#suffering cmv

[sherbertquake56]

one of my favorite things about the suffering cmv actually is the couple of people in the background- they bothered me at first cause I’d like it if there wasn’t any in the background, but if you look at them as the other SIRENS?? that shit goes hard.

they’re all only showing waist up far away in the water and that’s so tasty— like, they’re just out of sight so that odysseus’s attention is only on penelope but they’re still LURKING back there

anyways thanks random surfers in the background for worldbuilding my cmv

double anyways- GO WATCH THE CMV

[amv-reset]

HELLUVA BOSS - BLITZO | Family - Part 9 for Childhood Creativity Studios

[snow-lavender]

little thoughts about the brutus cmv

"that the people would see me too as a poet/and not just the muse" is really interesting coming from fable. because he kind of has a point. the aether is inherently derivative and dependent on the other three realms. if it's a work of great art, the other three major gods serve as muses

especially from fable's point of view; in more modern conceptions, the muse of an artist is often mistreated, exploited, and under-credited. (they're also usually like. women suffering under misogynist structures of art and finance, but fable has such a victim complex i can see him being fine with co-opting that /j)

similarly, "i'll never forget that you showed me how to make art" alerion made the other realms for his siblings, which then inspired the creation of mortals. the works of art that fable is driven to kill by losing to alerion also owe their existence to him, in a way

it is so weird seeing trees in full leaf knowing this cmv was filmed, what, two weeks ago? that is NOT how i'm used to trees looking in early may. why is it so green.

"frater meus" hits harder when you remember that vo'lete is largely based off latin. fable is calling alerion his brother in his own language while rationalising why he has to die

obviously the song choice is fucking incredible, you don't need me to tell you that. espicially when that fourth verse hits my god

also alerion desperately crawling backwards and fable shouting why and how this is for the best down at him. peak cinema

it seems like when fable is stewing on the bench there's actually blood on the tip of the sword? like it's mostly out of frame but i swear it's red in some places

in conclusion:

[covid-safer-hotties]

Also preserved in our archive

The cost is set to go far beyond human suffering, yet almost five years into the pandemic, not only are there still no treatments for long Covid, there aren’t even any diagnostic tools – and we don’t seem overly interested in finding them.

The jig is up. People are catching on that “mild” Covid-19 may not be so mild, and that the mysterious lingering symptoms they’ve experienced after catching the virus, such as fatigue and brain fog, may just be connected. For others, this will be the first time that they put two and two together. I hate to be the bearer of bad news, but strap in for what comes next.

Recently, RNZ ran a piece outlining the estimated $2bn per year economic cost of long Covid in New Zealand and signalling that further research would be needed to determine a more precise figure. The average reader would assume that this research is under way or has at least been planned and funded. Human suffering aside, such a hit to productivity would surely raise alarm bells across the political spectrum!

I say this solemnly: yeah… nah.

Almost five years into the pandemic, not only are there still no treatments for long Covid, there also aren’t even any diagnostic tools – and we don’t seem overly interested in finding them.

At present, a long Covid diagnosis relies on a patient finding a doctor with up-to-date knowledge, who will believe their symptoms, and who will spend time investigating further to rule out other possibilities. This mythical trifecta is out of reach for most people, particularly women, who are affected by immune conditions at far higher rates, but have their symptoms written off as hysteria; and Māori and Pasifika, who face barriers to healthcare, and have their symptoms written off as laziness. Obtaining accurate data on prevalence under these circumstances is simply impossible.

In this way, and several others, long Covid mirrors ME/CFS (myalgic encephalomyelitis), a brutally debilitating biophysical condition, though the oft misused term “chronic fatigue” doesn’t quite convey that. Around half of long Covid sufferers meet the criteria for ME/CFS, which by the World Health Organization’s scale has a worse disease burden than HIV/Aids, multiple sclerosis (MS), and many forms of cancer. But again, there are no treatments.

I suffer from ME/CFS myself. My illness predates Covid-19 and came on after an infection with cytomegalovirus (CMV). I went from a fit and active young man to debilitatingly sick and fatigued, with several unexplained symptoms.

Pre-pandemic there was estimated to be more than 25,000 people in New Zealand suffering from ME/CFS, and only one specialist in the country, working one day a week, who has since retired (well earned, bless her). For years I had been praying for any sort of diagnosis, even if it was bad, so that I could get on the path to recovery. I got the diagnosis – but for a disease with no path to recovery.

As the pandemic unfolded, patients and advocates in the ME/CFS community warned that a tsunami of disability was approaching. They were of course ignored, as they have been for decades, and are now joined by masses of long Covid sufferers facing the reality that the medical profession has no answers for them, except perhaps euthanasia.

Frustrated with my lack of options, I connected with cellular immunologist Dr Anna Brooks, who had become a leading expert on long Covid, so I assumed that her biomedical research would be well supported. Alas, she detailed the uphill grind that it’s been to gain traction compared to other countries, and that generous donations, usually from patients themselves, had been the driving force of funding.

Together we founded DysImmune Research Aotearoa, with the goal of developing diagnostic tools leading to treatment for post-viral illnesses like long Covid and ME/CFS. In layman’s terms, we collect blood samples, analyse differences in cells, and put together an immune profile. My priority is ensuring that Māori and Pasifika patients and researchers are at the table and taking action into our own hands.

We’ve made a small start, and we have some incredible collaborations lined up, with far-reaching implications for community health. We’re in the process of seeking partnerships to take things forward. The expertise exists, it’s here in New Zealand. Still, the barrier to progress across the research space is the urgency for resourcing. It is dire to say the least.

Without some long-term project certainty, it’s difficult to pull the necessary teams together. While study after study illuminates more horrifying long-term effects of Covid infections, and prevention has been completely abandoned, research and development for treatments for long Covid is tanking. The private sector is at the whim of the quarterly financial report, and with no guaranteed short-term profit in treating us, it has very little incentive to take the risk.

So, barring some philanthropic miracle, only government can fill this gap. Yet where Australia had set aside A$50m specifically for long Covid research, and the US Senate considers a billion-dollar long Covid “moonshot” bill, New Zealand has allocated nothing. We’re fast asleep at the wheel. No other country can determine how many of our people are impacted by post-viral illnesses. No other country can address our specific needs.

Since this government is focused on ambition, productivity and fast-tracking, I assume they’d want to be world leaders in research, warp-speed some projects, and get long Covid sufferers back into work, no? This is what we are calling for. Not surveys. Not “talk” therapy and positive thinking. Biomedical research.

Put the money down and commit to this. Seize this opportunity to right decades of neglect. There are tens of thousands of us fighting for our lives, and millions more around the world. You think it won’t be you, then after your next inevitable Covid-19 reinfection, it is, and you’re left to wonder why nobody stepped up.

Government, iwi and whānau ora groups, health organisations, philanthropists – reach out. Let’s work.

