Assessment and management of Barrett's disease Essay

Assessment and management of Barrett's disease - Essay Example This condition is seen more commonly in later age. Barrett’s esophagus is a pre malignant condition in which changes of dysplasia and carcinoma reported. Patients having Barrett’s disease have 30-40 fold increase risk of developing carcinoma- esophagus. To critically understand the disease, first we have to learn normal esophageal defence mechanism because most of the cases this disease is result of failure of esophageal defense mechanism. The lower esophageal sphincter, which is a localized area of specialized smooth muscles cited at distal end of the esophagus, is the main barrier to reflex. This sphincter is normally contracted thus creating a zone of high pressure so preventing the passage of gastric contents into the esophagus. In normal subjects the esophageal sphincter relaxes during swallowing but at other times there are spontaneous transient relaxations. In those with reflex esophagitis, reflex is increased because the normal or resting pressure of the sphincter is reduced and number of transient relaxations is increased because the sphincter is situated below the diaphragm, its high pressure is reinforced by intra abdominal pressure, moreover the oblique entry of esophagus into the stomach ensures that the intra abdominal esophagus is closed when the stomach is distended. These mechanisms are lost when the lower esophageal sphincter moves proximally to be situated above the diaphragm. Once reflex has occurred, rapid clearance of acid from the esophagus into stomach limits its contact with esophageal mucosa and this effective clearance depends upon secondary peristalsis and the presence of saliva and is enhanced by the erect position. It is impaired in supine position. Barrett’s disease is commonly seen in later age groups. It is divided into short ( 3 cm), according to the length of

Government Regulation of the Internet Essay Example | Topics and Well Written Essays - 1250 words

Government Regulation of the Internet - Essay Example Since the cyberspace’s geopolitical demarcation is virtually erased, the question whether a government should step on the internet became in itself questionable. Given that with the issues spawned by the cyberspace are disturbing, that it now becomes an imperative to maintain an acceptable standard of behavior over the internet, it is questionable whether the government do it and will it bring good or disaster?This brings to mind the geographic relativity of laws. Laws are not uniform and essentially differ in each country while the nature of internet stays the same whichever country it may be. For example, laws governing e-commerce and speech in the United States may differ or may not even exist say that of the Middle East country and vice versa that the enforcement of cyberspace regulation may prove to be a challenge if not impossible to implement. Speaking against the government may be a crime in the Middle East and other countries but is perfectly acceptable in the United States as guaranteed by the First Amendment of the Constitution. E-commerce and the Anti-Piracy law may be stringent in countries such as the United States but may also be non-existent in other countries. Such, many concerned parties proposed to adopt an intergovernmental regulation to create a cross-border harmonization of internet governance policy for greater efficacy. This may appear good on paper but quite impossible to apply. As mentioned above, what can be acceptable in one country may not be acceptable in other countries.... For example, laws governing e-commerce and speech in the United States may differ or may not even exist say that of the Middle East country and vice versa that the enforcement of cyberspace regulation may prove to be a challenge if not impossible to implement. Speaking against the government may be a crime in the Middle East and other countries but is perfectly acceptable in the United States as guaranteed by the First Amendment of the Constitution. E-commerce and Anti-Piracy law may be stringent in countries such as United States but may also be non-existent in other countries. Such, many concerned parties proposed to adopt an intergovernmental regulation to create a cross-border harmonization of internet governance policy for greater efficacy. This may appear good on paper but quite impossible to apply. As mentioned above, what can be acceptable in one country may not be acceptable in other countries. Asserting one’s law on another sovereignty country is just out of the ques tion to regulate the internet. It will just complicate the issue more. There is however other interest groups that espouse the idea of self-imposed regulation of cyberspace conduct. Among these is the Internet Corporation for Assigned Names and Numbers (ICANN) in the United States whose mandate is to develop a bottom-up consensus on the usage of the internet among the private sector. Though it differed in identity compared to that of the government, it still called for the regulation of the cyberspace by a broader consensus of different interested parties in the private sector. It is not coercive and is done by an initiative of the private sector who acknowledges that there has to be a set of acceptable behavior in the cyberspace to curb if not eliminate misconduct. For