponatremia, distension medium, infusion pressure, TURP (transurethral resection of the prostate ) syndrome. Introduction Hysteroscopy technique in the detection and treatment of intrauterine diseases plays an dominant role because of its unique feature of minimal invasion and remains the ââ¬Å"gold standardâ⬠mean for the diagnosis of uterine disease, but may result in potentially disastrous complication known as TURP syndrome or hyponatremia and hypervolemia. A hysteroscopy precdure requires an intrauterin installation inserting into the uterine cavity accompanied by a suitable type of distention medium including dextrose 5% in water (D5W), 2.7% sorbitol, 0.54% mannitol and saline for the visualization of intrauterine situation. The most common fluid used clinically is D5W for its distinct features of low-viscosity, electrolyte-free, safety and lower cost. TURP syndrome appears when large scale of distension media (D5W) is overly absorbed including the following clinical signs: dyspnea, headache, nausea and vomiting, coma, and even can progress to cerebaral and pulmonary edema. Signs and syndrom es are nonspecific when the conditon is in its early stages and, as a result, itââ¬â¢s easy to be ignored. Vigilance and communication of the whole medical team is extremely required to avoid state of illness aggravating. Early management must be rendered as soon as possible for the critically ill patients by anesthetists. We report a case of a 36-year-old woman who developed TURP syndrome during hysteroscopic of intrauterine adhesion herein. 2. Case Report A 36-year-old, weight 62 kg , no medication or coexisting diseases, ASA physical status II , underwent hysteroscopy treatment because of her reiterative intrauterin adhesion during epidural anesthesia. Past surgical history revealed four times of previous hysteroscopies within the year, both of which were aimed to remedy for her secondary infertility but failed in acquiring satisfactory therapeutic efficacy. There were no positive fingds on the preoperative physical examination and normal values in laborarory results included blood routine test and plasmic electrolytes, and the concerntrations of sodium ion, potassium ion and blood glucose level were 139 mmol/L, 3.47 mmol/L and 4.0 mmol/L, respectively. A 12-lead electrocardiogram showed sinus rhythm. Upon arrival to surgical operating room, 500 ml lactated Ringers solution was dripped intravenously as maintenance fluid after standard monitors were placed. The heart rate was 76 beats per minute, respiratory rate was 18 breathes per minute and the oxygen saturation was 99%. Contiuous epidural anesthesia was performed successfully with 0.5% lidocaine and 0.375% ropivacaine 15ml totally within 15 minutes. Then the patient was placed in lithotomy position and no catheterization was offered because of the short operation period we had anticipated preoperatively although she expressed her micturition desire. The surgery initially proceeded unevenfully with very steady state of hemodynamics. 8,000 mL D5W as the irrigation fluid was delivered throught the hysteroscope by gravity pressure (60cm above the patient), and the irrigation pressure for uterine cavity distending was 150 mmHg. Monopolar electrode system was selected for endometrium resection, and controled the watts of electroresec tion and electrocoagulation within 40 60 watts and 60 80 watts, respectively. Simultaneous ultrasonographic monitoring was used to identify the sickness of uterus wall and uterine cavity size. A total of 1,000 mL of lactated Ringers solution was infused during the 70 minutes of surgery, with a total blood loss of 20 mL. Twenty minutes before the termination of surgery , the patient complainted of difficulty in breathing with simultaneous polypnea, shiver, and sensations of vertigo and nausea. Oxygen saturation dropped from 98% to 90% and recoverd soon after mask oxygen inhalation. Thereupon tramadol 50 mg was administered intravenously, and excellent effect obtained. Approximately 300 mL output of urine when the bladder was squeezed incautiously by ultrasound probe and the patient vomited once just the procedure completed. The patient appeared haziness of spirit-mind but responded appropriately to verbal stimulate. A dorsalis pedis artery blood sample was obtained from the patient , and electrolytes were reported using a blood-gas analyzing device. Results as follows: PH 7.31; Na+, 115 mmol/L; K+, 3.0mmol/L; ionized Ca2+, 0.93 mmol/L; Glucose, 27.8 mmol/L; HCO3ââ¬â, 18.6 