1) The study aimed to evaluate saliva as an alternative to blood for detecting HIV antibodies using ELISA tests.
2) Saliva and blood samples were collected from 100 confirmed HIV-positive patients and 100 healthy controls.
3) ELISA tests found HIV antibodies in 99% of saliva samples and 100% of blood samples from HIV-positive patients. The tests found no HIV antibodies in samples from healthy controls, showing the tests were 100% specific.
4) The results demonstrate saliva can accurately detect HIV antibodies and is as effective as blood testing, but is less invasive making it preferable for testing.
THE IMPORTANCE OF SCIENCE AND THE ROLE OF GOVERNMENTS IN THE FIGHT AGAINST TH...Fernando Alcoforado
This article aims to emphasize the importance of using the scientific method in the search for a drug for the cure of people infected with the new Coronavirus and a vaccine to immunize the population, as well as coordinating action by governments to prevent the spread of viruses in order to safeguard the population's health and avoid its harmful effects on the economy.
This study was conducted to understand the status of scabies infection and its
epidemic characteristics in the Korean hospitals. 43 hospitals (86.0%) received the
reports of scabies infection with suspicious or definite diagnosis to infection control
department, implicating continuous increases 14.6% (7/48), 20.8% (10/48), 35.7%
(17/48), 44.1% (21/48), and 56.7% (27/48) in 2010 to 2013 and 35.7% (17/48) in 2014
up to April.
92.0% of the hospitals had the rules and guideline of scabies infection control,
which seemed to be prepared by the recent certifications of medical institutions and
establishment of rules in infection control departments. However, less than half of the
hospitals 44.0% (22/50) prepared the screening system related to scabies during the
admission processes of the patients, 56.7% of the patients had the typical symptoms
related to scabies when they admitted with 47.0% of pruritus, requiring the system to
prevent from the scabies epidemic beforehand
According to an investigation published in The Lancet, people with HIV who maintain low, but still detectable, levels of the virus and follow their antiretroviral regimen have essentially little chance of HIV sexual transmission.
Epidemiology of HIV & AIDS.pptx presentation 2024Motahar Alam
Epidemiology of HIV/AIDS encompasses the study of the distribution and determinants of HIV infection and AIDS-related illnesses within populations. HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immunodeficiency Syndrome), a condition characterized by a weakened immune system, making individuals susceptible to various infections and illnesses.
Key aspects of the epidemiology of HIV/AIDS include:
Prevalence and Incidence: Prevalence refers to the total number of people living with HIV/AIDS within a population at a specific time, while incidence refers to the rate of new infections occurring within a given period. These measures help understand the burden of the disease and its spread over time.
Demographic Patterns: HIV/AIDS affects different demographic groups differently. Factors such as age, gender, race/ethnicity, socioeconomic status, and geographical location can influence susceptibility, access to healthcare, and outcomes. For example, in many regions, young adults and certain minority populations may have higher rates of infection.
Transmission Routes: Understanding how HIV is transmitted is crucial for prevention efforts. HIV primarily spreads through unprotected sexual intercourse, sharing contaminated needles or syringes, and from mother to child during childbirth or breastfeeding. Other modes of transmission include blood transfusions (though rare in regions with screening protocols) and occupational exposure.
Risk Factors: Certain behaviors and circumstances increase the risk of HIV transmission. These include having multiple sexual partners, engaging in unprotected sex, using intravenous drugs, lack of access to healthcare, poverty, stigma, and discrimination. Additionally, structural factors such as laws and policies can influence risk behaviors and access to prevention and treatment services.
Global Distribution: HIV/AIDS is a global pandemic, but its prevalence varies widely between countries and regions. Sub-Saharan Africa remains the most affected, with the highest burden of HIV infections worldwide. However, significant progress has been made in some regions, while new challenges emerge in others, such as Eastern Europe and Central Asia.
Progress in Prevention and Treatment: Efforts to combat HIV/AIDS include prevention strategies such as promoting condom use, harm reduction programs for injecting drug users, pre-exposure prophylaxis (PrEP), and comprehensive sexual education. Antiretroviral therapy (ART) has transformed HIV/AIDS into a manageable chronic condition for many, reducing mortality and transmission rates.