Rohan Botica (Te Ātihaunui-a-Pāpārangi, Ngāti Tūwharetoa) is a lived-experience researcher and co-founder of DysImmune Research Aotearoa.

[moonlight-bloop-rambles]

my thoughts after watching the Icarus Morningstar "Gold" cmv

I realized I never posted them anywhere so tumblr may have them. -the thought of quixis being a sherbert variant from another universe and them having no eyes. what if they had the power to change things to their will but couldn't controll it and on accident glitched out their own eyes and they were looking for a way to fix that giving the different sherbert variants across dimensions different eyes to see if one is stable and the can use it for themselve but no one is. it always bleeds… -also with the fingers being blackend. what if the more they change things the more it hurts them. we know the worldport is falling appart. and big changes like the wings cause more damage but they keep trying to communicate. trying to warn icarus. they once said at the pond that somebody was going to be in danger. and quixis changed the pond to brewing stands basically saying that icarus is in danger. -my running theory is: quixis is a sherbert whos home dimension was destroyed and who could safe themself into the world port. Now they are trying to warn other sherbert variants from suffering the same fate even if their powers get out of controll and they hurt themself while doing so. but i do like the idea of quixis being a rae variant i once saw too.

[caius-hhhhhh]

I got into a mood. Let’s round out my portfolio a smidge more with this relatively short podfic of @soot-and-salt’s gorgeous (gore-geous) narrative poem, Transubstantiation: Alastor and Rosie eat Lucifer for lunch.

CW: cannibalism, gore, very brief character death. I mean, duh.

Original tags: M, M/M, Alastor/Lucifer, Lucifer, Alastor, Rosie; aesthetic gore, they are cannibals so you know, the inherit beauty of suffering, RadioApple, Alastor and Rosie are best friends, a picnic where Lucifer is the main course, you know you have catholic trauma when you write stuff like this, Based on a CMV, how many ways are there to butcher a fallen angel, Dead Dove: Do Not Eat, [< imo it’s not that rotten. it’s very tasteful], not unless you're a cannibal really into angel liver pâté, to be loved is to be consumed, Very Brief Character Death, Don't worry he gets better.

You can listen to and download my reading of it through this Dropbox file:

Duration: 13:00 File type: mp3 File size: 23.81 MB

Music used: “Something, Everything Is Wrong”, Madoka Magica: Rebellion; composed by Yuki Kajiura “Outside”, from that hilarious Coraline video game; composed by Mark Watters

Follow along with (and make sure to leave a comment on) soot’s original fic:

I’m publishing my recording with her explicit (she was screaming in my DMs lol) permission.

[coochiequeens]

I normally post about how surrogacy exploits women but this is an example of how the business part of ivf exploits women. They took that couples money after promising careful screening of the soerm donors. Instead the mother was infected with an STI that would impact any future pregnancies, they lost one baby and the other will need life long care.

The state Supreme Court confronted philosophical questions about “wrongful birth” and the value of life Wednesday when the state asked the justices to reverse a $37 million verdict awarded to a family whose lives were upended by a tragically flawed artificial insemination procedure at UConn Health.

Jean-Marie Monroe-Lynch, her husband Aaron Lynch and their surviving son Joshua sued for malpractice after fertility specialists affiliated with the University of Connecticut’s medical center inseminated her with sperm from an anonymous donor infected with cytomegalovirus, or CMV, a common, sexually transmitted virus that has catastrophic effects on fetal development.

The procedure, a therapeutic donor insemination, succeeded in that the mother became pregnant with twins, a boy and girl. But she and the children were infected with CMV. One of the twins died and the other was born in January 2015 with a long list of devastating disabilities that will put him in need of constant, life-long care. The surviving twin, Joshua, cannot communicate or care for himself, has global developmental delays; suffers from cognitive, hearing and movement deficits; suffers from autism and seizures, and spends hours each day having nutrition pumped into his body through a tube.

In its appeal, the state is arguing, among other things, that the family’s suit was not based in the usual definition of malpractice but is rather what has become known as a wrongful life suit, a relatively new and controversial action against medical practitioners for failing to properly prevent the birth of children, such as Joshua, shown through prenatal examinations to have tragically debilitating conditions.

See rest of article

[vausena]

Hokotae in Stalemate- Korlan Fails to Encircle Hēre in Fourth Month of Invasion

[Federal Kingdom of Vau’sena, Kuwhara, Rangat- 17 November 2053

Annalies Willems, Cosonan News Network]

     The war in the Kuata Strait opened quickly- the robust Korlanic Navy wasted no time surrounding, besieging, and bombarding the islands of Hokoihoko and Hokotae off of the coast of Ramisola, Vau’sena’s largest island and home to over 74 million people in the constituencies of Kuwhara and Volios. After capturing Hokoihoko in only four days of conflict, Korlanic forces looked to make quick work of the Kuwharan province of Hokotae to complete its conquest of the Korlanic Isles before advancing into the heart of Kuwharan society on Ramisola. 

     Uniting the various ethnically Korlanic populations of Ailou has been a long-standing goal of Korlanic Rangatira Ikaroa Storinka, with Kuwhara’s status as a democratic and patriotic constituency of the Federal Kingdom of Vau’sena resting as a particular thorn in Storinka’s side. From its broad ethnic and linguistic diversity to its democratic leadership centered in the Ripieran constituency of Cosona, the very existence of the Vau’senaan state flies in the face of Storinka’s Ilfiatist ideology of control and uniformity. The ideological struggle simmering across the Kuata Strait came to a boil in late June, culminating in the ongoing battle on the Island of Hokotae.

      The Battle of Hokotae, however, has proved to be far from the decisive victory that Korlan experienced on the island of Hokoihoko. Zones of control remain static as the battle drags into its 134th day, a fact held as a point of pride by Vau’senaan defenders initially caught encircled flat-footed by the sudden blockade. The beginning of the Korlanic attack employed brutal tactics to bring the island to its knees- a campaign of etymological warfare that employed swarms of locusts to destroy crops and block out targeting systems on the island, the deployment of chemical weapons into population centers, and the assassination of leading logistics directors which sent the island into famine and allowed Korlanic landing parties to make footholds on the south of the island. 

     The Korlanic blockade was first broken on the 21st day of the battle, however, through the use of new implosion-type precision ordinances by the Royal Vau’senaan Air Force. While the specifics of this new Vau’senaan weapon have remained highly classified, observers have described the missile’s implosive force as sufficient to rip a third of a battleship away in under 30 seconds, blasting away surrounding seawater and slowly falling into the air pocket left behind until losing power about 45 seconds after impact, leaving the battered ship to be crushed by the force of returning seawater. Each of the three times the new weapon has been deployed in significant numbers onto the battlefield it has seen crushing success, breaking blockades on the 21st, 77th, and 115th days of the battle, each time allowing between 6 and 18 days for Vau’senaan forces to bring in supplies, transport casualties and civilians to Ramisola, and even permitting the damaged aircraft carrier CMV Kiti Firine'a to be evacuated to Cosona for repairs. The Vau’senaan access to Hokotae, however punctuated by returning Korlanic ships, has proved crucial in repelling the Korlanic Army from the regional capital and largest city Hēre, which has come near to being encircled on numerous occasions.

