My life after five years from now Free Essays

I am an adolescent who have just completed high school and has started attending college. My academic progress is satisfactory and I am getting good grades. By nature I may be considered a shallow person who takes things rather lightly. We will write a custom essay sample on My life after five years from now or any similar topic only for you Order Now I don’t go much deeper into any problem to really comprehend it. Although, I am gregarious and fun loving, basically I am an introvert and I keep my personal life sheltered as I don’t take people into confidence easily. I have a weak personality and lack self confidence. To camouflage this, I always try to be over friendly and talkative with my friends. But deep down, I don’t trust my friends and never share my innermost thoughts with them. If things don’t work out according to my expectations, I become a recluse, and refuse to discuss it with anyone. My outlook is conservative and can not accept any open show of affection easily. Fear of the unknown, fear of failure has totally blinded my vision and obstructed my rational thinking capacity. Although I am well aware of my drawbacks, I am unable to change for the better. Currently my vision about life is blurred by my short sightedness and lack of wisdom and experience. I would like to change these negative attributes and enhance my personality. The vision of my life five years from now is a complete transformation of my personality. I’ll accept my friends as they are and respect them as an individual. I’ll take some of my friends into confidence and share my problems and successes with them. I’ll always listen to their point of view before taking any difficult decision. I’ll shed my pessimistic and gloomy attitude and encounter any problem with a positive mind. I’ll acknowledge my fear, will analyse it and make a conscious effort to eliminate it from my system, in a slow but determined way. This negative personality trait affected me greatly and prevented me from taking right kind of decisions at the right moment. I’ll overcome fear with double determination and become a person with an independent personality, who can take right kind of decision at the right moment, and can dream, believe and act towards realising his cherished goal. Career-wise I have not thought of any particular profession which I would like to pursue within the course of next five years. While I’ll concentrate on my studies to ensure good grades, on spare times I would do odd jobs to earn some extra money. Since travelling excites me a lot, I would take up part time job in travel agencies such as tourist guide or interpreter which will take me to exotic tourist places. While accompanying the tourists, I’ll visit beautiful islands, see exotic landscapes of steep mountains, and lush green vegetations. Sometimes I’ll lie down in solitude on a sandy beach, and gaze at the blue azure sky. Associating with nature will give me a clear perspective on life and what it holds. I’ll shed my superficial self and emerge a more genuine person who will appreciate anything from beauty of nature to the beauty of a girl from aesthetic sense. This will help me to get into a permanent relationship, which till now is eluding me. I want to confidently go in the direction of my goal of transforming my personality within five years from now. Only time will tell how far I’ll be successful in changing my negative personality traits and become a person who is honest with himself and with others and have emotional strength, integrity of character, clarity of mind and confidence in others. If I fit the personality mentioned above within five years from now, my goal of personal transition will become a reality. Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   Â   How to cite My life after five years from now, Essay examples

