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Early pregnancy bleeding

Early pregnancy bleeding refers to bleeding before 24 weeks of gestational age. Complications may include hemorrhagic shock. Concerns are increased in those who have had a loss of consciousness, are short of breath, or have pain in their shoulder. Common causes include threatened miscarriage. Most miscarriages occur before 12 weeks gestation age. Other causes include implantation bleeding, gestational trophoblastic disease and cervical cancer. Tests to determine the underlying cause include a speculum examination, hCG. Treatment depends on the underlying cause. If tissue is seen at the cervical opening it should be removed. In those in who the pregnancy is in the uterus and who have fetal heart sounds, watchful waiting is appropriate. Anti-D immune globulin is recommended in those who are Rh-negative. Surgery is required. About 30% of women have bleeding in the first trimester. Bleeding in the second trimester is less common. About 15% of women who realize they are pregnant have a miscarriage. Ectopic pregnancy occurs in under 2% of pregnancies.

The differential diagnosis depends on whether the bleeding occurs in the first trimester or in the second/third trimesters. Obstetric causes of first trimester bleeding include the following: Early pregnancy loss refers to the natural death of an embryo before it is able to survive independently, it is associated only with heavy bleeding. However, patients remain hemodynamically stable. Threatened early pregnancy loss considered a type of early pregnancy loss, refers vaginal bleeding in the presence of an intrauterine pregnancy and a closed cervix; the presence of fetal heart rate determines whether the pregnancy will progress to a viable outcome. Ectopic pregnancy refers to a pregnancy outside the uterus in the fallopian tube, it is a more serious cause of early pregnancy bleeding. Ectopic pregnancies can rupture. Implantation bleeding involves a small amount of bleeding that may occur 10 to 14 days after implantation of the fertilized egg. However, there is little evidence to support the existence of such bleeding.

Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, the uterine wall. It is the most common cause of first trimester bleeding. Gestational trophoblastic neoplasia, which refers to pregnancy-related tumors that be either cancerous or non-cancerous; this cause is rare with non-cancerous gestational trophoblastic neoplasia found in 23 to 1,299 cases per 100,000 pregnancies and cancerous forms with a 10-fold lower incidence. Obstetric causes of second/third trimester bleeding include the following: Bloody show refers to the passage of a small amount of blood or blood-tinged mucus resulting from labor or cervical weakness. Abortion, see above. Placenta praevia or vasa praevia refers to the placenta or fetal blood vessels covering or being located close to the opening of the uterus. More than half of women affected by placenta praevia % have bleeding before delivery. Vasa praevia occurs in about 0.6 per 1000 pregnancies. Placental abruption involves the separation of the placental lining from the uterus of the mother.

It occurs most around 25 weeks of pregnancy. Uterine rupture is a when the muscular wall of the uterus tears during childbirth or, less during pregnancy. Nontubal ectopic pregnancy refers to an ectopic pregnancy that occurs occurs in the ovary, cervix, or intra-abdominal cavity. Other causes of early pregnancy bleeding include the following: Postcoital bleeding, vaginal bleeding after sexual intercourse that can be normal with pregnancy. Iatrogenic causes, or bleeding due to medical treatment or intervention, such as sex steroids, anticoagulants, or intrauterine contraceptive devices. Vaginal or cervical bleeding, which may arise from many causes including fibroids, warts, vaginitis, or trauma; these causes may co-occur with other causes of early pregnancy bleeding. Lower genitourinary tract bleeding, which may result from a urinary tract infection, strenuous exercise, or bladder cancer. Early pregnancy bleeding is from a maternal source, rather than a fetal, one; the maternal source may be a disruption in the vessels of the decidua or a lesion in the cervix or vagina.

