Adenoviruses (members of the family Adenoviridae) are medium-sized (90–100 nm), nonenveloped (without an outer lipid bilayer) viruses with an icosahedral nucleocapsid containing a double-stranded DNA genome. Their name derives from their initial isolation from human adenoids in 1953.
The presentation includes disease, treatment and management.
Adenoviruses (members of the family Adenoviridae) are medium-sized (90–100 nm), nonenveloped (without an outer lipid bilayer) viruses with an icosahedral nucleocapsid containing a double-stranded DNA genome. Their name derives from their initial isolation from human adenoids in 1953.
The presentation includes disease, treatment and management.
BACTERIAL PNEUMONIA BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE SOPOR...Prof Dr Bashir Ahmed Dar
DR BASHIR ASSOCIATE PROFESSOR MEDICINE SOPORE KASHMIR PRESENTLY WORKING IN MALAYSIA TEACHING MEDICAL STUDENTS THE ART OF TREATING PATIENTS SPEAKS ABOUT THE IMPORTANCE OF HISTORY TAKING.MEDICAL STUDENTS AND DOCTORS should probe more deeply WHILE TAKING HISTORY OF A PATIENT as it gives the useful information in formulating a diagnosis and providing medical care to the patient.
summary of Bacterial meningitis
Describe the properties, transmission and pathogenesis of
Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae
as causative agents of meningitis.
BACTERIAL PNEUMONIA BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE SOPOR...Prof Dr Bashir Ahmed Dar
DR BASHIR ASSOCIATE PROFESSOR MEDICINE SOPORE KASHMIR PRESENTLY WORKING IN MALAYSIA TEACHING MEDICAL STUDENTS THE ART OF TREATING PATIENTS SPEAKS ABOUT THE IMPORTANCE OF HISTORY TAKING.MEDICAL STUDENTS AND DOCTORS should probe more deeply WHILE TAKING HISTORY OF A PATIENT as it gives the useful information in formulating a diagnosis and providing medical care to the patient.
summary of Bacterial meningitis
Describe the properties, transmission and pathogenesis of
Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae
as causative agents of meningitis.
Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis.
Anti diabetic medications
Patients who are intolerant of metformin are unlikely to be successful with a third trial of that agent. Empagliflozin, an SGLT2 inhibitor, is considered a second-line choice for patients who are intolerant of metformin. Both sitagliptin, a DPP-4 inhibitor, and liraglutide, a GLP-1 receptor agonist, should be avoided or used with caution in patients with a history of pancreatitis
-Linagliptin is not cleared by the kidney second choice if GFR<35(Stop Metformin)
only liraglutide has been shown to lower the risk of recurrent cardiovascular events and has received FDA approval for this indication
Empagliflozin, an SGLT2 inhibitor, has also been associated with secondary prevention of cardiovascular disease.
Fasting C-peptide levels are markedly elevated in patients with T2DM, but in people with T1DM, C-peptide levels should be low
. TZDs tend to cause fluid retention and should not be used in patients with congestive heart failure
References
ADA
Step up to medicine
Toronto notes
UpToDate
ABFM
Membranous GN
MOST COMMON cause is idiopathic (85%); peak age 30-50; male:female, 2:1
May be secondary to:
Drugs-captopril, penicillamine, gold, mercury, trimethadione, NSAIDS
Infections-malaria (P. malariae), leprosy, schistosomiasis, syphilis, hepatitis B and C, filariasis, hydatid disease and enterococcal endocarditis
Diseases-malignancy (Carcinoma of breast, lung, colon, stomach, and esophagus) melanoma, renal cell CA, SLE, sarcoidosis, diabetes, thyroiditis, sickle cell anemia, Crohn’s disease
Normal Heart
Fist size muscular pump
Pumps 6000 lit of blood daily
Perfuses
tissues with nutrients and
Facilitates
removal of waste products.
Heart diseases
Have severe physiologic consequences
Are leading cause of morbidity and mortality in developed nations
750,000 deaths/ year (In US
Congenital Heart Diseases(CHD)
Are abnormalities of the heart or great vessels that are present at birth.
Majority due to faulty embryogenesis.
Etiology:
Idiopathic (90%)
Genetic associations*
Trisomies, Cri du Chat, Turner syndrome
Viral infections
Congenital rubella*
Drugs and alcohol
Infective Endocarditis(IE)
Is due to bacterial or fungal infection of the heart valves (endocardium).
Characterized by:
Formation of bulky, friable,easily detached and infected vegetations.
Damage to heart Valves and Chorda tendinae
perforation, ulceration, destruction (causes valve dysfunction)
Ischemic Heart Disease
IHD is caused by myocardial ischemia due to
Imbalance between the myocardial oxygen demand and supply from the coronary arteries.
Majority of cases due to
Reduction in coronary artery blood flow caused by
Obstructive atherosclerotic disease.