Visual Impairment Essay Example For Students

Visual Impairment Essay Vision ImpairmentsPeople catergorized as visually impaired range from individuals with mild visual losses to those with low vision to those who are totally blind (Winzer,370). Vision impairments does not necessarily mean a total loss of sight. Some visually impaired person can detect light, others can see shapes and forms, and others can see nothing at all. Generally, many different problems that interfere the retina to form image or the transmission of retinal images to the brain can cause blindness or vision impairment. It can be heredity or caused by disease or damage after birth. In some cases a specific reason cannot be determined. There are four major types of vision impairments. The first type are refractive errors. It is cause by the change of shape or size of the eyeball, conera or the lens. Myopia (short-sighted) and hyperopia (long-sighted) are two common examples. People with myopia or hyperopia cannot focus image accurately on the retina. Another example is astigmatism, it is caused by the abnormal curve shape of the cornera or the lens. And it can cause distorted or blurred vision. The second type are ocular motor problems. It is caused by irregular movement of the ocular muscles that control the movement of the eyeballs. It leads to the inability for the eyes to control focusing objects. Strasbismus is an example. This condition effects about 2 percent (2 out of 100) of all young children. Strabismus is a lack of coordinated muscle movement or focusing ability between the eyes, causing the eyes to point in different directions. One or both eyes may turn inward (crossed eyes) or outward (walleye). The eyes, the brain area that controls vision, and the muscles attached to the eyeball are involved. It result in the child that looks in certain directions, double vision (sometimes), vision in one eye only, with loss of depth perception. Strabismus can affect both sexes, all ages, but it usually begins during early childhood, frequently before age 5. If not corrected through therapy or surgery, crossed eyes can result in permanent loss of vision. The third type are eye diseases, it is caused by damage or disease before or after birth to one or more structure of the eye (Winzer, 374). One off the most common causes of blindness is cataracts. Cataracts are a clouding of the lens of the eye that keeps light from reaching retina. Resulting in badly blurred vision, double vision, sensitivity to bright lights and change in color vision. One eye is often more seriously affected than the other. It may be cause by chemical change in the lens. The exact cause is still unknown, but there are many factors that can accelerate cataract formation.These include an injury, either from a blow to the head or direct eye injury, other diseases exposure to radiation of any kind (x-rays, microwaves, or infrared rays) long-term use of a corticosteroid drug. A child may be born with cataracts or develop them at an early age. These cataracts, called congenital cataracts, may be caused by a genetic disorder such as down syndrome or from a condition the mother had during pregnancy such as German measles. The fourth type are other defects such as color blindness, photophobia or albinism. Color blindness is a inherited vision disorder which is often found in male rather than in female. Persons who have color blindness do not have one of the three cone cells which are responsible for receiving either blue, green and red. Therefore, people with color blindness are likely to confuse with red and green. But the condition is not serious enough to connect with visual impairments. Albinism is a hereditary disease. It must be pass thorugh from both parents, each of whom either has albinism or is a carrier of that trait. Albinism affects the production of melanin(Winzer,379). A lack of melanin in the retina, iris and choroid will cause the pupil to become in deep red color, the iris will become in grey, light blue or pink. A person with albinism will also suffer from photophobia, which is the extreme sensitivity to light. Bright light may decreases the persons visual acuity and may blinds the p ersons with albinism.