Vasa praevia is a rare condition. The initial evaluation of early pregnancy bleeding involves physical examination; the relevant history includes determining the gestational age of fetus and characterizing the bleeding. Bleeding, at least as heavy as menstrual bleeding or associated with clots, lightheadedness, or pelvic discomfort is associated with increased risks of ectopic pregnancy and spontaneous abortion. Discomfort in the middle of the abdomen is more associated with spontaneous abortion. Risk factors for ectopic pregnancy or spontaneous abortion should be considered; the physical examination includes assessing vital signs and performing an abdominal and pelvic examination. Signs of hemodynamic instability or peritonitis require emergent intervention. A pelvic examination may reveal non-obstetric causes of bleeding such as bleeding from the vagina or cervix, it may demonstrate visible products of conception suggestive of an incomplete abortion. If the person is stable and a pelvic exam is unrevealing, ultrasonography a

Itamar Moses

Itamar Moses is an American playwright and television writer. Moses grew up in a Jewish family in Berkeley, earned his bachelor's degree at Yale University, his Master of Fine Arts degree in dramatic writing from New York University, he has taught playwriting at both Yale and New York University, he has written for Men of a Certain Age and Boardwalk Empire. His most prominent work, the musical The Band's Visit, opened on December 8, 2016 at the Atlantic Theater Company; that production won the 2017 Obie Award for Musical Theatre Off-Broadway. After closing on January 9, 2017, the musical moved to Broadway, it began previews on October 7, 2017 and opened on November 9, 2017 at the Ethel Barrymore Theatre. For his work on The Band's Visit, Moses won the 2018 Tony Award for Best Book of a Musical. Dorothy and Alice, world premiere at the Manhattan Theatre Source, January 2001 Bach at Leipzig, world premiere at the Hangar Theatre in Ithaca, New York, July 2002. Outrage, world premiere at Portland Center Stage, 2003.

Workshop at Just Add Water: A Playwright's Festival in 2001. Authorial Intent and Idea, world premiere as a double-bill at Manhattan Theatre Source, New York, April 2005 Celebrity Row, world premiere at Portland Center Stage, March 2006 The Four of Us, world premiere at the San Diego Old Globe Theatre, February 3, 2007 Szinhaz, world premiere at the Duke Theater, New York City, April 2007 Yellowjackets, world premiere at Berkeley Repertory Theatre, September 2008 Back Back Back, world premiere at the San Diego Old Globe Theatre, September 2008 Love/Stories, world premiere at the Flea Theater, New York City, February 2009 Completeness, world premiere at South Coast Repertory Theatre, April 17, 2011 Nobody Loves You, co-written with Gaby Alter. New York: Faber and Faber, 2005; the Four of Us. New York: Faber and Faber, 2008. Internet Off-Broadway Database Outrage at Google Books Review of Outrage at Review of Bach at Leipzig at

Delovak Athara

Delovak Athara is a 1966 Sri Lankan drama film directed by Dr. Lester James Peries, the screen play dialog and script by Dr. Tissa Abeysekara; the film stars Tony Ranasinghe and Suvineetha Weerasinghe in lead roles along with Jeevarani Kurukulasuriya and Wijeratne Warakagoda. Peries developed the movie as a character study utilizing a single incident to provide insight into the newly rich society of Sri Lanka in the time period, it proved to be his most successful film up to that time, surpassing Gamperaliya in box office earnings. It was a critical success, winning praise from Sinhala critics like Philip Cooray and making the rounds at European film festivals, including the Valladolid Film Festival in Spain. At the onset of the film, Nissanka is engaged to marry a woman of the same social class. Nissanka asks Shiranee who politely declines, he meets an old friend Chitra. They rekindle their friendship and Nissanka offers a ride home. Chitra agrees and they set off only to accidentally hit and kill a pedestrian.

