In this video we will learn the about the mountains of Peninsular and Deccan plateau. They are – Aravalli, Vindhya, Satpura, Western Ghats & Eastern Ghats.

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The changing front lines of the Peninsular War in Spain and Portugal, between 1807 and 1814.

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Music:
Jon Bjork – The Battle of Mount Valor
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Diabetic ketoacidosis (one of the hyperglycemic crises), DKA, pathophysiology, causes, clinical presentation (signs and symptoms) and treatment. This video is available for instant download licensing here: https://www.alilamedicalmedia.com/-/galleries/narrated-videos-by-topics/diabetes/-/medias/bda71a7a-4598-4b1d-b298-ed06b3c54238-diabetic-ketoacidosis-dka-narrated-animation
Voice by: Penelope Hammet
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All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
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Diabetic ketoacidosis, DKA, is an ACUTE and potentially life-threatening complication of diabetes mellitus. DKA is commonly associated with type 1 but type 2 diabetics are also susceptible. DKA is caused by a critically LOW INSULIN level and is usually triggered when diabetic patients undergo further STRESS, such as infections, inadequate insulin administration, or cardiovascular diseases. It may also occur as the FIRST presentation of diabetes in people who did NOT know they had diabetes and therefore did NOT have insulin treatment.
Glucose is the MAJOR energy source of the body. It comes from digestion of carbohydrates and is carried by the bloodstream to various organs. Insulin is a hormone produced by beta-cells of the pancreas and is responsible for DRIVING glucose INTO cells. When insulin is DEFICIENT, glucose can NOT enter the cells; it stays in the blood, causing HIGH blood sugar levels while the cells are STARVED. In response to this metabolic starvation, the body INcreases the levels of counter-regulatory hormones. These hormones have 2 major effects that are responsible for clinical presentation of DKA:
– First, they produce MORE glucose in an attempt to supply energy to the cells. This is done by breaking down glycogen into glucose, and synthesizing glucose from NON-carbohydrate substrates such as proteins and lipids. However, as the cells CANNOT use glucose, this response ONLY results in MORE sugar in the blood. As blood sugar level EXCEEDS the ability of the kidneys to reabsorb, it overflows into urine, taking water and electrolytes along with it in a process known as OSMOTIC DIURESIS. This results in large volumes of urine, dehydration and excessive thirst.
– Second, they activate lipolysis and fatty acid metabolism for ALTERNATIVE fuel. In the liver, metabolism of fatty acids as an alternative energy source produces KETONE bodies. One of these is acetone, a volatile substance that gives DKA patient’s breath a characteristic SWEET smell. Ketone bodies, unlike fatty acids, can cross the blood-brain barrier and therefore can serve as fuel for the brain during glucose starvation. They are, however, ACIDIC, and when produced in LARGE amounts, overwhelm the buffering capacity of blood plasma, resulting in metabolic ACIDOSIS. As the body tries to reduce blood acidity by EXHALING MORE carbon dioxide, a deep and labored breathing, known as Kussmaul breathing may result. Another compensation mechanism for high acidity MOVES hydrogen ions INTO cells in exchange for potassium. This leads to INcreased potassium levels in the blood; but as potassium is constantly excreted in urine during osmotic diuresis, the overall potassium level in the body is eventually depleted. A blood test MAY indicate too much potassium, or hyperkalemia, but once INSULIN treatment starts, potassium moves BACK into cells and hypokalemia may result instead. For this reason, blood potassium level is monitored throughout treatment and potassium replacement is usually required together with intravenous fluid and insulin as primary treatment for DKA.

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This video is for educational purposes. This session was presented on January 26, 2022, for RFUMS students.

Taxes as a married couple are already pretty complicated. But when you add in the fact that how you file your taxes as a married couple can greatly impact your student loan payments, it adds even more confusion. Check out our video where we cover the different ways couples can file their taxes, how it impacts your loan payment and determining the best option for your family.

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– Tax Deductions, Tax Credits and Adjusted Gross Income
– Progressive Tax Brackets 101
– How To Know When It’s Worth It To File Taxes Separately

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Revised Pay As You Earn For Married Couples

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Ultra Borrowers Academy exists to offer relief to people owing a mountain of student loan debt. Our course breaks down all of complexities of your federal and private student loans so that you can not only understand how your loans work, but also how to form a strategy so that student debt doesn’t prevent you from reaching your other financial goals. Join us as we tackle student loans together!

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Many men over the course of their lifetime will feel pain at the tip of their penis. Pelvic Floor expert Elizabeth Akincilar is here to talk about the nerves and muscles that are involved in this, why it occurs, and what you need to know to get better.

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About Pelvic Health and Rehabilitation Center:
PHRC is the leading physical therapy center for patients experiencing pelvic pain. At PHRC our advanced pelvic floor training allows us to integrate pelvic floor and pelvic girdle physiology to help the person function better as a whole. The benefit of our focus is that it has allowed us to establish a deep well of experience that we are able to draw from when treating this complex part of the body.

About Elizabeth Akincilar, MSPT
Liz received her Masters of Physical Therapy from the University of Miami Medical School. She is a Pennsylvania native but spent much of her early professional career in San Francisco. In 2015 Liz was excited to move back to the east coast to open PHRC’s first New England location. Now she is a fully acclimated New Englander who loves the four seasons. Liz’s happy place is in the kitchen cooking for friends and family or in the mountains with her partner and two rescue German Shepherds, Gunner and Jackson.
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