     The Battle of Hokotae has come at a heavy cost to attacking Korlanic forces. According to a statement given by the Dive’ira’Ministerie Vau’senaan (Vau’senaan Ministry of Defense), Defense Minister Liyet Ts’iyniyn estimates Korlanic casualties on the island to have reached 125,000 since the beginning of the invasion, putting Korlanic casualties suffered on the ground at a higher figure than those sustained in the 28 July nuclear strike which wiped out an estimated 100,000 embarked forces in deep water in the middle of the Kuata Strait. The Vau’senaan defense of Ponder has seen its own successes, succeeding in deterring an invasion at all from being launched from the Korlanic-occupied Hegiite province. However, the unfolding Korlanic invasion of Pylerick threatens to expose the Vau’senaan mainland to danger from Korlanic weaponry.

[In accordance with the Wartime Information Act of 2053, information published by any and all private persons and registered media outlets within the Federal Kingdom of Vau’sena may be subject to censorship with or without notice]

[robot-roadtrip-rants]

aight fam let's do this. pick out your favorite trio of war criminals and slap 'em into this baby. however i like the categories in the original post better so we're revoerting to them:

murderer

poor sleepless bastard

massive fuckup

now i will admit that i don't have an ot3, or otp, or otanything in 40k, i'm very much a multishipper kind of gal when it comes to this fandom. except for dantilux. THEY R IN LUUUUURVVVVVVV i guess that's my otp. ANGYWANYS everyone else is fair game for shipping for me, so i just picked out a threesome that i liked, which is Blondes in Crisis. Blondes in Crisis is the main reason i ever picked up an HH book outside of know no fear, love me sum oversized demigods YELLING!! at each other for fucking up everything, do you know how refreshing it was to watch gman lose his shit about lion at poor sangy in the middle of the rolling depression that is pharos?? AMAZING what an asshole. anyways they are clearly all fucking each other because if they didn't blow off steam that way they'd kill each other and possibly the whole of macragge in the process. so here's my breakdaown:

murderer - lion, because duh

poor sleepless bastard - sanguinius is the poor sleepless bastard for the whole damn series cmv, the man is the tragic wattpad self-insert we all wrote when we were 13 and we love him for it. and for what does a tragic wattpad slef-insert exist, if not to suffer? tragically? your honor i rest my case

massive fuckup - big bobby g earsn this for coming up with imperium sanctus in the first place. remember the bit in unremembered empire where he fucking talks himself into starting imperium 2.0?? my dude, just announce a regency while y;all figure the ruinstorm out, people will roll with it. gman himself agrees with this cateogorization later on in the timeline, he's soooo fucking ashamed of himself, dude got all melodramatic and closed the library of hera instead ovf burning a few books because he's so fucking embarassed

the only other trio i could think of was emps/malc/erda. this one's pretty straightforward:

murderer - empse, BECAUSE DUH

poor sleepless bastard - malcador, lord knows he cleans up all the messes. worst sugar baby job ever!!!

massive fuckup - erda. bitch yeeted her sons into the warp and called it a day, WHY WOULD YOU DO THAT, THAT DOES NOT FIX ANYTHING ANGRON WAS FUCKING LOBOTOMIZED YOU DUMBASS

ok i'm done it's your turns

This has probably DEFINITELY already been done before oof

Training Trio Training Trio Training Trio!!! ❤️💙💜

[cmcshealth]

Living Donor Kidney Transplant in India

Kidney diseases are on the rise. Lifestyles, dietary habits, and excessive alcohol and tobacco consumption are the major factors responsible for kidney diseases. In India, there are many Kidney transplant specialist surgeons at many better-equipped hospitals to provide successful live donor Kidney transplants. As the awareness and availability of organ donation post-death(deceased Donor) are still in a very nascent stage, Kidney from deceased donors are not readily available and patients suffering from an end-stage renal disease requiring a kidney transplant depend on donation from living family members for live donor kidney transplants. At CMCS Health We are associated with the best and most experienced Kidney transplant surgeons and the best kidney transplant hospitals in India.

Who can be a living donor for a Kidney transplant needing patient in India?

A healthy blood-related family member usually a son or daughter/parents, grandparents and grandchildren, and brothers and sisters are considered blood relations. The donor needs to be a major in the age group of 18-55 years preferably and healthy enough to donate one of his kidneys, without any risk to his quality of life post-donation. Prelim tests for the fitness and compatibility of donors are done for screening and choosing the correct donor for a successful kidney transplant. Any other relative is considered an unrelated donor and certain documents are needed to prove to the Government of India-appointed organ transplant committee that the donor is related to the patient requiring kidney transplant. And donor is willing to donate one of his kidneys to the patient out of love and family bonding and not under any pressure or monetary obligations.

What happens to a Living Donor after a successful Kidney Donation?

A healthy and fit donor lives a perfectly normal life post the donation of one of his kidneys. The doctors do advise him on certain do's and do not post-donation. Anything that is not good for the health of a person with both kidneys functioning normally is also considered bad for the live donor. Regular and periodic checkups are suggested for a live donor. As high blood pressure and diabetes are considered two major causes of kidney function going bad, the donor is advised to follow a healthy lifestyle to remain disease-free.

Does live donors have a health risk or compromised life post-kidney donation?

A healthy donor lives a perfectly normal life, post-donation. Donation of a kidney does not hurt overall life or quality of life for the donor. Selecting the right donor is important as it cuts down the cost of dialysis and the need for frequent admission of patients till the time we get approval from the government of India-appointed transplant committee for kidney transplants. Once the approval is given by the Committee, the patient is given a date and time for surgery. The following tests for donors are required to lessen the chances of flying in the wrong donor and save time and money for guests till we fly in the right donor.

1. Urine ( SPOT), Protein creatinine ratio, LFT (Liver function test), Urea, Creatinine, Sodium(Na), Potassium (K), Blood sugar( Fasting and Postprandial), HBA1C, Calcium (Ca), Phosphate (Po4), Uric Acid, PTH, Lipid profile, Vitamin D level, T3, T4, TSH and LDH.

2. Complete Hemogram, BT, CT, PT, PTTK, and urine routine.

3. Urine culture, CMV-IGG, EBV(CAPSId)_IGG, for MALE patient PSA (if above 50 years of age). for Female patient CA-125 and pap smear.