mmol/L. Based on the symptoms mentioned above, TURP syndrome was suspected. An indwelling urinary catheter was inserted immediately and 1,800 mL urine output was collected totlly at twice. A mixture of 50ml 10% saline and 100ml 0.9% saline was dripped to raise sodium concentration, meanwhile metoclopramide 10 mg was used for anti-nausea. But there were no diuretic and insulin used in case of aggravating of hypokalemia. Oxygen saturation maintained in 92% after oxygen mask was removed and with a progressive rise. Vital signs on permission to PACU were as follows: blood pressure, 126/79 mmHg; heart rate, 79 beats per minute; breathing rate, 20 breaths per minute; and oxygen saturation, 96%. The patient was transported to postanesthesia care unit (PACU) for continued treatments and review of blood gas analysis. On our arrival into PACU, arterial blood gas (ABG) analysis was performed when the venous transfusion of the hypertonic saline solution ended, revealing PH 7.36; Na+, 127 mmol/L; K+, 3.0mmol/L; ionized Ca2+, 1.0 mmol/L; glucose, 22.9 mmol/L; HCO3ââ¬â, 21.5 mmol/L; BE, -3.6 mmol/L. The patient still had low sodium and potassium level from ABG, a mixture of 100ml 10% saline and 100ml 0.9% saline containing potassium chloride 0.5 g was supplemented in low-speed intravenously. Nurse anesthetist was asked to record vital signs every 15 minutes. 16:15~18:05, the patient got her vital signs stablized gradually and oxygen staturation could maintain over 95%. Review of her blood gas analysis showed: PH 7.36; Na+, 137 mmol/L; K+, 3.4mmol/L; ionized Ca2+, 1.0 mmol/L; glucose, 7.2 mmol/L; HCO3ââ¬â, 23.2 mmol/L; BE, -3.6 mmol/L. The patient recieved 500 ml lactated Ringers solution totally in PACU, with a total urine output of 850 mL(data from PACU anesthetic chart), and sent back to the ordinary ward without any complaints and Alderete scores 10. 2. Discussion Hysteroscopy has gained widely used in diagnostic and therapeutic in gynecologic surgery for many special advantages, but is not devoid of risks especially when hysteroscopy is applied to resection of extensively endometrial lesion. Excessive absorption of irrigation fluid during hysteroscopic surgery from uterine cavity is the main cause of TURP syndrome or water intoxication, of which reported incidence is 0.2% [1]. The TURP syndrome mainly has clinical symptoms in cardiovascular system, respiratory system and nervous system including elevation of blood pressure, bradycardia, dyspnea, pulmonary edema, cerebral hemia and even death. The severity of consequence is associated with multiple factors, analysis of this case were as follows. The patientââ¬â¢s uterine cavity has low compliance and severe adhesion, so an intrauterine pressure (IUP) of 150 mmHg is required to obtain excellent visual conditions of bilateral tubal orifices. 8,000 mL D5W as the irrigation fluid is delivered i nto uterine for uterine distension in 70 minutes operation time. Based on clinical research, the absorptivity of distension media by body is within the range of 10 30 ml/min only when the irrigation pressure is less than 100 mmHg [2]. Therefore, we estimated 700 2,100 mL D5W is absorbed into circulatory system approximately, along with an infusion of 1,000 mL lactated Ringers solution. As a result, 1,700 3,100 mL is administered into blood intravenously at least, and even more. Hyperglycemia caused by excessive absorption of D5W produces hyperglycemic hyperosmolar status and then makes intracellular fluid transfers to outside the cell, which bings about exacerbating of hyponatremia status. The patient received high frequency hysteroscopy procedure in the short term leads to large-scale and severe damage of endometrium, allowing the distension fluid entering into blood circulation more easily, which contributes to hypervolemia in a more faster pace. As one of essential factors, ex cessive irrigation pressure plays a crucial role in distension fuild over absorption in the condition that endometrial venous sinus are widely open in hysteroscopic electric resection. In our case, we have to raise the pressure to 150 mmHg for a clear surgical vision of uterine cavity, therefore, rendering excellent chance for fluid entering into body. No catheterization was performed preoperatively, thus a large amount of fluid accumulates in bladder and circulation system. To sum up, in this case, fluid overload, hyperglycemic hyperosmolar status, high intrauterine pressure, disruption of endometrial vessles and lack of preoperative