ABC OF PREVENTION OF HERPES ZOSTER IN ADULT WOMEN DR. Sharda Jain Lifecare Centre
This document provides information on herpes zoster (shingles) in adults. It discusses how varicella-zoster virus causes chickenpox initially and can reactivate later in life to cause herpes zoster. Older age is a risk factor for developing herpes zoster as immunity to the virus decreases with age. Herpes zoster causes a painful rash that follows dermatomal distributions and can lead to postherpetic neuralgia, which is chronic nerve pain following the rash. Herpes zoster and postherpetic neuralgia negatively impact physical, psychological, social, and functional health.
This document contains a curriculum vitae for Melissa Inman including her publications and research papers. It lists 28 publications from 1992 to 2015 related to her research on viruses that affect animals like African horse sickness virus, bovine herpesvirus 1, herpes simplex virus, Newcastle disease virus, swine influenza virus, and avian pathogenic Escherichia coli. The publications cover topics like viral infection mechanisms, detection methods, vaccine development, and viral latency and reactivation.
רגישות מוגברת לוריאנטים דווקא בקרב מי שנטלו את התרכיבwww.epidella.com
This study analyzed SARS-CoV-2 virus samples from 149 fully vaccinated individuals and 247 partially vaccinated individuals in Israel who later tested positive for COVID-19, compared to matched unvaccinated individuals. Genome sequencing found the B.1.351 variant was disproportionately present in fully vaccinated individuals, while the B.1.1.7 variant was disproportionately present in partially vaccinated individuals. This provides real-world evidence that both the B.1.1.7 and B.1.351 variants may be able to overcome protection from the BNT162b2 mRNA vaccine to some degree. However, mass vaccination coupled with public health measures have kept spread of these variants in Israel relatively low to date.
1) The document discusses the potential risk of antibody-dependent enhancement (ADE) with coronavirus vaccines, where previous antibodies against the virus cause a worse infection rather than protecting.
2) ADE was a factor in past coronavirus vaccine failures due to animals having worse infections after exposure to a slightly different variant after vaccination.
3) More research is needed to fully understand and address the risk of ADE, as it could undermine the goal of widespread vaccination to reduce coronavirus infections and spread.
The Potential Neurological Side Effect of The Covid-19Ade Wijaya
This document discusses the potential neurological side effects of COVID-19 vaccines. It describes the main components of vaccines, including antigens and adjuvants. It then summarizes the four main types of COVID vaccines: inactivated vaccines, viral vector vaccines, protein subunit vaccines, and nucleic acid vaccines. For each type, it provides brief details on examples of vaccines, potential side effects observed, and neurological safety concerns. The summary concludes that while neurological adverse effects are rare, cases of demyelinating disease were reported for viral vector vaccines, and fever, a common side effect, could potentially lower seizure thresholds as warned by epilepsy organizations.
Guided by several doctors, Dr. Chavan Sneha S. presented on the role of viruses in periodontal diseases. The summary is:
1) Periodontal diseases have multiple etiological factors, and various viruses may play a role in their development, including herpesviruses like cytomegalovirus and Epstein-Barr virus.
2) These viruses are more frequently detected in aggressive periodontitis lesions compared to healthy sites or gingivitis, and their presence may impair host defenses allowing bacterial pathogens to proliferate.
3) Local reactivation of herpesviruses from latent infections in the periodontium has been proposed as one mechanism by which viruses could contribute to period
ABC OF PREVENTION OF HERPES ZOSTER IN ADULT WOMEN DR. Sharda Jain Lifecare Centre
This document provides information on herpes zoster (shingles) in adults. It discusses how varicella-zoster virus causes chickenpox initially and can reactivate later in life to cause herpes zoster. Older age is a risk factor for developing herpes zoster as immunity to the virus decreases with age. Herpes zoster causes a painful rash that follows dermatomal distributions and can lead to postherpetic neuralgia, which is chronic nerve pain following the rash. Herpes zoster and postherpetic neuralgia negatively impact physical, psychological, social, and functional health.
This document contains a curriculum vitae for Melissa Inman including her publications and research papers. It lists 28 publications from 1992 to 2015 related to her research on viruses that affect animals like African horse sickness virus, bovine herpesvirus 1, herpes simplex virus, Newcastle disease virus, swine influenza virus, and avian pathogenic Escherichia coli. The publications cover topics like viral infection mechanisms, detection methods, vaccine development, and viral latency and reactivation.
רגישות מוגברת לוריאנטים דווקא בקרב מי שנטלו את התרכיבwww.epidella.com
This study analyzed SARS-CoV-2 virus samples from 149 fully vaccinated individuals and 247 partially vaccinated individuals in Israel who later tested positive for COVID-19, compared to matched unvaccinated individuals. Genome sequencing found the B.1.351 variant was disproportionately present in fully vaccinated individuals, while the B.1.1.7 variant was disproportionately present in partially vaccinated individuals. This provides real-world evidence that both the B.1.1.7 and B.1.351 variants may be able to overcome protection from the BNT162b2 mRNA vaccine to some degree. However, mass vaccination coupled with public health measures have kept spread of these variants in Israel relatively low to date.