Challenges and Future Directions: Despite significant progress, challenges remain in the global response to HIV/AIDS. These include disparities in access to healthcare, stigma and discrimination, funding gaps, emergence of drug-resistant strains, and persistent barriers to prevention and treatment in certain populations.
33.Vohra P, Jamatia K, Subhada B, Tiwari RVC, Althaf MN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care. 2019 Oct;8(10):3247-3252. doi: 10.4103/jfmpc.jfmpc_767_19. eCollection 2019 Oct. PubMed PMID: 31742150; PubMed Central PMCID: PMC6857402.
THE IMPORTANCE OF SCIENCE AND THE ROLE OF GOVERNMENTS IN THE FIGHT AGAINST TH...Fernando Alcoforado
This article aims to emphasize the importance of using the scientific method in the search for a drug for the cure of people infected with the new Coronavirus and a vaccine to immunize the population, as well as coordinating action by governments to prevent the spread of viruses in order to safeguard the population's health and avoid its harmful effects on the economy.
This study was conducted to understand the status of scabies infection and its
epidemic characteristics in the Korean hospitals. 43 hospitals (86.0%) received the
reports of scabies infection with suspicious or definite diagnosis to infection control
department, implicating continuous increases 14.6% (7/48), 20.8% (10/48), 35.7%
(17/48), 44.1% (21/48), and 56.7% (27/48) in 2010 to 2013 and 35.7% (17/48) in 2014
up to April.
92.0% of the hospitals had the rules and guideline of scabies infection control,
which seemed to be prepared by the recent certifications of medical institutions and
establishment of rules in infection control departments. However, less than half of the
hospitals 44.0% (22/50) prepared the screening system related to scabies during the
admission processes of the patients, 56.7% of the patients had the typical symptoms
related to scabies when they admitted with 47.0% of pruritus, requiring the system to
prevent from the scabies epidemic beforehand
According to an investigation published in The Lancet, people with HIV who maintain low, but still detectable, levels of the virus and follow their antiretroviral regimen have essentially little chance of HIV sexual transmission.
Epidemiology of HIV & AIDS.pptx presentation 2024Motahar Alam
Epidemiology of HIV/AIDS encompasses the study of the distribution and determinants of HIV infection and AIDS-related illnesses within populations. HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immunodeficiency Syndrome), a condition characterized by a weakened immune system, making individuals susceptible to various infections and illnesses.
Key aspects of the epidemiology of HIV/AIDS include:
Prevalence and Incidence: Prevalence refers to the total number of people living with HIV/AIDS within a population at a specific time, while incidence refers to the rate of new infections occurring within a given period. These measures help understand the burden of the disease and its spread over time.
Demographic Patterns: HIV/AIDS affects different demographic groups differently. Factors such as age, gender, race/ethnicity, socioeconomic status, and geographical location can influence susceptibility, access to healthcare, and outcomes. For example, in many regions, young adults and certain minority populations may have higher rates of infection.
Transmission Routes: Understanding how HIV is transmitted is crucial for prevention efforts. HIV primarily spreads through unprotected sexual intercourse, sharing contaminated needles or syringes, and from mother to child during childbirth or breastfeeding. Other modes of transmission include blood transfusions (though rare in regions with screening protocols) and occupational exposure.
Risk Factors: Certain behaviors and circumstances increase the risk of HIV transmission. These include having multiple sexual partners, engaging in unprotected sex, using intravenous drugs, lack of access to healthcare, poverty, stigma, and discrimination. Additionally, structural factors such as laws and policies can influence risk behaviors and access to prevention and treatment services.
Global Distribution: HIV/AIDS is a global pandemic, but its prevalence varies widely between countries and regions. Sub-Saharan Africa remains the most affected, with the highest burden of HIV infections worldwide. However, significant progress has been made in some regions, while new challenges emerge in others, such as Eastern Europe and Central Asia.
Progress in Prevention and Treatment: Efforts to combat HIV/AIDS include prevention strategies such as promoting condom use, harm reduction programs for injecting drug users, pre-exposure prophylaxis (PrEP), and comprehensive sexual education. Antiretroviral therapy (ART) has transformed HIV/AIDS into a manageable chronic condition for many, reducing mortality and transmission rates.
Challenges and Future Directions: Despite significant progress, challenges remain in the global response to HIV/AIDS. These include disparities in access to healthcare, stigma and discrimination, funding gaps, emergence of drug-resistant strains, and persistent barriers to prevention and treatment in certain populations.