catheterization lead to a significant increasement of circulating volume and a sharply reduce of plasma colloid osmotic pressure. Extracellular free water in brain are transported from the outside to the inside of the cell, which results in cerebral edema and causes intracranial hypertension. A serious of neurological syndromes develop including dizzin ess, headache, nausea, vomiting, and haziness of spirit-mind. Likewise, as a consequence of irrigation fluid overload and dilution of the plasma protein concentration, pulmonary hydrostatic pressure elevated, leading to the accurrence of acute pulmonary edema and pulmonary interstitial edema. The ventilation/perfusion imbalance occurs, and then manifests in dyspnea, hypoxemia and a sustained downward trend of oxygen saturation, etc. Timely recognition and urgent corresponding treatment measures should be taken in the early course of water intoxication to prevent the condition deteriorated. In a general way, for every liter of hypotonic fluid absorbed, the serum sodium concentration will decrease by 10 mmol/L(10 mEq/L) [3]. The result of ABG analysis of the patientââ¬â¢s dorsalis pedis artery blood sample indicates severe hyponatremia (Na+ à ¯Ã ¼Ã
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¸Ã ¥Ã¢â¬Ëà ½Ã £Ã¢â ¬Ã¢â¬Å¡ Reference [1] Jansen FW, Verdevoogd CB, Ulzen KV, et al. Complications of hysteroscopy: aprospective multicenter study [J], Obstet Gynecol, 2000, 96 (2): 266 270. [2] Rhymer JS, Bell TS, Perry KC, et al. Hyponatremia following transurethral resection of the postate [J].Br Jurol, 1985, 57(4): 450à ¯Ã ¼Ã 452. [3] Prost AM, Liberman RF, Harlow BL, Ginsburg ES. Complication of hysteroscopic surgery: predincting patients at risk. Obster Gynccol. 2000; 96:517-520 [4] Cooper JM Brady RM. Intraoperative and early post-operative complications of operative hysteroscopy. Obstetric and Gynecology Clinics of North America 2000; 27: 347-365 [5]Romer T. Benefit of GnRH analogene treatment for hysteroscopic surgery in patients with bleeding disorders [J].Gynecol.Obstet Invest,2003,50:112-120. [6]Murdoch JA. Tong JG. Anesthesia for hysteroscopy. Anesthesiol Clin North Am. 2001;19:125-140 [ J ].à ¤Ã ¸Ã à ¥Ã¢â¬ ºÃ ½Ã ¥Ã ¾Ã ®Ã ¥Ãâ â⬠ºÃ ¥Ã ¤-à §Ã §Ã¢â¬Ëà ¦Ã ââ¬Å¡Ã ¥Ã ¿-,2009,9(12):1097-109 à ¨Ã¢â¬Å¾Ã ±Ã ©Ã «Ã¢â¬Å"à ©Ã
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¡Witz CA, Silverberg KM, Burns WN, Schenken RS, Olive DL. Complications associated with the absorption of hysteroscopic fluid media. Fertil Steril 1993;60:745-56.
Friday, January 17, 2020
Assignment on Annual Report
Assignment On Mercantile Bank Limited Annual Report for the year ended 31st December, 2009 Topics are to be discussed here (Context) 01. Letter to Transmittal 02. Notice of 11th Annual General Meeting 03. Mission, Vision & Objectives 04. MBL Timeline 05. Credit Rating 06. Sponsors of the Bank 07. Board of Directors 08. Corporate Structure 09. Management Team 10. Head Office & Branch Network 11. Where We Locate 12. Financial Summary 13. Economic Impact Report 14. Message from the Chairman 15. From the Desk of Managing Directors and CEO 16. Directorsââ¬â¢ Report 17. Managing Directors and CEOââ¬â¢s Report on Risk Management 18. Report on Corporate Governance 19. Compliance Report on SEC Notification 20. Report of Audit Committee 21. Report on Corporate Social Responsibility 22. Report on Customer Service 23. Report on Human Capital 24. Recognition 25. Signing of Financial Statements 26. Auditorsââ¬â¢ Report 27. Financial Statements 28. Notes to the Financial Statements 29. Annexure A-G 30. Highlights of Mercantile Bank Limited 1. Letter to Transmittal: Here the Executive Vice President and Company Secretary wrote a letter to all shareholders informing the important items of the Annual Report. Such as Balance Sheet, Income Statement, Cash Flow Statement of the year. 2. Notice of 11th Annual General Meeting: In the notice the date, year, day, time and place of the AGM clearly (in bold letter) described. Important Agenda also represented in the notice. There are 5 Agenda are mentioned. In addition 6 footer Notes also published here. Important notes are record date of the share (March 07, 2010), amount of dividend (22%) etc. Executive Vice President and Company Secretary give his signature with date. 3. Vision, Mission & Objectives: The Vision of the back is make finest corporate institution. Mission is making the make profitable by caring, equitable growth by required and proper distribution of recourses. Strategic Objectives: to positive Economic Value Added, market leader in product innovation, achieve cost efficiency, be in the top five financial institution in Bangladesh. Financial Objectives: to achieve stable (? 