IHD is also known as Coronary artery disease
Restrictive lung diseases (interstitial lung diseases)
Histological Structure of Alveoli
The wall of the alveoli is formed by a thin sheet of tissue separating two neighbouring alveoli.
This sheet is formed by epithelial cells and intervening connective tissue.
Collagenous , reticular and elastic fibres are present.
Between the connective tissue fibres we find a dense, anastomosing network of pulmonary capillaries. The wall of the capillaries are in direct contact with the epithelial lining of the alveoli.
Neighbouring alveoli may be connected to each other by small alveolar pores (pores of Kohn).
The epithelium of the alveoli is formed by two cell types:
Alveolar type I cells (small alveolar cells or type I pneumocytes) are extremely flattened and form the bulk (95%) of the surface of the alveolar walls.
Alveolar type II cells (large alveolar cells or type II pneumocytes) are irregularly (sometimes cuboidal) shaped.
They form small bulges on the alveolar walls.
Type II alveolar cells contain are large number of granules called cytosomes (or multilamellar bodies), which consist of precursors to pulmonary surfactant (the mixture of phospholipids which keep surface tension in the alveoli low) .
Cilia are absent from the alveolar epithelium and cannot help to remove particulate matter which continuously enters the alveoli with the inspired air. Alveolar macrophages take care of this job. They migrate freely over the alveolar epithelium and ingest particulate matter.
FUNCTIONS OF PULMONARY CELLS
Type I pneumocytes
Permeable to Oxygen and CO2, do not divide
Type II pneumocytes
Reserve cells
secrete pulmonary surfactant
Serve as repair cells
Alveolar macrophages
Phagocytosis
Pores of Kohn (allow passage of Macrophages)
Asthma
A chronic relapsing inflammatory disorder characterized by:
Hyper-reactivity of the respiratory tree to various stimuli leading to
Reversible airway obstruction
Obstruction produced by combination of :
Constriction of bronchial musculature (bronchospasm)
Mucosal inflammation (edema)
Excessive secretion of mucus.
Clinically Manifested by :
Difficulty in breathing (Dyspnea)
Wheeze (a soft whistling sound during expiration)
Difficulty in expiration.
Asthma is:
Episodic and reversible airway disease
Primarily targets the bronchi and terminal bronchioles
MC chronic respiratory disease in children
Two types:
Extrinsic asthma (allergic, atopic)
Intrinsic asthma (non-allergic asthma or idiosyncratic asthma)
Obstructive diseases : Chr.by
Obstruction to airflow out of the lungs
Due to partial or complete obstruction in airway.
Increase in lung compliance and
Decrease in lung elasticity.
Restrictive diseases : Chr by
reduced expansion of lung parenchyma with problems in getting air in the lungs.
Lung compliance is decreased
Elasticity is increased: once air is in the lungs it comes out rapidly on expiration.
Tumors of lung
Malignant tumors of lung
Primary
Metastatic
Metastatic lung cancer
More common* than primary lung cancer.
Breast cancer (MCC)
Renal Cell carcinoma
Choriocarcinomas
Colorectal carcinomas
Appear as: "Cannon Balls” On X rays
Respiratory symptoms most common cause of presentation to family doctor.
Rhinitis = common cold
Sinusitis = inflammation of paranasal air sinuses
Pneumonia , Asthma , Bronchitis
Bronchogenic carcinoma – MC cancer causing death in men and women.
Lungs are the major site of opportunistic infections in immuno-compromised individuals.
Tuberculosis
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
3. Measles : clinical
Koplik's spots : White
spots on red oral
mucosa near the
opening of Stensen
duct.
Look like “grains of
salt”
pathognomonic for
measles
Koplik's spots
4. Measles (Rubeola)
Measles: leading cause of vaccine preventable
death and illness.
The virus is trnasmitted by inhalation of
infective droplets.
Measles is clinically characterized by:
Fever,
Cough, coryza and conjunctivitis (3 C’s).
Mucosal lesions k/a Koplik’s spots and
Rash:
Starts on face and spreads to trunk and
extremities.
Disappears in the same order.
5. Complications
Otitis media
Measles pneumonia (giant cell pneumonia)
Warthin-Finkeldey giant cells in lung
=multinucleated giant cells
Pathognomonic for measles
Subacute Sclerosing Panencephalitis (SSPE)***
Rare but serious complication in
immunocompromised individuals
8. Mumps
Clinically, mumps defined as
acute unilateral or bilateral parotid gland
swelling that lasts for more than two days
with no other apparent cause.
Mumps virus infects salivary gland ductal
epithelial cells
leading to classic signs of mumps :
Parotid gland swelling and pain.
Other features include:
Fever, malaise, headaches
This virus can also spread to other sites:
CNS aseptic meningitis***
Testis and ovary orchitis/ oophoritis
Pancreas pancreatitis
9. Complications
Aseptic meningitis
most common complication** (50% of cases)
CSF findings:
mimics bacterial meningitis
low glucose, high protein, mixed
inflammatory reaction.
neutrophils in first 24 hours; then
lymphocytes
Others:
Orchitis /oophoritis, pancreatitis.