The two now have a large secret. Nissanka's family subsequently attempts to cover up the murder. Chitra doesn't give Nissanka up the police, she urges him to turn himself in. Meanwhile, mounting tensions and conflicts exacerbate the tense situation, making Nissanka's life unbearable. Tony Ranasinghe as Nissanka Wijesinghe Suvineetha Weerasinghe as Chitra Karunaratne Jeevarani Kurukulasuriya as Shiranee Gunasekara Iranganie Serasinghe as Clara Wijesinghe, Nissanka's mother J. B. L. Gunasekera as Herbert Wijesinghe, Nissanka's father Winston Serasinghe as Francis Gunasekara, Shiranee's father Somapala Dharmapriya as Martin Sujatha Jayawardena as Mrs. Gunasekara, Shiranee's mother Wijeratne Warakagoda as Police Inspector Kithsiri Perera as Asoka Nawanandana Wijesinghe as Drunk witness Thilakasiri Fernando as Andiris'Appu' Sunila Abeysekera as Chitra's niece Premini Gunaratne as Chitra's sister G. W. Surendra as Office newspaper reader Shirani Gunathilaka as Drama performer Sujatha Paramanathan as Drama performer Shirani Kurukulasuriya as Drama performer Lillian de Abrew as Drama performer Shanthi Lekha as Accident victim's Amma Asoka Peiris as Factory walker Wickrama Bogoda Tissa Abeysekara Bernard Ranasinghe Elson Divithuragama Delovak Athara on IMDb

New Rose

"New Rose" is the first single by British punk rock group the Damned, released on 22 October 1976 on Stiff Records, in 1977 in the Netherlands and France. It is considered to be the first single by a British punk group. Written by guitarist Brian James, "New Rose" was included on the group's full-length debut album, Damned Damned Damned; the deadpan intro by singer Dave Vanian parodied the 1964 Shangri-Las song "Leader of the Pack". The single's B-side was a cover of the Beatles' hit "Help!", performed about twice as fast as the original. Both songs became staples of the Damned's live shows, appeared on various compilations. "New Rose" was reissued in Stiff's Damned 4 Pack mail-order set. Original copies had a press-out centre. Copies from the four-pack had matrix details: ""AY 50332" printed. A CD version was issued in the Stiff Singles 1976–1977 boxed set by Castle Music in 2003. "Help!" appeared on Hits Greatest Stiffs. The song was produced by Nick Lowe, it was recorded at Pathway Studios in London, recorded in one day, according to drummer Rat Scabies. and "Nick Lowe may have taken an extra day to mix it".

"New Rose" was released on 22 October 1976. James stated that Captain Sensible wanted the song "I Fall" as the first single. Sensible said that "I Fall" would have been "even more gobsmacking because it's so snotty and fast". In a retrospective review in 1992, music critic Dave Thompson heaped praise on the single:'New Rose' is today rightly revered as one of the greatest songs to emerge from 1970s Britain. More than anything outside of the Pistols,'New Rose' brought a focus to the still burgeoning punk scene lifting it out of the musical basket it had hitherto shared with the Stooges/Dolls/MC5 axis, knocking the Feelgoods and Hot Rods-powered pub rock angle clean out of sight; this was no high octane R&B revival. Rather, it was the absolute redefinition of all that rock'n' roll held dear, a stunning return to basics which threw every last iota of expertise and experience to the winds; the band's detractors thought they were smart when they called the Damned's record'primitive.' They were way off the mark – the Damned's fans saw it as primeval.

Guns N' Roses covered the track on their 1993 covers album The Spaghetti Incident?. When asked about the Guns N' Roses cover, Damned guitarist Captain Sensible said that he had not heard it because he does not listen to music released after 1980; the song was released as a promo single in 1993. Rachel Sweet covered the song on her 1980 album Protect the Innocent. "New Rose" – 2:46 "Help!" – 1:43 Producer: Nick Lowe Musicians: Dave Vanian − vocals Brian James − guitar Captain Sensible − bass Rat Scabies − drums Sources

The Stone Flower

"The Stone Flower" known as "The Flower of Stone", is a folk tale of the Ural region of Russia collected and reworked by Pavel Bazhov, published in Literaturnaya Gazeta on 10 May 1938 and in Uralsky Sovremennik. It was released as a part of the story collection The Malachite Box. "The Stone Flower" is considered to be one of the best stories in the collection. The story was translated from Russian into English by Alan Moray Williams in 1944, several times after that. Pavel Bazhov indicated that all his stories can be divided into two groups based on tone: "child-toned" with simple plots, children as the main characters, a happy ending, "adult-toned", he called "The Stone Flower" the "adult-toned" story. The tale is told from the point of view of the imaginary Grandpa Slyshko; the Moscow critic Viktor Pertsov read the manuscript of "The Stone Flower" in the spring of 1938, when he traveled across the Urals with his literary lectures. He was impressed by it and published the shortened story in Literaturnaya Gazeta on 10 May 1938.