33.Vohra P, Jamatia K, Subhada B, Tiwari RVC, Althaf MN, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care. 2019 Oct;8(10):3247-3252. doi: 10.4103/jfmpc.jfmpc_767_19. eCollection 2019 Oct. PubMed PMID: 31742150; PubMed Central PMCID: PMC6857402.
Vohra P, Jamatia K, Subhada B, Tiwari RV, Althaf MS, Jain C. Correlation of CD4 counts with oral and systemic manifestations in HIV patients. J Family Med Prim Care 2019;8:3247-52.
Xem online tại: http://www.thuvienso.vn/tai-lieu/aids-hiv-assignment.102.html
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV). This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumours. HIV is transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk. This transmission can involve anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breast feeding or other exposure to one of the above bodily fluids.
Genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century. AIDS was first recognized by the U.S. Centres for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s. Although treatments for AIDS and HIV can slow the course of the disease, there is no known cure or vaccine. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but these drugs are expensive and routine access to antiretroviral medication is not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organizations promoting safe sex and needle-exchange programmes in attempts to slow the spread of the virus.
In the beginning, the U.S. Centres for Disease Control (CDC) did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, lymphadenopathy, the disease after which the discoverers of HIV originally named the virus. The earliest known positive identification of the HIV-1 virus comes from the Congo in 1959 and 1960 though genetic studies indicate that it passed into the human population from chimpanzees around fifty years earlier.
The HIV virus descends from the related simian immunodeficiency virus (SIV), which infects apes and monkeys in Africa. There is evidence that humans who participate in bush meat activities, commonly acquire SIV. To explain why HIV became epidemic, there are several theories, each invoking specific driving factors that may have promoted SIV, rapid transmission of SIV through unsterile injections, colonial abuses and unsafe smallpox vaccinations or prostitution and the concomitant high frequency of genital ulcer diseases (such as syphilis) in nascent colonial cities.
ABSTRACT- Introduction: Blood group antigens have been reported to be associated with many diseased conditions
severally. Studies have suggested that ABO blood groups have an impact on infection status of the individuals
possessing a particular blood group due to the significant associations observed when analyzed. However there is
limited information on the relationship between these blood group antigens with haemoglobin genotype and CD4 cell
count in Human Immunodeficiency Virus (HIV) infection, hence the need for this study.
Materials and Method: Exactly 240 newly enrolled seropositive patients attending the HIV Clinic of LAUTECH
Teaching Hospital, Osogbo, Nigeria and 120 healthy blood donors were recruited for this study. Antibodies to HIV
were determined using determine rapid HIV 1/HIV 2 test kit (Abbott), enzyme linked immunosorbent assay (ELISA)
(GenScreen plus HIV Ag-Ab test kit, Paris) and Western blot (New-LAV Blot 1, BioRad, France) for confirmatory test.
ABO and Rhesus blood grouping was determined by standard tile and tube techniques. Haemoglobin genotype
determined by alkaline cellulose acetate haemoglobin electrophoresis while CD4 cell count was estimated with Partec
Cyflow analyser.
Result: There is no significant association between the ABO/Rh antigens and haemoglobin genotypes of the test and
control groups (P<0.05). All participants in the control group had CD4 count >200cells/mm3 while 198 (55%) HIV
infected subjects had CD4 count ≥200cells/mm3 and 42 (11.7%) had CD4 count <200cells/mm3. A significant
association was observed between the CD4 cell count of the patients and their ABO blood group antigens (P<0.05) with
blood group A and AB having the highest CD4count.
Conclusion: The outcome of this study reiterates the fact that blood group antigens are involved in immune protection
against infectious disease. Blood group A which has been implicated to confer susceptibility in some diseased condition
has been observed to confer immunity in this study.
Key-words- CD4 cells, Blood Group Antigens, HIV and Haemoglobin Genotype
Prevalence of anti-HCV Antibodies Among Healthy Asymptomatic Indian Blood Don...Apollo Hospitals
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a bulk of acute and chronic liver diseases world-wide. Since, both the viruses share similar risk factors and modes of transmission, a combined HBV and HCV infection is frequently encountered especially in the HBV endemic areas. Until lately anti-HBc antibodies were considered as surrogate marker for HCV infection. But with the development of advanced tests for HCV detection the role of anti-HBc in this regard stands uncertain.