4. Blood group, HBSAG, Anti HCV antibody, HIV1 & 2, HCV RNA qualitative, Anti-HBS antibody.

5. ECG, Echo/stress echo, Cardiac clearance.

 6. Chest X-ray, Ultrasound-whole abdomen, CT (Angio) for renal vessels, DTPA scan, etc.

CMCS Health is a leading medical tourism company in India. We offer medical tourism services such as finding the right doctor, the right hospital, and cost estimation for medical treatment in India for foreign patients. Some of the main countries are Bangladesh, South Africa, Egypt, Kenya, Saudi Arabia, Ethiopia, Nigeria, Uganda, Zambia, Sudan, Dubai, Namibia, Iraq, and so on. We provide free medical assistance aplastic anemia treatment cost, stomach cancer treatment, sickle cell treatment cost, the best hospital for heart valve replacement, heart valve surgery, arthroscopic surgery, bone marrow transplant cost, best liver transplant hospital, brain tumor surgery cost, cosmetic andplastic surgery, heart surgery, kidney transplant cost,spine tumor surgery,cancer treatment cost, lung transplant,liver transplant cost, top knee replacement surgeons, knee replacement surgery cost, top shoulder replacement surgeons, hip replacement surgery cost, best bone marrow hospital, etc.  If you are searching for free medical and healthcare consulting to find the best hospitals and top doctors and surgeons in India for any treatment then contact us- Cmcshealth.com.

Source: https://cmcshealth1.blogspot.com/2024/11/living-donor-kidney-transplant-in-india.html

[healthcaremarketfmi]

Cytomegalovirus Treatment Market Trends, Key Driven Factors, Region-wise Outlook, Segmentation And Forecast To 2022-2028

The global Cytomegalovirus Treatment market is experiencing significant growth, driven by a rising demand for effective treatment options and advancements in technology. Cytomegalovirus (CMV) is a common viral infection that can cause serious complications, particularly in individuals with weakened immune systems.

According to market research, the Cytomegalovirus Treatment market is predicted to increase at a steady CAGR of 6.1% from 2022 to 2028. The market growth can be attributed to various factors, including an increase in the prevalence of CMV infections, expanding geriatric population, and growing awareness regarding early diagnosis and treatment.

The cytomegalovirus treatment market is poised to grow at an impressive y-o-y of over 5.5% in 2019, as per the latest research study published by FMI. A cohort of macro factors, including rapid adoption of innovative treatment procedures and burgeoning investments in healthcare, are auguring well for the wide-spread adoption of cytomegalovirus treatment. These insights are per the latest FMI research study that conveys a healthy outlook for global cytomegalovirus market in 2019 and beyond.

Patient pool affected by cytomegalovirus is on a consistent rise, necessitating adoption of effective treatment methods and therapies. As per a revelation by the MedlinePlus, between 50 percent and 80 percent of adults in the US have suffered from cytomegalovirus by the age of 40. Statistics as such demonstrate augmented adoption of cytomegalovirus treatment products and procedures in the future, creating sustained opportunities for the manufacturers to reap sizeable revenues.

To remain ahead of your competitors, request for a sample – https://www.futuremarketinsights.com/reports/sample/rep-gb-8665

As per the FMI report, demand for valganciclovir drug continues to be buoyant on account of effective results if taken at evenly spaced intervals, with global sales likely to surpass US$ 55.5 Mn in 2019. In addition to this, valganciclovir is less time-consuming and affordable, which is further adding to its popularity in the cytomegalovirus treatment space.

“The drug development framework for treatment of cytomegalovirus continues to be progressive, offering ample scope for development of new products and procedures. There are multiple clinical trials being performed for cytomegalovirus treatment worldwide, led by prominent regions including Europe and North America. The late-stage pipeline comprises exceptional drugs which are envisioned to enter the market. This, in turn, is likely to create favorable scenario for cytomegalovirus treatment market over the forecast period”, says FMI report.

Hospital Pharmacies Remain Highly Lucrative Channel for Manufacturers with Notable ROI Benefits

As per the report, congenital CMV infection registers substantial demand for cytomegalovirus treatment, with global sales expected to surpass over US$ 65.5 Mn in 2019. Hospital pharmacies are likely to steer sales of cytomegalovirus treatment products and procedures, owing to reliable offerings at reasonable costs. The well-informed and modern patients seek a combination of efficiency with convenience, which is making e-commerce a rapidly growing distribution channel for manufacturers to commercialize their offerings.

As per the report, high cost of cytomegalovirus treatment procedures remains a key factor hampering adoption and deterring market’s growth potential. Along with high prices, associated side effects of cytomegalovirus treatment products and procedures are denting end-user confidence. Some of the prevalent side effects associated with cytomegalovirus treatment products and procedures include neutropenia, nausea, thrombocytopenia, hematological toxicity, renal dysfunction, and so on.

[rayanabee]

Is it hard to clear a DOT physical?

Not if you are in good physical and mental health. You need normal healthy vision, hearing, and mobility, and you need to be free from debilitating medical conditions that prevent you from safely operating a motor vehicle for long periods of time.

In addition, there are multiple exemptions for existing medical conditions, provided you can show that they are corrected (for example, with eye glasses or limb prosthetics) or controlled (for example, with medication).

How often is the DOT physical required?

The exam is required every two years, unless you have applied for a medical exemption or have a potential DOT disqualifying medical condition, in which case it may be every 12 months or less.

Is a DOT physical required to keep a commercial driver’s license?

While the procedures vary by state, yes, a valid FMCSA medical certificate is required to maintain a commercial driver’s license.

Who performs the DOT physical exam?

The exam is performed by doctors, nurses, and other medical professionals certified by the FMCSA and listed in the National Registry of Certified Medical Examiners (NRCME).

Will I be disqualified if I have a medical condition?

As discussed in the main article above, the medical examiner may not certify you if you have a DOT disqualifying medical condition. However, many conditions are assessed based on the individual and the subjective medical judgment of the examiner. In addition, objective medical disqualifications can sometimes be reversed through exemptions granted by the FMCSA.

If I fail the DOT physical, is it permanent?

This depends on whether your disqualifying medical condition is permanent. Medical disqualifications can be reassessed if your condition improves or becomes controlled through treatment.

What can disqualify me from getting the DOT medical certification?

Potential disqualifying medical conditions include vision or hearing impairment, epilepsy or seizure disorders, fainting spells, uncontrolled hypertension, heart or respiratory conditions, diabetes, sleep disorders, psychiatric disorders, alcoholism, and drug abuse. As explained in the article above, the majority of these are assessed based on the overall capabilities of the individual, so if you suffer from any of these conditions, it does not necessarily mean you will fail the physical.

Can high blood pressure disqualify me from passing the DOT physical?

If you have stage 3 hypertension (BP higher than 180/110), you are considered high risk and will fail the DOT physical exam. You can retest if you reach a stable 140/90.