South Africa Essays (926 words) - South Africa, Africa, Xhosa People

South Africa South Africa is a place of hurt, heart, and change. Over the years, South Africa has either been through rough times in the traditional tribal part, or being descriminated because of their color of skin. South Africa has two major tribal groups; The Nguni/South Ndebele, and the khoi/San. The South Ndebele, together with the Zulu, Xhosa and Swazi, belong to the South Nguni ethnic group. In the case of the South African Ndebele group, the area is the Southern part of South Africa. Here, they have lived, worked on farms, and hunted for generations. They are a very communal tribe. They work together, share together, help each other out, and hunt with each other. This group is very dependent on all of their family. On the other hand the Khoi/San group is the complete opposite of the Nguni/South Ndebele. They live in the Kalahari Desert, they are Nomadic, and rely on livestalk to live. They might be more Independent then the Nguni, but they still get alittle help from their families too. Like they go hunting together. Unlike the Nguni the Khoi/San use poisoned arrows to kill their livestalk.Little did these groups know what they were going to be going through the next 300 years; colonialism. In 1652 South Africa was forever changed when Dutch established a rest stop in South Africa.Apartheid also unofficially started. At that time, the area was occupied by the Khoi/San clans. The pressure on the Khoi/San increased as more Dutch and French settlers arrived. By the 18th century, most Khoi/San had lost their land to these European settlers. Cape Town became a major port as a way station for the Europeans. The colonists were mostly farmers and cattle herders. They became known as the Boers. They developed their own culture and language (Afrikaans). In the 1770's, the Boers encountered the Bantu, who were migrating. The Nguni Bantu clans settled between the Drakensberg Mountains and the sea. The Sotho clans settled in the interior, north of the Cape Colony. The 19th century competition for land led to the conflict between the Bantu clans, which led to the boer war, 1899-1902. Hundreds and thousands died during the wars, entire clans disappeared and it resulted in the creation of many Bantu nations. Now they are unable to communicate with each other, and now they don't have any power to stop the Europeans. British forces twice occupied the Cape region, in 1795 and 1806. In 1814, toward the end of the Napoleonic Wars, Great Britain purchased the Cape Colony from the Dutch for 6 million Britidh pounds. After 1820 thousands of British colonists arrived in South Africa, and they demanded that English law be imposed. English became the official language in 1822. The Khoi/San were given protection, and slavery was abolished in 1833. When the Dutch, or the Afrikanns found out that slavery was ebolished they got angry, because they thoght that the Bilble said that black people were supposed to be slaves, which then created the Boer war. It is now 1948, the Europeans have now taken over South Africa. Four Years earlier a man named Nelson Mandela became a lawyer, and joined the A.N.C. so he could help the salvaging African people. Even though he played a very important roll in Apartheid, colonialism, and their human rights, that still didn't stop the Europeans from torturing them for the next 46 years. Nelson Mandela was a nice man, but in 1956 Mandela went on trial for treason, but was acquitted in 1961. During this time he married Nkosikazi Nomzamo Madikizela. He was again arrested in August of 1962, he was sentenced to five years in prison. While in prison, Mandela, along with several others, was convicted of sabotage and treason and in June 1964 was sentenced to life imprisonment. During this period Mandela became a worldwide symbol of resistance to white domination in South Africa. In prison he acted nice to everybody. When an Officer told him to do something, he politely answered Yes sir, but he did this for a reason. He did that so the officers could feal the guilt for what they have been doing to all the black people. The goverment soon got pressured by the people to let