Assessing the Quality of Life of HIV/AIDS Patients attending Anti-Retroviral ...RosyPurakayastha
The study was an observational, cross-sectional study, which was conducted from May to July 2013, in the outpatient department of the Anti-Retroviral Therapy (ART) Clinic at MGM Medical College and Hospital, Kamothe, which is a tertiary care Hospital in Navi Mumbai. The study aimed to assess the Quality of Life (QOL) of patients living with HIV and AIDS using WHOQOL-HIV BREF Scale.
53.Vohra P, Nimonkar S, Belkhode V, Potdar S, Bhanot R, Izna, Tiwari RVC. CD4 cells count as a prognostic marker in HIV patients with comparative analysis of various studies in Asia Pacific region. J Family Med Prim Care. 2020 May;9(5):2431-2436. doi: 10.4103/jfmpc.jfmpc_137_20. eCollection 2020 May. PubMed PMID: 32754515; PubMed Central PMCID: PMC7380754.
60.Srinivasan S, Velusamy G, Munshi MAI, Radhakrishnan K, Tiwari RVC. Comparative Study of Antifungal Efficacy of Various Endodontic Irrigants with and without Clotrimazole in Extracted Teeth Inoculated with Candida albicans. J Contemp Dent Pract. 2020 Dec 1;21(12):1325-1330. PubMed PMID: 33893253.
Mathew P, Kattimani VS, Tiwari RV, Iqbal MS, Tabassum A, Syed KG. New Classification System for Cleft Alveolus: A Computed Tomography-based Appraisal. J Contemp Dent Pract. 2020 Aug 1;21(8):942-948. PubMed PMID: 33568619
Sahu S, Patley A, Kharsan V, Madan RS, Manjula V, Tiwari RVC. Comparative evaluation of efficacy and latency of twin mix vs 2% lignocaine HCL with 1:80000 epinephrine in surgical removal of impacted mandibular third molar. J Family Med Prim Care. 2020 Feb;9(2):904-908. doi: 10.4103/jfmpc.jfmpc_998_19. eCollection 2020 Feb. PubMed PMID: 32318443; PubMed Central PMCID: PMC7113948.
65.Izna, Sasank Kuntamukkula VK, Khanna SS, Salokhe O, Chandra Tiwari RV, Tiwari H. Knowledge and Apprehension of Dental Health Professionals Pertaining to COVID in Southern India: A Questionnaire Study. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S448-S451. doi: 10.4103/jpbs.JPBS_551_20. Epub 2021 Jun 5. PubMed PMID: 34447131; PubMed Central PMCID: PMC8375944.
Vohra P, Belkhode V, Nimonkar S, Potdar S, Bhanot R, Izna, Tiwari RVC. Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: A cross-sectional study. J Family Med Prim Care. 2020 May;9(5):2437-2441. doi: 10.4103/jfmpc.jfmpc_138_20. eCollection 2020 May. PubMed PMID: 32754516; PubMed Central PMCID: PMC7380795
Mittal S, Hussain SA, Tiwari RVC, Poovathingal AB, Priya BP, Bhanot R, Tiwari H. Extensive pelvic and abdominal lymphadenopathy with hepatosplenomegaly treated with radiotherapy-A case report. J Family Med Prim Care. 2020 Feb;9(2):1215-1218. doi: 10.4103/jfmpc.jfmpc_1125_19. eCollection 2020 Feb. PubMed PMID: 32318498; PubMed Central PMCID: PMC7113973.
36.Kesharwani P, Hussain SA, Sharma N, Karpathak S, Bhanot R, Kothari S, Tiwari RVC. Massive radicular cyst involving multiple teeth in pediatric mandible- A case report. J Family Med Prim Care. 2020 Feb;9(2):1253-1256. doi: 10.4103/jfmpc.jfmpc_1059_19. eCollection 2020 Feb. PubMed PMID: 32318508; PubMed Central PMCID: PMC7113959.