Those with stage 2 hypertension (160–179 systolic and/or 100–109 diastolic) may be given a one-time certification of three months, during which if they reduce their BP to 140/90, they may be granted a 12-month certification.

If you have stage 1 hypertension (140–159 systolic and/or 90–99 diastolic), you may be certified for a 12-month period.

Does diabetes disqualify me for a CDL?

Previously, diabetes was a blanket DOT disqualifying medical condition. Standards were revised in 2018 to permit insulin use for diabetic CMV drivers, provided medical recertification is acquired every 12 months and certain physical requirements, such as visual acuity, are met.

Is poor vision a DOT disqualifying medical condition?

Not if corrected to a specific level with glasses or contact lenses. To pass the physical, you are required to have 20/40 vision in each eye and both eyes together, with or without glasses or contacts, and a field of vision of at least 70 degrees in both eyes. If you are unable to meet these levels, then impaired vision is a disqualifying medical condition and you will fail the test.

Color blindness is also an issue: You must be able to distinguish traffic signal colors (red, green, and amber).

If you are unsure whether you meet the above requirements, you should obtain a Vision Evaluation Report from a licensed ophthalmologist or optometrist covering visual acuity, field of vision, and recognition of colors prior to your DOT physical and bring this document with you to the test.

Do they check for hernias in the DOT physical?

Yes, the medical examiner will perform an abdominal examination for hernias, and any current or past hernias should be self-reported in the first part of the FMCSA Medical Examination Report Form.

I’m an amputee – can I still get a CDL?

Yes, if corrected with prosthetics or other means and demonstrated by receiving a Skill Performance Evaluation Certificate from the FMCSA. This will show that you have no limiting mobility or dexterity issues, and are able to drive CMVs across state lines.

Cannabis products are legal in my state; do they check for marijuana use in the DOT physical?

No, and the urinalysis does not screen for any legal or illegal drugs. However, in the self-reporting section, you need to answer the question, Have you used an illegal substance within the past two years? Depending on the state where cannabis use occurred, this could create an issue for the user.

[ijcimr]

 Acute pancreatitis in Thalassemia post allogeneic stem cell transplant with Cyclosporine-A as a possible etiology: A report of two cases by Narendra Agrawal in International Journal of Clinical Images and Medical Reviews

Abstract

Cyclosporine is an important component of GVHD Prophylaxis in Hematopoietic Stem Cell Transplant (HCT). It has narrow therapeutic index and is known to cause hypertension, electrolyte imbalances, Acute Kidney Injury, etc. High suspicion of these adverse effects helps us in managing them effectively. We report here two cases of pediatric age group who presented with acute pancreatitis post matched sibling HCT for Thalassemia transplant. To our knowledge we could find only 2 case reports of Cyclosporine induced pancreatitis post HCT in literature and none reported post HCT in Thalassemia. Diagnosis of acute pancreatitis especially in pediatric age group can be challenging without high suspicion.The purpose of our report is to highlight the importance of keeping acute pancreatitis in differential of unwell child post HCT in Thalassemia and careful rechallenge of Cyclosporine may be possible with careful monitoring, thereby not compromising on GVHD prophylaxis.

Key-words: Pancreatitis, Cyclosporine, Thalassemia, GVHD prophylaxis

Key Messages: This report highlights the importance of suspecting pancreatitis in a paediatric thalassemia patient post allogeneic stem cell transplant with cyclosporine –A  as possible causative factor. CSA reintroduction can be attempted with careful monitoring after recovery.

Introduction

Cyclosporine (CsA) is a cyclic polypeptide immunosuppressant agent. It is produced as a metabolite by the fungus species Beauveria nivea1. CsA has been used extensively for immune suppression in allogeneic hematopoietic cell transplantation (alloHCT) as well as solid organ transplants for prevention and treatment of graft versus host disease (GVHD) and graft rejection1. CsA has a narrow therapeutic index and requires therapeutic dose monitoring. Common adverse effects of CsA include nephrotoxicity, HCT, hypertension, and hypomagnesemia1. Acute Pancreatitis has been reported with the use of CsA in organ transplants2.

With an extensive literature search, we could not find any report of CsA induced acute pancreatitis after  alloHCT for thalassemia or other hemoglobinopathies. Here we report two pediatric patients with thalassemia major, of CsA induced acute pancreatitis after HLA matched family donor HCT.

Case History

Case 1, a 2-year-old female child with Thalassemia major, presented on day +66 of HLA matched mother donor alloHCT with a history of constipation, irritable behavior, episodes of crying, decreased oral intake and vomiting of 2 days duration. Abdominal examination was remarkable for mild diffuse tenderness and sluggish bowel sounds. X-ray abdomen was suggestive of dilated colon while an USG of abdomen was suggestive of gaseous bowel distension. Pediatric Surgery review suggested a possibility of subacute intestinal obstruction. The patient was treated conservatively by withholding oral foods and fluids (NPO) and application of bisacodyl suppositories. Constipation resolved but she continued to remain irritable with the persistence of abdominal signs. A possibility of acute pancreatitis was considered and serum amylase and lipase were sent which turned out to be 183 IU/L (normal range 22-80) and 2350 IU/L (normal range 23-300). CT Abdomen was notable for modified CT severity index for acute pancreatitis (CTSI) of 43.  A careful review of her drugs and history of illness was carried out. She was not found to be suffering from viral prodrome anytime in the previous month. Her serum calcium and triglyceride levels were normal while PCRs for CMV and EBV were negative. She was receiving CsA along with prophylactic acyclovir, penicillin V and co-trimoxazole. Her plasma CsA trough level was 61 ng/mL on the day of her presentation. A possibility of CsA induced acute pancreatitis was considered4. Naranjo algorithm for causation score was 7 for CsA suggesting probable causation5. Her blood pressure and renal functions were normal. She had no other CsA toxicity. With conservative management her symptoms improved over 1 week, USG done after 1 week was suggestive of resolving pancreatitis with falling levels of serum lipase and amylase. She was shifted to Mycophenolate Mofetil (MMF) for GVHD prophylaxis. On day+100 follow up, her chimerism was maintained at 100% donor, but liver enzymes were raised. After excluding infective and drug-induced hepatitis, a possibility of liver GVHD was considered. A decision to re-challenge with CsA under close monitoring was taken. CsA was re-introduced starting at low doses with monitoring of amylase and lipase levels and close monitoring for clinical signs. She did not have a repeat episode of acute pancreatitis and is currently on tapering immunosuppression on day+260 of follow up.