Trials and Verdicts

Trials and Verdicts The important result of the legal decision-making process is the verdict which can end the trial process and state the form of punishment for the convicted person.Advertising We will write a custom research paper sample on Trials and Verdicts specifically for you for only $16.05 $11/page Learn More However, to understand the details related to interpreting the cases and law and to stating the verdict, it is necessary to analyze the processes related to different courts according to their jurisdiction, and to focus on the real-life examples in order to discuss the problems of accepting a plea bargain and of being wrongly accused. The question of the court’s jurisdiction is discussed when it is necessary to select which court can decide on the certain case appropriately. Following the Felkner v. Jackson case, it is possible to state that different courts are effective to discuss concrete issues and decide on the aspects of the case, but the process of t he case resolution can be rather long and complicated. In 2011, Steven Frank Jackson was convicted of many sexual offenses. However, Jackson referred to the Batson v. Kentucky case, and focused on the issue of racism in relation to the California jury who discussed the case. Jackson’s petition was accepted and examined by the California Court of Appeal, and then the California Supreme Court decided according to the court’s jurisdiction to reject the necessity of the case’s review (Felkner v. Jackson, 2011). Nevertheless, the case was not unresolved even in relation to the Federal District Court. In this situation, the Supreme Court took the jurisdiction to provide the decision, and the previous courts’ decisions were defined as unreasonable. Finally, it is stated by the Supreme Court of the United States that the petition â€Å"for certiorari and the motion for leave to proceed in forma pauperis are granted. The judgment of the Court of Appeals for the N inth Circuit is reversed, and the case is remanded for further proceedings consistent with this opinion† (Felkner v. Jackson, 2011). As a result, it is possible to note that the decision to discuss the case in the Supreme Court of the United States is appropriate because of the necessity to resolve all the controversial points of the case which cannot be resolved in the other courts.Advertising Looking for research paper on constitutional law? Let's see if we can help you! Get your first paper with 15% OFF Learn More The cases when the defendant accepts a plea bargain as an alternative to trial are also very controversial and complicated because this decision can be associated with a kind of pressure from attorneys and prosecutors. Furthermore, the defendant can change his or her decision during the process. Thus, to discuss the question in detail, it is necessary to focus on the Freeman v. United States case (2011). William Freeman was convicted of dif ferent crimes associated with drug trafficking and drug delivery. However, Freeman decided to develop the plea agreement under Fed. R. Crim. P. 11(c)(1)(C). The agreement meant that Freeman could plead guilty depending on receiving a specific sentence. The case was rather complicated, and it was decided in 2011 that referring to 18 U.S.C.  § 3582(c)(2), the sentence could be reduced â€Å"for the offense to which the defendant pled guilty† (Freeman v. United States, 2011). In spite of the fact that the plea agreement does not mean the alternative to the trial, the case is important to be discussed to decide whether or not justice was served. Referring to this concrete case, it is possible to state that the justice was served because the severity of crimes should be taken into account every time when the possibility of the plea agreement is discussed. The most problematic cases are those ones in which defendants are wrongly accused and later vindicated. One of the most famou s cases is the case associated with the famous sportsman Brian Banks who was convicted of raping Wanetta Gibson. Brian Banks accepted a plea bargain because of the threat to be imprisoned for more than 40 years. However, in 2011, it became possible to state that Banks was not guilty, and he was vindicated. The most important aspect to be discussed in relation to the case is the fact that Wanetta Gibson lied during the first trial process in order to receive the significant financial compensation (Powers, 2012). The decision of the court could be different, but the lawyers failed to prove or not Gibson’s words. That is why, these details affected the whole trail process, and Brian Banks had to accept the plea agreement in order to avoid being imprisoned for a long period of time.Advertising We will write a custom research paper sample on Trials and Verdicts specifically for you for only $16.05 $11/page Learn More In spite of the fact, the United State s’ legislative system should contribute to the people’s welfare and protection, there are many controversial verdicts and trials which can influence the statement of the principles of justice in the country. From this point, it is necessary to pay much attention to the controversial aspects and issues discussed during the trial processes in order to resolve cases in the appropriate courts with the focus on their jurisdiction and to avoid the ineffective decisions which can lead to the unalterable consequences. As a result, all the details of the case should be taken into consideration to decide on the person’s guilt and possible verdict. References Felkner v. Jackson. (2011). Retrieved from https://www.supremecourt.gov/opinions/10pdf/10-797.pdf Freeman v. United States. (2011). Retrieved from https://www.supremecourt.gov/opinions/10pdf/09-10245.pdf Powers, A. (2012). A 10-year nightmare over rape conviction is over. Retrieved from https://www.latimes.com/local/l a-xpm-2012-may-25-la-me-rape-dismiss-20120525-story.html

Hospitality Operations Coursework Example | Topics and Well Written Essays - 500 words - 1

Hospitality Operations - Coursework Example Banking on business development also aims at maximizing the quality of services provided to clients. The hospitality industry experiences seasonal fluctuation in client turnout. Products in the industry also tend to be based on determinants that dictate the supply and demand trends in the sector. Tourists, for instance, may visit a region during a given period or depending on climatic conditions. The sales of various products may as well be high during a given event or occasion. This is inclusive of income from a number of tourist attractions that may have peak and off-peak periods. Tourists may visit a park to observe a given behavior of wildlife, e.g., migration, which they portray during a given season. The seasonality in pricing is also prominent in the hospitality industry with variations in demand (Laws, 2005, p. 117). Unlike other industries, customers in the hospitality industry do not acquire physical ownership of the products offered. Being a service industry, customers own the experience that they achieve from the services offered. They do not, notably, own the services offered. Provision of quality service is vital to ensure customers get the best experience. This helps maintain customer loyalty and aids organizations to maintain competitiveness in the industry. Services offered in the tourism industry are nearly perishable and challenging for the time limit available during service provision. This also creates a challenge in achieving harmony between demand and supply constraints. Achieving valuable management of yields is vital in achieving the best performance in the hospitality industry. Setting up complementary services and strategies to boost income during nonpeak demand is essential, as well. Need to Ensure Conformity to Local Needs A strategy by hospitality business to expand operations may meet a number of challenges. Expansion strategies