More from CLOVE Dental OMNI Hospitals Andhra Hospital (20)
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Vohra, et al.: Detection of HIV antibodies in salivary fluids
Journal of Family Medicine and Primary Care 2438 Volume 9 : Issue 5 : May 2020
Health Organization (WHO) and National AIDS control
organization (NACO) in 1997 enumerated the different modes
of transmission of HIV. These are sexual intercourse (anal/
vaginal/oral) with an infected partner (man to woman, woman
to man, and man to man), transmission with infected blood,
blood products, organs, tissue transplantation and artificial
insemination, contaminated syringes and needles, and from an
infected mother to child, i.e. perinatal or vertical transmission.
Worldwide, HIV is most commonly transmitted by sexual
activity. HIV is found in blood and other body fluids including
semen, vaginal fluid, and saliva. The immense majority of HIV
infections are produced during unprotected sexual intercourse
via the vaginal mucosa and especially the anal mucosa.[2,3]
The
risk of HIV transmission via oral secretion is an issue of
growing interest to dental health professionals, above all with the
upsurge in the number of infected individuals. Although HIV
RNA, proviral DNA, and infected cells are readily detectable in
salivary secretions and gingival crevicular fluid (GCF) of infected
individuals, the transmission of HIV by oral route is very low
or virtually non‑existent. The mechanism of this oral immunity
is poorly understood. Reports of antiviral activity in the saliva
of both healthy individuals and HIV‑infected individuals
suggest the presence of a factor or factors in saliva that can
inhibit HIV infection. Furthermore, it is well‑established that
human saliva inhibits HIV infectivity in vitro.[4‑7]
The anti‑HIV
inhibitory factors in saliva may make a major contribution to
the extremely low or negligible rates of oral transmission of the
virus reported by epidemiological studies.[1,4,5]
Evaluation and
diagnostic usefulness of saliva for detection of HIV antibody
have been studied since 1986 as saliva is a body fluid containing
antibodies of diagnostic significance. Unlike venipuncture, saliva
collection is painless, non‑invasive, inexpensive, simple, and
rapid. By using sensitive immunoassays in salivary specimens,
it is possible to diagnose immunoglobulins against a wide
range of infectious diseases, e.g. hepatitis A, B, and C, measles,
mumps, rubella, human immunodeficiency virus, Epstein Barr
virus, parvovirus B 19, human herpesvirus 6, and Helicobacter
pylori infections. Salivary antibody testing may provide better
access to epidemic outbreaks, children, large populations,
hard‑to‑reach risk groups and may thus play a major role in the
surveillance and control of infectious diseases. Evaluation and
diagnostic usefulness of saliva for detection of HIV antibody
have been done by enzyme‑linked immune assay (ELISA) which
has been modified by increasing the specimen volume, altering
the incubation periods, reagent concentrations, and reducing
the assay cutoff values.[6‑9]
These modifications have resulted
in improved ELISA sensitivity and specificity compared with
those of matched serum test.
Material and Method
The total of 200 subjects, 100 HIV confirmed seropositive as
study group and 100 age and sex matched healthy individuals
who had undergone a checkup by a qualified medical physician
as control group, were randomly selected for the study from
the OPD of Dhiraj General Hospital SSG Hospital and
Anti‑Retroviral Treatment Center, K. M. Shah Dental College
and Hospital Piperia, Vadodara and Non‑Governmental
organizations named Kirpa foundation working for HIV
positive patient in Vadodara. The study was approved by Ethical
Committee of Sumandeep Vidyapeeth, Vadodara years starting
from January 2007–2010 with the approval of institutional
research ethical committee SUVEC/ON/20/2007 (dated
20‑08‑2007). Written consent was obtained from each
participant. The aim and objectives of the study were to
detect HIV antibodies in saliva and serum of newly diagnosed
confirmed HIV seropositive patients by ELISA and to evaluate
the sensitivity and specificity of ELISA test in serum and saliva
samples of HIV positive and healthy individuals. Hence, for
the study, the first step taken was to select a newly diagnosed
confirmed seropositive patients before starting ART. Three
separate positive ELISA tests were considered confirmatory
as western blot, a confirmatory test, for HIV detection was
not done for selected subjects due to its cost and unavailability
for the confirmed seropositive patients who were selected for
the study. Participants were excluded if they were on ART,
had any history of autoimmune disorder, e.g., systemic lupus
erythematosus (SLE) or discoid lupus erythematosus (DLE),
and rheumatoid arthritis as such cases were likely to give
false‑positive results with ELISA test. Saliva collection and blood
collection apparatuses were used which included whole saliva
collector (50 ml); saliva collection was done by simple spitting
method in isolation by making the patient sit comfortably
without stimulating the salivary flow for a period of 2 min. For
serum collection, tourniquet was used and forearm was cleaned
with spirit and cotton and then with help of bi ended needles/
connector, the blood was collected in vacutainer tubes—4 ml
and 10 ml vials were used and then stored in cool icebox till
transferred to microbiology lab for future test by ELISA for
antibodies detection. For all this procedure, universal precautions
were strictly used for collection, storage, and disposal of HIV
positive patients’ samples.