20%) return on shareholdersââ¬â¢ equity. Moreover Core value for Customers, Shareholders, Employees and Community 4. MBL Timeline: Here the development of Mercantile Bank Limited stated. It started incorporation in business and commercialization in 1999. Circulated Primary Share (IPO) in 2003. Got listed in both Bangladesh Stock Exchanges (Dhaka & Chittagong) in 2004 and end of year 2009 it has 50 braches all over the country. 5. Credit Rating: As per Credit Rating and information Services Limited (CRISL), Mercantile Bank Limited rated as ââ¬Å"Aâ⬠(Pronounced as Single A) in the long term and ST-2 rating in the short term on the basis of Financial Statements as on December 31, 2008. High certainty of timely payments, strong liquidity factors, good company fundamentals, easy excess to capital market and minimal risk factors are the key issues of the rating. 6. Sponsors of the Bank: Here the 27 sponsorsââ¬â¢ names with photos are representing clearly. 7. Board of Directors: 22 Directorsââ¬â¢ name and photo with their designation stated here. There are 1 Chairman, 2 Vice Chairmen and 18 Directors and 1 Managing Director and CEO in the Bank managing committee. 8. Corporate Structure: In Corporate Structure there are 8 different government body represented. Including Board of Directors (22 persons), Executive Committee (18 persons), Audit Committee (3 persons), Managing Director & CEO (1 person), Chief Financial Officer (1 person), Company Secretary (1 person), Auditors (2 persons) and Tax Advisor (1 person). . Management Team: Here the detail list of different managing committee separately represented with their designation. There are 10 categories of designation. Such as Managing Director & CEO, Additional Managing Director, principal, Deputy Managing Director, Senior Executive Vice Presidents, Executive Vice Presidents, Senior Vice Presidents, Vice Preside nts, First Vice Presidents and Assistant Vice Presidents. 10. Head Office & Branch Network: Under this title the details addresses of bankââ¬â¢s all 50 banking branches, SME braches and Brokerage House with Phone, Mobile and Fax number given. 1. Where We Locate: Here the map of Bangladesh given and all 53 (3 SME/Agro Branches) branches marked by companyââ¬â¢s logo under district wise. 12. Financial Summary: Under Financial Summary Companyââ¬â¢s last 5 years Net Interest Margin (NIM), Profit after Tax, Return on Assets (ROA), Cost Income Ratio, Return on Equity (ROE), Operating Efficiency Ratio and in the last 8 years comparable companyââ¬â¢s Income Statement, Balance Sheet, Foreign Exchange Business, BIS Capital Measure, Credit Quality, Share Information, Operating Performance Ratio and Other Information represented. 3. Economic Impact Report: Here Economic Impact described in two ways; Direct Impact and Indirect Impact. Direct Impact are employment opportunities, paymen t of tax to the government, increase value to the Shareholders. Indirect Impact created by catering financial services, Bank generated wealth in the economy and profit for itself which is ultimately distributed amongst the shareholders and other participants in different form. In 2009, total value added by MBL was BDT 2,559. 96 (millions) and direct contribution to the economy was BDT 855. 26 (millions). There are two value added statements (Economic and Market) showed by column chart. A pie chart showed for distribution of Value Addition (maximum for government tax 33. 4%). Bank added BDT 129. 5 (million) under Economic Value Addition and BDT 4229. 48 (million) under Market Value Addition. 14. Message from the Chairman: At the first of the message the Chairman invited Shareholders to the 11th Annual General Meeting. There are some topics the Chairman discussed briefly. Those are: World Economy in 2009: here the impact of sub-prime mortgages landslip discussed. Bangladesh Economy in 2009: here the benefit of growth Bangladesh economy in the particular year stated. Performance of the Bank in 2009: here the actual amount of bankââ¬â¢s deposits collection, loan and advance, import business, export business and foreign remittance described. Diversified Business Activities of the Bank: under this section the details activity of bank represented here. Such as Deposits, Loan and Advances, Import & Export Business and Inward Foreign