Hobbes' Leviathan Essay Example | Topics and Well Written Essays - 1500 words

Hobbes' Leviathan - Essay Example The problem, as he sees it, is that there is no overarching 'figure', a being or entity or idea with power to instill awe, to occasion obedience to a greater good beyond the three causes of perpetual war, which he sees as competition, diffidence [fear of attack], and glory [or vanity] [ch13, p2]. Consequently, the lives of people in such a state are famously described as 'solitary, poor, nasty, brutish and short' [ch13, p3]. Hobbes appears to have been influenced in this negative characterization by the civil war raging in England at the time of his writing. He acknowledges that such a state may never have existed 'generally', but that it exists in places where the power to instill awe is absent: Howsoever, it may be perceived what manner of life there would be, where there were no common power to fear, by the manner of life which men that have formerly lived under a peaceful government use to degenerate into a civil war. (ch 13, p4]. More notably, he argues that this state of perpetual conflict exists in societies, such as the native societies of America, where, according to his somewhat distant reading, there are no powers to instill awe and obedience. Hobbes believes that humanity emerges out of this peculiarly solitary, untrusting state - in which justice, being a socially developed concept, does not yet exist (ch13, p4] - through a combination of reason and the passions. Hobbes asserts [somewhat contradictorily] that man's nature, besides being a cause of perpetual conflict with his neighbors, also inclines him to peace: The passions that incline men to peace are: fear of death; desire of such things as are necessary to commodious living; and a hope by their industry to obtain them. And reason suggesteth convenient articles of peace upon which men may be drawn to agreement [ch13, p4]. The 'articles of peace' here mentioned are further developed, in chapters 14 and 15, into nine 'laws of nature'. Of these, Hobbes places the one he considers most important at the head. This law states that 'man ought to endeavour peace' [ch14, p1], as far as he is able to achieve it - and failing this, should seek all the advantages of war. Man's natural diffidence, or fear of attack, as mentioned earlier, would best be assuaged by the creation of a peaceful estate, but if this cannot be created, then a preparedness for war, based on the idea that attack is the best method of defense, is the next best option. Hobbes' second law of nature is central to his idea of man moving out of the state of nature into civil society, in that it involves a willingness to restrict individual liberty. He states it thus: That a man be willing, when others are so too, as far forth, as for peace, and defence of himself he shall think it necessary, to lay down this right to all things, and be contented with so much liberty against other men, as he would allow other men against himself [ch14, p2]. With Hobbes' third law comes the important idea of the covenant - what we nowadays translate as 'ontract'. 'Men perform their covenants made', he writes [ch15, p1]. I take