1) The document discusses the potential risk of antibody-dependent enhancement (ADE) with coronavirus vaccines, where previous antibodies against the virus cause a worse infection rather than protecting.
2) ADE was a factor in past coronavirus vaccine failures due to animals having worse infections after exposure to a slightly different variant after vaccination.
3) More research is needed to fully understand and address the risk of ADE, as it could undermine the goal of widespread vaccination to reduce coronavirus infections and spread.
The Potential Neurological Side Effect of The Covid-19Ade Wijaya
This document discusses the potential neurological side effects of COVID-19 vaccines. It describes the main components of vaccines, including antigens and adjuvants. It then summarizes the four main types of COVID vaccines: inactivated vaccines, viral vector vaccines, protein subunit vaccines, and nucleic acid vaccines. For each type, it provides brief details on examples of vaccines, potential side effects observed, and neurological safety concerns. The summary concludes that while neurological adverse effects are rare, cases of demyelinating disease were reported for viral vector vaccines, and fever, a common side effect, could potentially lower seizure thresholds as warned by epilepsy organizations.
Guided by several doctors, Dr. Chavan Sneha S. presented on the role of viruses in periodontal diseases. The summary is:
1) Periodontal diseases have multiple etiological factors, and various viruses may play a role in their development, including herpesviruses like cytomegalovirus and Epstein-Barr virus.
2) These viruses are more frequently detected in aggressive periodontitis lesions compared to healthy sites or gingivitis, and their presence may impair host defenses allowing bacterial pathogens to proliferate.
3) Local reactivation of herpesviruses from latent infections in the periodontium has been proposed as one mechanism by which viruses could contribute to period
Group B Streptococcus (GBS) is a leading cause of stillbirths and infant mortality worldwide. About 50% of colonized mothers transmit GBS to their newborns, putting them at risk for early-onset and late-onset invasive infections like pneumonia, sepsis, and meningitis. Current prevention strategies rely on intrapartum antibiotics and screening of pregnant mothers, which have limitations. Vaccination offers the most promising prevention by inducing transplacental antibody transfer from mothers to newborns. Proposed multivalent GBS conjugate vaccines targeting the capsular polysaccharides show potential but have limitations. Alternative vaccine designs focusing on conserved surface proteins show promise for inducing broad protection against multiple GBS serotypes.
This document provides an overview of chronic granulomatous disease (CGD), including its history, epidemiology, pathogenesis, and clinical features. CGD is a primary immunodeficiency caused by defects in the NADPH oxidase complex that generates superoxide in phagocytes. This impairs the ability to kill certain bacteria and fungi, leading to life-threatening infections. The condition was first described in the 1950s and genetic causes involving mutations in CYBB, CYBA, NCF1, NCF2, and NCF4 genes that encode phagocyte oxidase subunits were identified starting in the 1980s. CGD has an incidence of approximately 1 in 200,000 individuals.
The document outlines the immune response to viral infections. It discusses that viruses are obligate intracellular parasites that cannot replicate without hijacking a host cell. The innate immune response includes epithelial barriers, interferons like IFN-α and IFN-β, natural killer cells, and macrophages. Adaptive responses involve antiviral antibodies that can neutralize viruses or mediate antibody-dependent cellular cytotoxicity, as well as cytotoxic T lymphocytes that identify and kill infected cells. Overall, the immune system employs diverse innate and adaptive mechanisms to recognize, control and clear viral infections.
This document provides an overview of Autoimmune Polyendocrinopathy-Candidiasis–Ectodermal Dysplasia (APECED), also known as Autoimmune Polyendocrinopathy Syndrome Type 1 (APS-1). It discusses the epidemiology, pathogenesis, clinical manifestations, diagnosis, and management. The pathogenesis involves mutations in the autoimmune regulator (AIRE) gene leading to loss of central tolerance and autoimmunity against various endocrine and other tissues. Common clinical manifestations include chronic mucocutaneous candidiasis, hypoparathyroidism, adrenal insufficiency, and others. Diagnosis is based on clinical criteria and AIRE gene mutation analysis can confirm. Management requires treatment of
Johannes Vogel is a senior group leader and professor at the Institute of Veterinary Physiology at the University of Zurich. He was born in 1964 in Bonn, Germany. He received his medical degree from the University of Bonn in 1992 and has since held positions at the University of Heidelberg and University of Zurich. His research focuses on the physiological and pathophysiological roles of erythropoietin. He has authored or co-authored over 25 publications in peer-reviewed journals.