Remittance. SME: here bankââ¬â¢s SME structure described. Card Business: here bankââ¬â¢s different card business represented. Such as Credit card, Debit Card, VISA dual prepaid card, VISA Dual Hajj Card. Described itââ¬â¢s features and services. Corporate Governance Practice: here the responsibilities and activities of Board of Directors to the business operation represented. CSR Programs: here the guideline of management of the bank informs the board on CSR activities and is responsible to implement a specific line of approving authority, control and monitoring for financial support of such activities. Customer Service: here the Chairman describe how the bank server to the customer for achieve highest customer satisfaction. Human Resources Development: here the promotion and intensives to the employees represented for their superior performance. Recognition and Award: here the different achievements and rewards stated that in 2009 the bank gets thorough out the year. Future Outlook: here the challenges and opportunities for the bank in upcoming years described thoroughly. Challenges in 2010: here the economic effect on the bank in year 2010 is represented. Such as global downturn, slower growth of exports and workersââ¬â¢ remittance etc. Acknowledgement: here the Chairman gives his thank you notes and committed a stable growth of back where shareholder can rely on. 15. From the Desk of Managing Directors and CEO: Here the CEO describes the banksââ¬â¢ situation in the year 2009. He also represented Bankââ¬â¢s performance during the year 2009, its prospects and potential challenges in 2010. Such as Positive Growth: A Step Further: describing here the growth of the bank during the year. Prospects in 2010: he describe the opportunity, hope for the bank in upcoming year. Reviewing Our Business in 2009: here the business operation during the year stated clearly. Assets and Liabilities Position, International Business, MBLââ¬â¢s Products and Services, MBLââ¬â¢s Card Business, Agro-Based Financing, SME Financing, Our Priorities, Operation, Customer Relationship, Technology, Human Capital Development, Corporate Social Responsibilities (CSR), MBL Brokerage House, Mobile Banking, Commitment to Government, Base I-II Capital Accord, Anti Money Laundering, Network Expansion, Challenges in 2010, Our Preparation and Acknowledgement are the main topics he discussed. 6. Directorsââ¬â¢ Report: The parts of the Directorââ¬â¢s Report are World Economy, Bangladesh Economy (GDP, Inflation, Investment and Saving, Broad Money, Domestic Credit, Export, Import, Trade Balance, Remittance, Foreign Exchange Market, Prospect of Bangladesh Economy in 2010), Business Review (Deposit and Deposit Mix, Loan and Advance, Import Trade, Export Trade, Foreign Remittance, Treasury Operation and Fund Management, Earning Base in Assets, Asset Portfolio, Funding Structure, Capital, Statutory Reserve, Capital Adequacy, Number of Shareholders, Contribution to National Exchequer and Economy, Acquisition of IDLC Share, Purchase of Land, Branch Network, Board of Directors, Board and Committee Meeting, Corporate and Financial Reporting, External Auditors, Correspondence Relationship , R&D, Information Technology, Financial Products and Services, Different Deposit Products, Different Loan Products), Financial Review (Different Profit Incomes, Different Expenses, Different Tax, Dividend, EPS, O/E Ratio), Outlook 2010 and Acknowledgement are represented here. After that it repeated in Bengali Language. 17. Managing Directors and CEOââ¬â¢s Report on Risk Management: Here start with basic discussion on Risk Management. Such as Risk Management Realities, Approach, Oversight, Process etc. And later describe different types of Risk Management described with photo and tree table. Such as Credit Risk Management, Market Risk Management, Interest Rate Risk Management, Foreign Exchange Risk Management, Operational Risk Management, Internal Control and Compliance Risk Management, Equity Risk Management, Money Laundering Risk Management, Information Technology Risk Management, Liquidity Risk Management, Marketing Related Risk Management, Human Resource Related Risk Management etc. 18. Report on Corporate Governance: At first different names of Corporate Governance with responsibility and duty in the bank represented. Such as Board Of Directors, Boardââ¬â¢s Supporting Committee, Management Committee, Control Environment Committee. Each of every committee are presented with meetings photo. 