Anti-tuberculosis Drug-induced Liver Injury (ATLI) Effects

Anti-tuberculosis Drug-induced Liver Injury (ATLI) Effects Abstract Tuberculosis (TB) is world’s deadliest communicable disease, with 9 million incident cases and 1.5 million deaths globally in 2013. Most of the cases of TB were reported from Asian (56%), and African (29%) continents. In Saudi Arabia the annual incidence rate of TB ranged between 14 and 17/100,000. Two provinces, Makkah and Jazan showed the highest incidence around 20/100,000 over the last one decade. Jazan region showed more than double the incidence rate of TB compared to rest of the Southern province. Jazan share border with Yemen, and receives many illegal immigrants. Studies showed that non-Saudi Arabians had 2-3 times higher incidence of TB than Saudi national. The large number of Non-Saudis came from countries with high incidence of TB such as Bangladesh, Pakistan, India, Indonesia, Philippines, Yemen, Ethiopia, Somalia, Chad, Nigeria and other African countries. The active TB patients can be treated safely and effectively through the directly-observed therapy strategy (DOTS). DOTS is a short course of standard anti-TB treatment which consist of taking drug combinations of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol and Streptomycin for 6–9 months. The drug isoniazid, rifampicin and pyrazinamide have the potential to induce liver damage.This anti-tuberculosis drug-induced liver injury (ATLI) ranges from mild to severe forms, and can even be fatal. The incidence of ATLI during standard anti-TB treatment range from 2.0% to 28.0% according to different populations. Moreover, ATLI reduce the efficacy of anti-TB treatment, as they may cause treatment failure, relapse and drug-resistance which could significantly reduce the effects of TB control. To the best of our knowledge, there is no known published data on the incidence of anti-tuberculosis drug-induced liver injury (ATLI) and risk factors from Saudi population. Identification of patients at increased risk for ATLI is important because hepatotoxicity causes significant morbidity and mort ality and may require modification of the therapeutic regimen. The aim of this study will to estimate the incidence of ATLI and the risk factors associated with anti-TB treatment. The findings of this study will allow us to enhance TB treatment, monitoring and control of the TB in KSA. Introduction Tuberculosis (TB) is world’s deadliest communicable disease, with 9 million incident cases and 1.5 million deaths globally in 2013 [1]. Most of the cases of TB were reported from Asian (56%), and African (29%) continents [1]. In Saudi Arabia the annual incidence rate of TB ranged between 14 and 17/100,000 [2]. Two provinces, Makkah and Jazan showed the highest incidence around 20/100,000 over the last one decade [2]. Jazan region showed more than double the incidence rate of TB compared to rest of the Southern province. Jazan share border with Yemen, and receives many illegal immigrants. Studies showed that non-Saudi Arabians had 2-3 times higher incidence of TB than Saudi national. [3]. The large number of Non-Saudis came from countries with high incidence of TB such as Bangladesh, Pakistan, India, Indonesia, Philippines, Yemen, Ethiopia, Somalia, Chad, Nigeria and other African countries. Patients with active TB disease can be treated safely and effectively through the directly-observed therapy strategy (DOTS) which started in 2000. DOTS is a short course of standard anti-TB treatment which consist of taking drug combinations of Isoniazid, Rifampicin, Pyrazinamide, Ethambutol and Streptomycin for 6–9 months [4]. These drugs effectively kills the bacteria but it induced hepatotoxicity known as anti-tuberculosis drug-induced liver injury (ATLI) [5.tostmann 2008]. The ATLI ranges from mild to severe forms, and can even be fatal. The incidence of ATLI during standard anti-TB treatment range from 2.0% to 28.0% according to different populations. [5,6]. The incidence is higher in the developing countries (8% to 39%), compared to developed countries (3%–4%) (7-11). Moreover, ATLI reduce the efficacy of anti-TB treatment, as they may cause treatment failure, relapse and drug-resistance which could significantly reduce the effects of TB control. [5,6]. Many risk factors have been implicated for ATLI. These include older age, female gender, poor nutritional status, pre-existing liver disease, high alcohol intake, hepatitis B, malnutrition, hypoalbuminaemia and advanced TB (12-16). Inappropriate use of drugs, acetylator status, and recently, immunogenetic