Paragraph Texts 1 FOR everyone suffering from gout, the excruciating pain he or she feels from the inflammation

could be serious enough to cause moving difficulty and even painful, sleepless nights.
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Heres a guide to the disease, which includes lifestyle changes, exercise and most importantly, medication from Pantai Hospital Kuala Lumpur consultant nephrologist and general physician Dr Foo Siu Mei, to help patients manage their condition better.
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Increased uric acid production in the body and reduced excretion in the urine and intestine, Dr Foo says. The medication, therefore, is three-pronged: Allopurinol is used to reduce uric acid production, probenecid and benzbromarone are used to increase uric acid excretion, and colchicine is a goutspecific medication to relieve pain and inflammation when there is an attack.
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For patients with longstanding chronic gout, the accumulation of uric acid crystals can form in and around joints. Called tophi, in the long run if gout is not managed well, this can cause deformity and eventually destroy soft tissues, bones and joints. Patients also face the risk of kidney failure due to frequent intake of strong painkillers. Deposition of uric acid crystals in the kidneys can damage the kidney too, Dr Foo says.
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For patients with severe gout, exercises should be done in moderation. Rigorous exercise results in muscle breakdown, which further increases uric acid production. Thats why we experience a heavy sour sensation in muscles during rigorous activities, she says. So no strenuous exercise, like a marathon, for them.
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Allopurinol and probenecid are generally safe for long-term use and serious side effects are rare. Their most frequent side effects are allergic rash and diarrhoea. Colchicine may cause diarrhoea and nausea when used in high dosage, Dr Foo says. Read more: Living with gout - Health - New Straits Times

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Types of phrases Noun phrases

Example 1) sleepless night 2) excruciating pain 3) relieve pain 4) strong painkillers 1) are used 2) guide to 3) to relieve pain 4) to help patients 1) she feels 2) their condition better. 1) importantly 2) eventually 3) generally 1) with longstanding 2) 3) 4)

Sources Paragraph 1 lines 3 P1 L1 P3 L13 P 4 L20 P3 L12 P2 L4 P3 L13 P2 L7 P1 L2 P2 L7 P2 L4 P4 L18 P6 L28 P4 L15

Verb phrases

Adjective Adverb

Preposition

To understand punctuation, it is helpful to understand the difference between a phrase and a clause.

I. A phrase is a collection of words that may have nouns or verbals, but it does not have a subject doing a
verb. The following are examples of phrases: leaving behind the dog smashing into a fence before the first test after the devastation between ignorance and intelligence broken into thousands of pieces because of her glittering smile

In these examples above, you will find nouns (dog, fence, test, devastation, ignorance, intelligence, thousands, pieces). You also have some verbals (leaving, smashing), but in no case is the noun functioning as a subject doing a predicate verb. They are all phrases.

II. A clause is a collection of words that has a subject that is actively doing a verb. The following are
examples of clauses: since she laughs at diffident men I despise individuals of low character when the saints go marching in Obediah Simpson is uglier than a rabid racoon because she smiled at him.

In the examples above, we find either a noun or a pronoun that is a subject (bold-print and red) attached to a predicate verb (underlined and purple) in each case: since she laughs at diffident men I despise individuals of low character when the saints go marching in Obediah Simpson is uglier than a rabid racoon because she smiled at him

III. If the clause could stand by itself, and form a complete sentence with punctuation, we call the clause an
independent clause. The following are independent clauses: I despise individuals of low character Obediah Simpson is uglier than a rabid racoon

We could easily turn independent clauses into complete sentences by adding appropriate punctuation marks. We might say, "I despise individuals of low character." Or we might write, "Obediah Simpson is uglier than a rabid racoon!" We call them independent because these types of clauses can stand independently by

themselves, without any extra words attached, and be complete sentences.

IV. Dependent clauses have a subject doing a verb, but they have a subordinate conjunction placed in front
of the clause. That subordinate conjunction means that the clause can't stand independently by itself and become a complete sentence. Instead, the dependent clause is dependent upon another clause--it can't make a complete sentence by itself, even though it has a subject doing a verb. Here are some examples of dependent clauses: since she laughs at diffident men when the saints go marching in because she smiled at him

These clauses simply do not form complete thoughts or sentences by themselves. Those subordinate conjunctions--since, when, and because--cause the listener to expect some extra material. The thought is incomplete. If you walked up to a friend in the dorms and said, "since she laughs at diffident men," and then walked away without adding an independent clause, the friend would be completely baffled. It's important to understand the difference between phrases, dependent clauses, and independent clauses because many punctuation marks--such as commas, semicolons, and colons, require one or the other. Click here to move to subordinate conjunctions to learn more.