C ase 2, a 4-year-old female child with thalassemia major presented on day+154 of HLA matched sibling donor alloHCT with a history of abdominal pain, vomiting and poor oral intake of 2 days duration. The patient had no history of fever. On examination, the patient had tachyuration. The patient had no history of fever. On examination, the patient had cardia, normal blood pressure for age, abdominal distention with mild diffuse tenderness. Her USG was suggestive of the bulky pancreas, amylase, and lipase levels were 643 IU/L and 4253 IU/L. The plasma CsA trough level was 252ng/mL. Her chimerism test showed 68% of donor cells. A careful review of her clinical history, lab results, and medications couldn’t find other causes of acute pancreatitis than CsA. Naranjo algorithm causation score was 7 for CsA suggesting probable causation5. There were no other CsA toxicities. CsA was stopped and she improved with conservative management. The patient was started on MMF for GVHD prophylaxis thereafter. She was considered for a re-challenge of CsA especially after our experience of successful re-challenge of CSA in our previous patient. She was restarted on CsA starting from low doses with amylase and lipase monitoring from day +185 onwards. Currently, she is on escalating doses of CsA on day +225 of follow up with donor chimerism improved to 76%.

Discussion

Ito, T. et al showed that intravenous injection of CsA 10 and 20mg/kg body weight (BW) in rats increased the content of pancreatic amylase and protein and decreased the content of pancreatic DNA6. Histologically, intraacinar vacuolization and individual cell necrosis were observed6. CsA induced a significant increase in serum amylase and pancreatic wet weight in a dose-dependent manner6. Qi C et al reported acute pancreatitis in a 16-year-old female patient with acute leukemia on day 24 of alloHCT with CsA or Tigecycline as potential causative agents4. In a case report by Guo R et al from China, CsA induced acute pancreatitis was reported on day+20 of HLA matched alloHCT in a 49-year-old male with AML-M27.

Whether Acute pancreatitis developing in post alloHCT patients with relatively lesser duration of exposure to CsA is idiosyncratic or dose-dependent is yet to be elucidated. Although animal experiment data points towards dose-dependent toxicity, in both our cases acute pancreatitis, developed at acceptable plasma levels, questioning this notion.

Other than that, Post-transplant diabetes mellitus (PTDM) is a complication that takes place after solid organ transplant as well as alloHCTs, with reported incidences ranging from 2 to 53%. Cyclosporine is one of the risk factors for developing PTDM probably due to direct toxic effects on beta cells of the pancreas8.

From this experience, we conclude that studies are needed in the pathogenesis of CsA induced acute pancreatitis in post alloHCT patients. High suspicion of acute pancreatitis should be kept in post alloHCT patients with abdominal signs and symptoms especially in pediatric patients who may not be able to communicate the typical pain history. CsA re-challenge didn’t precipitate pancreatitis in our patients.

Declarations

Funding: Funding information is not applicable to this study.

Conflict of Interest: All authors declare no conflict of interest to declare.

Compliance with Ethical Standards

Ethical Approval Statement: All authors stated that the study has been approved by the appropriate institutional review board and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Acknowledgements We would like to acknowledge Dr Rayaz Ahmed, Dr Vishvdeep Khushoo and Dr Pallavi Mehta in treatment of the patients. We thank all the members, and staff of Rajiv Gandhi Cancer Institute and Research Centre, India for their contribution in the conduct of the study

For more details: https://ijcimr.org/editorial-board/

[skyfire85]

-USMC MV-22 Ospreys on the deck of USS Bataan. | Photo: Staff Sgt. Wayne Campbell, USMC

Flightline: 62 - Bell/Boeing V-22 Osprey

After the disastrous failure at Desert One during the 1980 Iran hostage rescue mission, the US DOD recognized that there existed a requirement for a transport that could take off and land vertically, but also travel long distance at speed. The Joint-service Vertical take-off/landing Experimental (JVX) program was begun in 1981 to obtain and combine requirements from the Army, Navy, Marines and USAF. In late 1982 a request for proposals was released, attracting interest from Aérospatiale, Bell Helicopter, Boeing Vertol, Grumman, Lockheed, and Westland. Bell later teamed with Boeing Vertol, submitting a design based on the former’s XV-15 tiltrotor.

-Early concept image of V-22 Osprey, probably from mid to late-1980s. | Photo: US Navy

Bell/Boeing submitted the only design, and were awarded a preliminary design contract was awarded on 26 April 1983. In 1985 the Bell/Boeing JVX design was named the Osprey, and given the designation V-22, with USMC Osprey known as MV-22 and USAF CV-22, in part to avoid confusion with USN carrier designation (CV). By March of that year, the first half-dozen prototypes were under construction, with work split between Bell and Boeing. The first V-22 was rolled out in 1988, but the program also suffered major issues that year. Costs ballooned, from $2.5 billion in 1986 to a projected $30 billion in 1988. Citing a need to focus on other programs, the US Army dropped out of the program. The following year, the US Senate voted twice to cancel the Osprey, though the program survived. The DOD then ordered the Navy to not spend more money on the V-22, and SecDef Cheney tried several times from 1989 to 1992 to defund the program, though each time he was overruled by Congress.

-Bell-Boeing’s first V-22 prototype transitions to forward flight. | Photo: Bell/Boeing

The first of six prototypes first flew on 19 March 1989 in the helicopter mode, and on 14 September 1989 in fixed-wing mode. Sea trials were completed on USS Wasp in December 1990, though the program was marred by crashes of the fourth and fifth prototypes in 1991 and 1992. The V-22 was grounded until June of 1993 to make needed changes. From October 1992 – April 1993, the V-22 was redesigned to reduce empty weight, simplify manufacture, and reduce build costs; resulting in the V-22B variant. The existing prototypes were upgraded to the new standard, and in 1997 flight testing of the first four full-scale development V-22s began at Pax River. Testing soon fell behind schedule, though a second round of sea trials on USS Saipan was accomplished in 1999.

On 8 April 2000, a night training exercise of four MV-22 in Arizona resulted in one aircraft crashing, killing the 19 Marines on board, and another suffered a hard landing, though no one aboard were killed. The V-22 was grounded again while the crash investigation was conducted, during which issues with the V-22's design, as well as with crew training, were determined to be the causes of the crash. As the V-22 descended to land it was dropping at 2,000 feet a minute, well above the prescribed 800 feet a minute. The speed caused the aircraft to enter an aerodynamic condition known as vortex ring state. In this condition, a vortex envelops the rotor, causing an aircraft to lose lift, in essence descending in its own downwash. Flight testing resumed after the board rendered its conclusions, but another MV-22 crashed in December 2000, killing four Marines. Despite the accidents, by June 2005 the V-22 had completed its final operational evaluation, including long-range deployments, high altitude, desert and shipboard operations. In September of 2005, the Pentagon approved full-rate production of the V-22, ordering 458 aircraft (360 for the USMC, 50 for the USAF, and 48 for the Navy). The USAF officially accepted the CV-22 in 2006, and the MV-22 reaching IOC the following year. Despite being in the 2005 contract, the Navy did not acquire any of the 48 HV-22 mentioned, for reasons unknown (though likely budgetary). Ospreys have since seen deployment to both Iraq and Afghanistan, as well as other hotspots around the world.