Results and Observations
The age range for the study group was from 6 years to 65 years
with mean age of 34.14 ± 11.51 years, whereas age range
for control group was from 11 years to 62 years with mean
age of 31.02 ± 7.15 years. The general sociodemographic
data of the population revealed that most of HIV positive
males were laborers (33.3%) and truck drivers (21%) by
occupation, whereas most of HIV positive females were
housewives (46.5%) [Figure 1]. The most common mode of
HIV transmission in the study group was unprotected sexual
practices (70%) followed by blood transfusion (18%), vertical
transmission (9%), and intravenous drug use (3%) [Table 1].
Out of total 25 married females of study group, 21 (84%)
had given history of single partner and 4 (16%) had multiple
partners, whereas 3 (27.2%) out of 11 widows also gave history
of multiple partners [Table 2]. Out of total 28 cases of sexual
transmission of HIV infection, only 7 (25%) females gave
history of multiple partners. Thus, the results indicated that
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3. Vohra, et al.: Detection of HIV antibodies in salivary fluids
Journal of Family Medicine and Primary Care 2439 Volume 9 : Issue 5 : May 2020
total 95% married males and 16% married females of study
group had unprotected sexual activities with multiple partners
which indicates 84% females acquired HIV infection from HIV
positive spouses [Table 3]. Out of total 100 subjects in study
group, 99 (99%) were tested positive for HIV antibodies in saliva
samples with one false negative result and all the subjects were
detected positive for HIV antibodies in serum samples, whereas
all the subjects of control group were tested negative for HIV
antibodies in serum and saliva samples [Figure 2]. Thus, the
ELISA test, which was performed using a specialized ELISA kit
by BIORAD laboratories, GERAMANY (Genscreen HIV1/2)
which had higher sensitivity to detect HIV antibodies, was found
to be 99% sensitive and 100% specific for detection of HIV
antibodies in saliva samples of study group, whereas it was found
100% sensitive and specific for detection of HIV antibodies in
serum samples of study group as only one false‑negative result
was reported in saliva sample as compared with serum samples.
Statistical analysis
The statistical analysis was done using SPSS (Statistical Package
for Social Sciences) version 17 statistical analysis software. The
tests used for analysis were independent t‑test and Pearson’s
correlation. On applying independent t‑test on all saliva and
serum samples, probability value (P‑value) obtained was < 0.05
and the results were highly significant.
Discussion
Generation of specific antibody response is a critical component
of the host defense against pathogenic microorganisms and
HIV is no exception. The presence of virus‑specific antibodies
in mucosal secretions including saliva has been well documented.
HIV specific antibodies of immunoglobulin isotopes IgA, IgG, and
IgM are readily found in salivary secretions of infected people but
at levels considerably lower than those in blood.[10]
Detection of
HIV‑specific antibodies in oral fluid transudate has been exploited
recently as a highly sensitive and specific alternative to blood for
diagnosis and population surveillance. Spencer Hedge et al. in 1998
explainedthediagnosticsignificanceof antibodiesinoralsecretions.