factor, have also been implicated (17,18). Infections with hepatitis C virus and human immunodeficiency virus (HIV) have also been said to increase the risk (19). It is very important to understand the risk factors of ATLI, in order to detect the adverse events earlier and deliver timely intervention. The identification of high-risk patients would be useful to allow early detection of hepatotoxicity and reduce the morbidity and mortality of this condition. Hence we plan this study to identify the risk factors associated with anti-tuberculosis drug induced liver injury in patients who receive anti-TB treatment. To the best of our knowledge, there is no known published data on the incidence of anti-tuberculosis drug-induced liver injury (ATLI) and risk factors from Saudi population. The aim of this study will to estimate the incidence of ATLI and the risk factors associated with anti-TB treatment. The findings of this study will allow us to enhance TB treatment, monitoring and control of the TB in KSA. 2. PROJECT OBJECTIVES This study aimed to estimate the incidence and risk factors of anti-tuberculosis Drug Induced Liver Injury (ATLI) in patient receiving anti-TB treatment in Jazan population. 1. To estimate the incidence of abnormal liver function tests (LFTs) in patient receiving anti-TB treatment. 2. To identify the risk factors associated with anti-tuberculosis Drug Induced Liver Injury (ATLI) in patient receiving anti-TB treatment. Review of Literature Incidence The first line drugs used to treat TB were isoniazid (INH), rifampicin (RIF), pyrazinamide (PZY) and ethambutol (EMB). Most of the TB patients tolerate the drugs but some develop hepatotoxicity known as anti-tuberculosis drug-induced liver injury (ATLI). [Forget 2006].The ATLI ranges from mild to severe forms, and can even be fatal. Data from the literature shows that the incidence of ATLI is 3.0% in Canada (Asia population accounted for 42%)[Yee 2003], China 2.5% [Shang 2011], 5.0% in Hong Kong[ Chang 2008], 5.3% in Singapore[teleman 2002], 16.1% in Taiwan [Huang 2003], 9.7% in Malaysia [Marzuki 2008],36% in Japan [Ellard 1978], 8-36 per cent in India [Parthasarthy 1986, Mehta 1990], 13% Iran [Baghaei]. The risk of developing ATLI was fivefold for hepatitis C patients, fourfold for HIV positive patients, and 14 fold for patients co-infected with hepatitis C and HIV [Ungo 1998]. The incidence is higher in the developing countries (8% to 39%), compared to developed countries (3%–4%) (7-11). Moreover, ATLI reduce the efficacy of anti-TB treatment, as they may cause treatment failure, relapse and drug-resistance which could significantly reduce the effects of TB control. [5,6]. Definition of ATLI The criteria for the diagnosis of ATLI in the absence of symptoms is elevation of transaminases up to 5 times the upper limit of normal (ULN) and in the presence of symptoms up to three times the ULN or twice the ULN of bilirubin in the blood [Saukkonen 2006]. Mechanism of toxicity Among Isoniazid, rifampicin, pyrazinamide and ethambutol, the first three drugs have the potential for hepatotoxicity with pyrazinamide (PZA) being the most hepatotoxic followed by isoniazid (INH) and rifampicin.[Yee]Rifampicin combined with PZA is more hepatotoxic than with INH.[ Jasmer 2002]Pyrazinamide contributes significantly to acute liver failure [ Durand 1995].The most important adverse effects of isoniazid are hepatic toxicity and potentially fatal drug-induced hepatitis[Nolan 1999], especially when associated with rifampicin. The frequency of occurrence of isoniazid-associated hepatitis depends on age. Other factors linked to a predisposition to isoniazid-associated hepatotoxicity include alcohol abuse, use of illegal drugs and a previous history of liver disease. Clinical features ATLI usually take place in the first 2 months of treatment but it may happen at any time during the treatment period. Clinical and biochemical features of ATLI are difficult to differentiate form viral hepatitis [Mitchell 1976]. The signs and symptoms of ATLI are jaundice, abdominal pain, nausea, vomiting and Weakness. Risk factors for ATLI Many risk factors have been implicated for ATLI. These include older age, female gender, poor nutritional status, pre-existing liver disease, high alcohol intake, hepatitis B, malnutrition, hypoalbuminaemia and advanced TB (12-16). Inappropriate use of drugs, acetylator status, and recently, immunogenetic factor, have also been implicated (17,18). Infections with hepatitis C virus and human immunodeficiency virus (HIV) have also been said to increase the risk (19).