-Marines push boxes out the back of a V-22 Osprey aircraft in Zaranj, Afghanistan, on Dec. 14, 2009. | Photo: USMC

-V-22s are fitted with LEDs in the rotors, which create a glowing ring when spinning, allowing the crew, ground personnel and passengers a clear indication of the rotor disc. | Photo: USMC

In 2015, the Navy signed an MOU to buy 44 redesigned CMV-22B Osprey for COD (carrier on-board delivery) beginning in 2018, with initial delivery expected in 2020. The CMV-22 has larger sponsons, which carry additional fuel, as well as a high-frequency radio. The type will also include a hoist on the ramp, allowing it to deliver cargo to other Navy ships, replacing some helicopters.

-A CMV-22B landing at Pax River after being ferried from the Bell Assembly Center in Texas. | Photo: USN

In 2014, the Japanese Self-Defence Force decided to acquire 17 MV-22Bs, with the first delivery occurring in August of 2017. The JSDF Osprey are based at Kisarazu Air Field, with plans to station some on the Izumo-class helicopter destroyers (*cough*aircraftcarriers*cough*).

India, Indonesia, Israel, South Korea and the UAE have expressed varying degrees of interest in acquiring V-22 of their own, though as of 2020 none have formally acted.

In addition to the transport versions currently in service, other variants were studied during development:

An AEW&C version known as the EV-22, which would replace the E-2 in US Navy service as well as the Sea King ASaC.7 in Royal Navy service

SV-22 Anti-submarine warfare variant, to replace the S-3 and SH-2.

Neither was pursued, though Bell/Boeing continue to pursue variants.

-Rendering of an EV-22 AEW variant, showing the new triangular radar pylon. | Image: Jeff Head

-Model of the SV-22. The ASW variant would have been armed with four torpedoes and carried a dipping sonar. | Photo: Justin Gibb

-Model of the SV-22. The proposal didn’t include a MAD boom, but I added one. | Photo: Justin Gibb

In 2017, HMX-1, the Marine helicopter squadron responsible for transporting the President, Vice President and other senior leadership, recieved 12 MV-22B, replacing its fleet of CH-46 helicopters for support operations.

-HMX-1's first MV-22B, in the squadron’s traditional gloss olive drab paint scheme. | Photo: Sgt. Rebekka S. Heite

[asunshinepuff]

It Started with a Piano

🎶 Hello! Honestly, this may be my most anticipated fic ever. Not because it’s been requested of me a lot, but because I have wanted to write a fic with this song probably since I saw a marauders CMV with it.

Until today, I had no clue how to write this and never thought too hard on it, then suddenly I’m listening to the song and it clicks. Talk about Inspiration. So anyway, enjoy this piece of wolfstar fluff from their Hogwarts years!

If you want to listen along, here’s the link to the song that inspired me to write this. Or you could listen to the piano cover.

The song technically doesn’t start until Remus begins playing the piano but do with that as you will.

Anyways, I hope you enjoy! 🎶

.

When life leaves you high and dry, I'll be at your door tonight. If you need help, if you need help.

I'll shut down the city lights, I'll lie, cheat, I'll beg and bribe. To make you well, to make you well.

Remus opened the doors of the fifth-floor classroom, grateful to find it empty, not that he hadn’t asked Professor Flitwick for permission beforehand. He didn’t know how he would've explained this - given that he wasn’t taking music as an extracurricular. 

Avoiding his fellow marauders was easier than he had anticipated, though to be fair, he had already told James and Sirius the plan for their next prank. He had some spare time as they brewed the necessary potion.

Walking towards the piano in the back center of the room, he gently lifted the lid and propped it open before taking a seat at the bench. Running a soft hand over the ivory keys, he thought about the cords that he had put together late last night in the dorms. 

Listening to the song over and over until it was ringing in his ears. Humming softly under his breath, he pulled a notebook out of his pack and flipped through the pages. 

Taking a breath, Remus began to play the first notes of the instrumental beginning, relaxing as the familiar tune began to fill the air and his strong focus lessened as it neared the first verse. 

“When life leaves you high and dry, I'll be at your door tonight, if you need help, if you need help.” He sang aloud, content at this moment to be on his own.

When enemies are at your door, I'll carry you away from war. If you need help, if you need help.

Your hope dangling by a string, I'll share in your suffering. To make you well, to make you well.

Sirius had a song stuck in his head, it echoed throughout the day ever since late last night. He knew it was because of Remus, though he had no idea what that song meant. Remus had him listen to countless muggle songs on his tape player that were his favorites or songs that they had discovered together. 

It was fascinating to hear the variety of music that could be created with instruments and recorded, to the point that it became a habit for them within their dorms. 

Something seemed strange though, he couldn’t help but muse as James stirred the fluxweed and knotgrass together for their Polyjuice Potion. Why is it that Remus took off after class? The moon wasn’t for another few weeks so he wouldn’t be headed to the hospital wing. 

He found himself unconsciously humming the tune again. What was Remus’ reasoning for the song? Wait, he was writing while he was listening. Was that song the reason why he avoided the preparation for today? 

His eyes widened slightly at that. Wordlessly, he got up from his chair, grabbing his pack, and headed out the door- ignoring the protesting and curious voices of Prongs and Wormtail that followed.

Give me reasons to believe, that you would do the same for me.

There was no sign of Remus in his usual locations. Not in the library, or the courtyard fountain, by the fire in the Gryffindor common room, or the tree by the Great Lake- actively all the spots where he could be alone and have the Marauders come and find him.

Sirius found himself walking up the grand staircase to the fifth floor, lost in thought about Moony when a soft piano piece seemed to flow through the air from the closed corridor doors. Once again, he thanked the fact that his animagus was a dog. There was no way he’d be able to hear it clearly otherwise.

As he walked down the halls of the corridor, nearing the classroom, the piece grew louder. He recognized it. The song. But, this was different than just hearing the words of the original singer or the instrumental melody. 

Remus was singing? Not the quiet hums he was used to hearing, but strong and carefree. His voice was hypnotizing, melodious, and the song seemed effortless to sing. He couldn’t help but smile, Moony always seemed to surprise him. 

And I would do it for you, for you. Baby, I'm not moving on, I'll love you long after you're gone.

For you, for you. You will never sleep alone, I'll love you long after you're gone.

And long after you're gone, gone, gone.

“Give me reasons to believe, that you would do the same for me.” Remus sang to himself, faintly hearing the approaching footsteps of someone but it was already too late to stop.

“And I would do it for you, for you. Baby, I'm not moving on, I'll love you long after you're gone.” Another voice joined his own, one that was familiar. That brought a smile to his face, but right now made him only feel embarrassed. 