His complimenting review The fairy tales of the Old Urals. After the appearance in Literaturnaya Gazeta, the story was published in first volume of the Uralsky Sovremennik in 1938, it was released as a part of Malachite Box collection on 28 January 1939. In 1944 the story was translated from Russian into English by Alan Moray Williams and published by Hutchinson as a part of the collection The Malachite Casket: Tales from the Urals; the title was translated as "The Stone Flower". In the 1950s translation of The Malachite Casket was made by Eve Manning The story was published as "The Flower of Stone"; the story was published in the collection Russian Magic Tales from Pushkin to Platonov, published by Penguin Books in 2012. The title was translated by Anna Gunin as "The Stone Flower"; the main character of the story, Danilo, is a weakling and a scatterbrain, people from the village find him strange. He is sent to study under the stone-craftsman Prokopich. One day he is given an order to make a fine-molded cup.

It turns not beautiful enough for Danilo's liking. He is dissatisfied with the result, he says that the simplest flower "brings joy to your heart", but his stone cup will bring joy to no one. Danilo feels. An old man tells him the legend that a most beautiful Stone Flower grows in the domain of the Mistress of the Copper Mountain, those who see it start to understand the beauty of stone, but "life loses all its sweetness" for them, they become the Mistress's mountain craftsmen forever. Danilo's fiancée Katyenka asks him to forget it, he finds the Mistress of the Copper Mountain. He begs her to show him the Flower; the Mistress reminds him of his fiancée and warns Danilo that he would never want to go back to his people, but he insists. She shows him the Malachite Flower. Danilo goes back to the village, destroys his stone cup and disappears. "Some said he'd taken leave of his senses and died somewhere in the woods, but others said the Mistress had taken him to her mountain workshop forever". The main character of the story, Danilo the Craftsman, was based on the real miner Danila Zverev.

Bazhov met him at the lapidary studio in Sverdlovsk. Zverev grew up and spent most of his life in Koltashi village, Rezhevsky District. Before the October Revolution Zverev moved to Yekaterinburg. Bazhov created another skaz about his life, "Dalevoe glyadeltse". Danila Zverev and Danilo the Craftsman share many common traits, e.g. both lost their parents early, both tended cattle and were punished for their dreaminess, both suffered from poor health since childhood. Danila Zverev was so short and thin that the villagers gave him the nickname "Lyogonkiy". Danilo from the story had another nickname "Nedokormysh". Danila Zverev's teacher Samoil Prokofyich Yuzhakov became the source of inpisration for Danilo the Craftsman's old teacher Prokopich. During Soviet times, every edition of The Malachite Box was prefaced by an essay by a famous writer or scholar, commenting on the creativity of the Ural miners, cruel landlords, social oppression and the "great workers unbroken by the centuries of slavery".

The scholars focused more on the relationship of the characters with nature, the Mountain and the mysterious in general. Maya Nikulina comments that Danilo is the creator, free from all ideological and political contexts, his talent comes from the connection with the secret force. Moreover, the local landlord, while he exists, is unimportant for Danilo's story. Danilo's issues with his employer are purely aesthetic, i.e. a custom-made vase was ordered, but Danilo, as an artist, only desires to understand the beauty of stone, this desire takes him away from life. The Stone Flower is the embodiment of the absolute magic power of stone and the absolute beauty, beyond mortals' reach. Many noted that the Mistress' world represents the realm of the dead, emphasized not only by its location underneath the human world but mostly by its mirror-like, imitation or negation of the living world. Everything looks strange there the trees are