Laboratory diagnosis:
Elevated Serum amylase (salivary gland
inflammation and pancreatitis)
10. Rubella (German Measles)
Also known as 3 day measles.
A mild disease in children and adults; usually
associated with rash.
In pregnant women: rubella is destructive fetal
pathogen.
Children and adults: present with:
painful post auricular and occipital
lymphadenopathy (very characteristic).
fever, arthralgia, and
Rash: begins on head and spreads downward
lasts 3 days
No 3 C’s of Measles
11. Face of adult with
rubella.
Rash of rubella on skin of
child's back
12. Congenital Rubella
Part of the TORCH complex of diseases.
Maternal infection during first 8 weeks high
incidence of congenital anomalies.
Transmission: Transplacental
Clinical findings:
Hearing loss (nerve deafness) **
most common defect.
Congenital heart defects:
PDA
Neurologic problems
mental retardation, microcephaly**
Ophthalmic problems
Cataract**,retinopathy, microphthalmia
14. Case
CC
A 25 year old white male complains of shortness of
breath and ankle edema.
HPI
He also complains of fatigue & chest pain. His
symptoms followed a severe upper respiratory
infection.
PE
Tachycardia, hypotension, low-grade fever, jugular
venous pressure raised; pitting pedal edema; fine
inspiratory rales at both lung bases; mild
hepatosplenomegaly.
Imaging
CXR: Cardiomegaly and pulmonary edema.
Echo: dilated cardiomyopathy with low ejection
fraction
16. Coxsackie virus
Type A : clinical manifestations
Hand-foot-mouth disease*
Herpangina
Aseptic meningitis
Acute hemorrhagic conjunctivitis
Type B: clinical manifestations
Myocarditis *
Pleurodynia (Bornholm’s Disease)
Aseptic meningitis
17. Hand, foot and mouth disease
Caused by Coxsackie type A16.
C/F include:
Ulcer: back of mouth and
Red rash: palm and soles
MC complication: dehydration
18. Myocarditis
Results when myocardium becomes infected.
MCC is Coxsackie virus B (also caused by
adenovirus)
Clinical findings:
Fever, chest pain, cyanosis, tachycardia
, cardiomegaly, EKG changes and
arrhythmia.
May result in cardiac failure.
20. Influenza virus
Influenza: acute, self limited infection of the
upper airways caused by strains of Influenza
virus
Three types of influenza virus A,B and C.
Type A virus : MC pathogen, causes
pandemics and epidemics (most severe form);
infects humans, pigs and horses.
Type B : epidemics
Type C: sporadic cases
21. Influenza virus
Influenza viruses have envelopes containing hemagglutinin
and neuraminidase.
Hemagglutinin : aids in attachment
Neuraminidase: dissolves mucus and facilitates release
of viral particles from infected cells.
The virus capable of altering its surface antigen:
Antigenic drifts:
point mutations resulting in change of antigenecity
of organism
Results in local epidemics.
Antigenic shifts:
involves replacement of H and Neur. through
recombination of RNA segments with those of
animal viruses.
Results in pandemics
New vaccine needed
22. Pathogenesis and disease
Spread
person to person via small particle aerosols
Site of infection
Epithelial cells of the respiratory tract
results in Cell death.
As a result, the efficiency of ciliary clearance
is reduced
Predisposition to secondary bacterial
infections
23. Influenza
Clinical findings:
Fever, chills, myalgia, headache and
nonproductive cough.
Complications:
1. Superimposed bacterial infections
Pneumonia
most common organism: Staph. aureus
2. Reye’s syndrome
24. Rabies
Transmitted to humans by bite of :
skunks, foxes, bats, raccoons, dogs
skunks most common source in U.S.
dog bite most common source in other
countries
May also be contracted by aerosol (bat
caves)
Results in severe encephalitis with increased
excitability of CNS
25. Virus enters CNS by ascending along peripheral
nerves from the wound site.
Initial manifestation:
fever, headache,parasthesias around wound
site .
CNS disease:
Chr by violent muscle contractions and
convulsions following minimal stimuli.
painful spasms of laryngeal and pharyngeal
muscles, frothing at the mouth, hydrophobia
followed by flaccid paralysis, coma, and
respiratory center paralysis.
28. Other RNA viruses
Yellow fever:
C/F: Hepatitis, jaundice, fever, black vomitus
Histological findings: characteristic midzonal
hepatocellular necrosis and apoptotic liver cells
(Councilman bodies).
SARS virus:
First appeared in November of 2002 in Guangdong
province of China.
First transmitted to humans through wild masked palm
civets.
infects lower respiratory tract.
may resolve or progress to severe respiratory
disease.