Pausing with a gasp and widened eyes, he quickly turned behind him. Sirius stood at the entrance of the classroom, leaning against the doorframe with a smile upon his face. Most likely filled with zero regrets, meanwhile, Remus could feel his cheeks beginning to flush at the fact that Sirius absolutely heard him. 

“Why’d you stop? You just reached the chorus.” Sirius said teasingly.

“Pads what… why are you here?” Remus replied with caution, pulling his hands away from the keys. The ebony-haired boy didn’t respond to him exactly, just pushed off of the doorframe and began making his way over to Remus’ side until he was at the bench and Remus had to look up to meet his eyes. 

“Well Moons, I wanted to find you. That, and you’ve gotten that song stuck in my head with your long hours of playing it last night.” He said with a chuckle as Remus’ eyes widened even further if it were possible. “Scoot over.”

Without waiting, Sirius placed his pack down on the floor beside the leather satchel that was already by the bench, then sat down to join his friend. Giving Remus a smile, he looks to the makeshift music sheet within the notebook, putting the melody together.

Remus stared at Sirius for a few seconds, stunned that he wanted to stay. Glancing down to their hands which were quite close together, he could feel the warmth radiating off of the other boy. 

He looks up to the notebook, then back to Sirius, watching as his grey-blue eyes scoured over the pages. “... Can you play?” He asked in curiosity.

Sirius looked at the tawny-haired boy beside him and nodded, “Mother dearest had a private teacher give Regulus and I lessons since I was five.”

At the look upon Remus’ face, which frequented whenever he spoke of his previous home life, he shakes his head. “I don’t play too often anymore, but I’ll make an exception for you.” He continued with a wink.

Remus chuckled exasperatedly, with a shake of his head, worry seeming to bypass for the moment. He stared silently at Sirius, watching as pale hands rested upon the ivory keys and began following the scale, then began playing the melody of the chorus. 

“You will never sleep alone. I'll love you long after you're gone, and long after you're gone, gone, gone.” Sirius sang softly, and it was Remus’ turn to be surprised. How much of the lyrics has he memorized? Enough he supposes, given that he had apparently forgotten to cast the silencing charm on his bed. 

When you fall like a statue, I'm gon' be there to catch you. Put you on your feet, you on your feet.

And if your well is empty, not a thing will prevent me. Tell me what you need, what do you need? “I surrender honestly, you've always done the same for me.” He continued, increasing the tempo of the piece as the chorus nears once again as he looks back to Remus with a smile and encouraging nod. Sing with me. His look said, and honestly, when has he ever said no? Or wanted to? 

“So I would do it for you, for you. Baby, I'm not moving on, I'll love you long after you're gone.” They sang in unison, voices melding together in a harmony that seemed rather perfect. Remus carried the melody as a guide as Sirius continued the rhythm. 

For you, for you. “You will never sleep alone. I'll love you long after you're gone, and long after you're gone, gone, gone.”

It was as if they were being pulled by a string, Remus found himself ever closer to the warmth that Sirius always provided. With a short pause, Sirius pulled his hands away and pulled Remus ever closer, shifting himself in the process.

You’re my backbone you're my cornerstone. You're my crutch when my legs stop moving.

You're my head start, you're my rugged heart. You're the pulse that I've always needed.

Like a drum, baby, don't stop beating. Like a drum, baby, don't stop beating.

With Sirius now flush behind him, Remus couldn’t help but blush, yet he did not pull away. It was warm and comfortable within his friend’s arms, and he found himself never wanting to leave Sirius’ embrace. He could hear his heart beating in his ears, and felt the fast pace of Sirius’ own heart.

Remus hesitantly reached down, and took hold of Sirius’ hands, intertwining their fingers. Just to see how he’d react. When he didn’t pull away, he sighed in relief and lifted their hands so that they rested together upon the keys.

Turning to look behind him, he saw the soft smile upon Sirius’ face. And he knew. That smile, it was only for him. He found himself mirroring it unconsciously, “Sirius…”

“I know Re,” He said softly, almost in a whisper. “Come on, we’re almost there. Want to sing this?” Remus nodded in reply, and turned back to the keys as he began to play again, Sirius’ hands never leaving his own.

As the song began nearing its end, Remus began to relax leaning back slightly into the warm weight behind him, causing Sirius to chuckle fondly. What the tawny-haired boy didn’t know, was that he had been watching him as he sang with a smile. 

Teasing from James be damned, he knew he was in love with Remus. And from the way Remus’ head leaned against his own, intertwined fingers tightening as the tempo began to slow, after placing a kiss upon his flush cheeks, he didn’t doubt that Remus felt the same.

Like a drum, baby, don't stop beating. Like a drum my heart never stops beating for you. 

And long after you're gone, gone, gone. I'll love you long after you're gone, gone, gone.

.

Tag List:

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@fleetingpieces​ 

@wonder-womans-ex​

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[srijitapaul12]

Causes and Treatment: Pregnancy Loss

The death of an unborn baby(fetus) at any point during pregnancy is known as pregnancy loss. Pregnancy loss will happen in 1 out of every 4 pregnancies. The majority of pregnancies end in the first trimester. The mother is always aware that she is pregnant because it occurs too early.

The Factors Which Contribute To Pregnancy Loss

It's important to identify the causes before beginning a pregnancy so that miscarriage can be avoided. Problems with genes or chromosomes account for almost half of all early pregnancy losses. Other factors, however, may also play a role. It is rare that it is caused by something the mother did.

The following are some of the factors that may play a role:

High blood pressure or diabetes in the mother

Trauma or injury

Lupus is an example of an autoimmune disease. The body produces antibodies against its own natural tissues as a result of these. antiphospholipid antibody syndrome is another autoimmune condition.

Infection caused by germs. CMV, mycoplasma, chlamydia, ureaplasma, listeria, and toxoplasma are examples of these diseases.

Obstacles in the uterus Scar tissue within the uterus, an abnormally formed uterus, or fibroids are sources.

Your chances of getting a miscarriage are influenced by a number of factors. It can be difficult for your doctor to pinpoint the precise cause of your pregnancy termination.

Preventing Pregnancy Loss Solutions

This can be avoided if the mother is aware of the problem from the beginning and receives prompt treatment.To assist you in getting the most out of your visit with your healthcare provider.

Mothers should live a balanced lifestyle and consume nutritious foods, as well.

Surgical care is also usable; hysteroscopy could be used to extract fibroid from the uterus.

The loss of a baby at any stage of pregnancy can be traumatic emotionally and physically for the mother and other family members. The importance of family counselling and support cannot be overstated.

As increase their folic acid intake to reduce the risk of miscarriage.

Dr. Deborjyoti Pal is a male gynaecologist in Dunlop who can treat people suffering from some kind of pregnancy-related issue. A doctor should be consulted before deciding on any medical condition since they will give the best advice.

For more Information follow us on: drdeborjyotipal.com