Immunoglobulins (IgG) were identified in human saliva nearly
50 years ago and shortly thereafter in 1963, the prevalence of IgA in
saliva was demonstrated.[11]
Parry et al., in 1987, performed sensitive
assays for viral antibodies in saliva. They described methods for
detecting antibodies to HIV as well as antibodies to other viruses
and proposed saliva as an alternative specimen for epidemiological
investigations.[12]
ELISAhasbeenmodifiedbyincreasingthespecimen
volume, altering the incubation periods, reagent concentrations, and
reducing the assay cutoff values for detection of HIV antibody in
saliva.[6,7,13,14]
These modifications have resulted in improved ELISA
sensitivity and specificity in saliva compared with those of matched
serum test as reported by Granade et al. in year 1995 and 1998.[5]
In
thepresentstudy,wehaveevaluateddiagnosticusefulnessof salivafor
detection of HIV antibodies. Unlike venipuncture, saliva collection
ispainless,non‑invasive,inexpensive,simple,andrapid.Inourstudy,
saliva and serum samples of 100 confirmed seropositive patients
and100healthyindividualsweretestedbyELISAkit.Theresultwas
foundtobe99%sensitiveand100%specificforsalivasampleswhile
it was 100% sensitive and specific for serum samples. The results
were congruent with studies done by Soto‑Ramirez et al.[15]
in 1992,
in 1993, Ishikawa et al. in 1995,[16]
and recently by Pant Pai et al. in
2007.[17]
Diagnostic sensitivity and specificity of saliva for detection
of HIV antibodies is reported by various authors is given in Table 4.
Thus, in the various studies, diagnostic sensitivity of saliva, analyzed
by ELISA, is ranged from 95% to 100% and diagnostic specificity
of under 90% has been reported.[8,14‑22]
12
2
3
1
19
5
13
2
7
10
14
13
6 6
13
5
5
20
5
13
8
0
7
11
0
5
10
15
20
25
MALE n=57 FEMALE n=43 MALE n=55 FEMALE n=45
GROUP A n=100 GROUP B n=100
DRIVER
FARMER/LABOUR
JOB
STUDENT
NOT WORKING
BUISNESS
Figure 1: Occupation status in study and control groups. It was seen
that most of HIV positive males were laborers (33.3%) and truck
drivers (21%) by occupation, whereas most of HIV positive females
were housewives (46.5%)
99
100
TOTAL NUMBER OF
ANTIBODIES DETECTED
INSALIVA
TOTAL NUMBER OF
ANTIBODIES DETECTED
INSERUM
Figure 2: Antibody detection in saliva and serum of HIV positive study
group Out of 100 subjects in the study group, 99 (99%) were tested
positive for HIV antibodies in saliva and all the subjects were detected
HIV positive in serum of HIV positive subjects, whereas all the subjects
100 (100%) were tested negative for HIV antibodies in serum and
saliva of control group (P-value <0.05). ELISA kit was found to be 99%
sensitive and 100% specific for detection of HIV antibody in saliva of
the study group, whereas it was found 100% sensitive and specific
for detection of antibodies in serum of study group (P-value <0.05)
Table 1: Mode of transmission of HIV in subjects of the
study group
Mode of transmission
Sexual 70
Blood transfusion 18
Vertical 9
I V drug users 3
The most common mode of HIV transmission in the study group was unprotected sexual practices
(70%) followed by blood transfusion (18%), vertical transmission (9%), and Intravenous drug users (3%).
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4. Vohra, et al.: Detection of HIV antibodies in salivary fluids
Journal of Family Medicine and Primary Care 2440 Volume 9 : Issue 5 : May 2020
Conclusion
Saliva can be used as an alternative to serum and plasma for the
detection of HIV antibodies as a highly sensitive and specific
alternative to blood for diagnosis and population surveillance.
Salivary fluid collection is painless, non‑invasive, inexpensive, simple,
and rapid. Salivary antibody testing may provide better access to
epidemic outbreaks, children, large populations, hard‑to‑reach risk
groups and may thus play a major role in the surveillance and control
of highly infectious diseases. Still much more work is required in this
field worldwide so that saliva can be used as alternative to blood for
detection of HIV antibodies as saliva has very less concentration of
HIV antibodies due to presence of enzyme SLPI (salivary leukocyte
protease inhibitor) which does not allow the virus to increase its load
in saliva as compared to blood; hence, due to decrease in viral load,
wehavetodevelopspecializedELISAkitswithincreasedefficacyand
accuracy for detection of HIV antibodies to avoid the false‑positive
resultsasHIV/AIDSisalife‑threateningdiseaseandhighlyinfectious.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient
consent forms. In the form, the patients have given their consent
for their images and other clinical information to be reported in
the journal. The patients understand that their names and initials
will not be published and due efforts will be made to conceal
their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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