19. Compliance Report on SEC Notification: It is the notification issued by The Security and Exchange Commission for all listed companies in order to improve Corporate Governance on ââ¬ËComply or Explainââ¬â¢ basis. There are three tables. First is Complied or Not Complied table. Only 3 rules are not complied by the bank among 43 rules which are under review. In second table the numbers with names of Directors attained Board Meeting during the year. And the last one is The Patter of Shareholding where shows the nos. and percentage of shares hold by Directors. 20. Report of Audit Committee: Here the name of Auditor with photo presented. And also some other topics such as composition of the Audit Committee, Role of the Audit Committee, Internal Control, Meetings, Financial Reporting, Internal Audit and Inspection, External Audit, Regulatory Compliance and Miscellaneous issues given here. 21. Report on Corporate Social Responsibility: Here the roles and responsibilities of the bank toward society described. In this section a table shows how much the bank contributed their profit to the society. The highest donation went to health sector. MBL has slogan to be the ââ¬Å"Banglar Bankâ⬠. MBL has given different awards to different sectors. Photos and arenas are mentioned here. 22. Report on Customer Service: The importance of customer to the bank is presented here. Some core demands of customer are fulfilling by the back. Such as Bringing Mass and More people into the Banking net, Addressing Unique Needs of the Customers, Meeting Demand of Customers through Alternative Banking Channels, Response from the People etc. 23. Report on Human Capital: In this topic the process of giving service in effective manner the back took some steps such as Nursing the People with Utmost Care, Recruiting the Best People (bonus, promotion, recognition, training etc), Managing the people, Performance from the People etc. 24. Recognition: An award giving ceremonyââ¬â¢s (ICAB Award-2008) photo given here. 25. Signing of Financial Statements: Here a photograph of Directors represented where they all present there for signing Financial Statements ââ¬â 2009. 26. Auditorsââ¬â¢ Report: At first Auditors declared those elements that they audited. Such as Balance Sheet, Profit and Loss account, Cash Flow Statement, Statement of Changes in Equity, Statements of Liquidity Analysis and Explanatory notes to Financial Statements. Also mention their responsibilities. In the auditorââ¬â¢s report they include Scope, Opinion (14 opinions), Auditors Firm Names, Auditor Signatures, Auditor Designation, Place and Date. 27. Financial Statements: In the Financial Statements there are 7 part of it. At first there is Balance Sheet (Classified Statement of all types of Assets and Liabilities), then Off-Balance Sheet Items (Contingent Liabilities and Other Commitments), Profit and Loss Account (Include all types of Incomes and Expenses, Provisions, Appropriations etc. , Cash Flow Statement (Net Cash Inflow and Outflow recorded here), Statement of Changes in Equity (Capital gain/reserve and losses/dividend), Liquidity Statement (assets and liabilities maturity analysis), Notes to the Financial Statements (details of financial statement such a s calculations, principals, disclosures etc). 28. Annexure A-G: In Annexure A all related assetââ¬â¢s depreciation charges calculated here, Annexure B described number of shares hold by Directors with their positions, Annexure C represented different Investment in Shares during the year. Annexure D stated market adjustment of approved Securities HTM and HFT shares. Annexure E mentioned maturity analysis of other assets (like as advanced deposits, stamps in hand etc. , Annexure F represented Compliance of BAS and BFRS (among 29 BAS 6 are not applied and among 4 BFRS none are applied), Annexure G provide Computation of Risk- Weighted Assets list. 29. Highlights of Mercantile Bank Limited: Here all necessary information towards the investors are presented here, such as paid-up capital, total assets, total deposits, ROA, ROI, EPS, NI per share, P/E Ratio etc. 30. Proxy Form: It is the application printed and provided by the firm to shareholders incase of his absence, shareholder can give voting power to his nominated person. Need to fill up the gaps and attach revenue stamps and send to the authority before particular date. It has two parts, one for office and other for shareholder. ââ¬âââ¬âââ¬âââ¬â-ENDââ¬âââ¬âââ¬âââ¬âââ¬â
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