A Case Report Analyzing Guillain-Barre Syndrome in COVID:JamesJohnson566920
This case report describes a woman who developed Guillain-Barre syndrome (GBS) after receiving the first dose of an mRNA COVID-19 vaccine. Tests showed she had antibodies to the SARS-CoV-2 spike protein from the vaccine but not to the nucleocapsid protein, indicating her GBS was likely precipitated by the vaccine rather than a natural COVID-19 infection. While COVID-19 and vaccines can both potentially cause GBS via molecular mimicry, the report concludes that vaccine benefits outweigh this rare risk and the case helps elucidate mechanisms of adverse vaccine reactions.
This document discusses human genetics research into infectious diseases. It summarizes that:
1) Genetic factors contribute to variability in individual responses to infection exposure and clinical outcomes. Rare single gene mutations can cause highly selective predispositions to specific pathogens like Herpes simplex virus-1 or mycobacteria.
2) Research has identified genetic causes of severe infectious diseases like Herpes simplex encephalitis and Mendelian susceptibility to mycobacterial disease. Defects in the TLR3 and IL-12/IFN-γ pathways increase risk.
3) Genome-wide studies of common infections like tuberculosis have found limited roles for common variants but suggest searching for rare variants using deep sequencing. Gen
CNS Iinfection dengue, Teaching Slides, Dr M D Mohire, Kolhapur, Maharashtra,...Mahavir Mohire
1) A study of 210 patients with infectious acute encephalitis syndrome (AES) in India found that 62% had a specific etiological diagnosis. The most common causes were herpes virus (12 patients) and Japanese encephalitis virus (8 patients) for neurological AES, and scrub typhus (42 patients) and dengue virus (20 patients) for systemic AES.
2) Using a syndromic approach, neurological AES could be differentiated from systemic AES with 100% specificity based on the absence of myalgia or rash. Thalamic involvement on imaging predicted Japanese encephalitis with 100% specificity for neurological AES cases.
3) Targeted testing and treatment based on the syndromic approach substantially reduced
The document discusses the history and early studies of transfer factors, which are immune system regulators found in colostrum that can transfer immunity. Early studies showed transfer factors from blood were effective against various infections and diseases but posed contamination risks. Researchers then found transfer factors in bovine colostrum that were non-species specific and more effective. Later studies showed bovine colostrum transfer factors reduced relapse in Burkitt's lymphoma, showed preliminary benefits for AIDS patients, and helped treat recurrent cystitis.
This document describes the development of a DNA vaccine for Chikungunya virus (CHIKV). CHIKV is an emerging pathogen spread by mosquitoes that causes fever and joint pain. The developed vaccine expresses three CHIKV envelope proteins (E3, E2, and E1) from a single DNA construct. Mice and nonhuman primates immunized with the vaccine developed antibodies against the envelope proteins and neutralizing antibodies. The vaccine induced both humoral and cellular immune responses providing protection in mice. This DNA vaccine shows potential as an effective vaccine against CHIKV by eliciting protective immunity.
Mucormycosis is a rare but serious fungal infection that can involve the central nervous system. It most commonly spreads to the CNS by direct extension from infected paranasal sinuses or through hematogenous dissemination from the lungs. Patients may present with neurological deficits alone or with rhino-orbital-cerebral syndrome. Diagnosis involves clinical, radiological, and microbiological examination of infected tissues. Treatment requires antifungal therapy combined with surgical debridement, but cerebral mucormycosis continues to have high mortality and morbidity rates.
This document discusses Japanese encephalitis (JE), a viral disease transmitted by mosquitoes that causes brain inflammation. It provides historical information on JE outbreaks globally and in India since the 1870s. Specific details are given about recent outbreaks in Gorakhpur, India in 2005 and the current situation in Karnataka. The epidemiological triad of JE transmission and clinical features are summarized. Prevention, treatment, vaccination approaches, and challenges to control are also reviewed.
Seroprevalence and risk factors of Coxiella burnetii (Q fever) infection amon...ILRI
Presentation by D.K. Mwololo, P.M. Kitala, S.K. Wanyoike and B. Bett at the 9th biennial scientific conference and exhibition of the Faculty of Veterinary Medicine, University of Nairobi, 3-5 September 2014.
Immune Responses: Whole Cell and Acellular Pertussis Vaccines - Slide set by ...WAidid
Many antigens for Bordetella pertussis.
Prof. Edwards analyzes the response to Acellular and Whole Cell Pertussis vaccines, with a special focus on maternal vaccination.
To learn more, visit: www.waidid.org
Population genomics and public health examines how population genomics, which synthesizes genomics, population biology, and evolution, can help answer public health questions about bacterial pathogens. Martin Maiden discusses how high-throughput sequencing and multi-locus sequence typing (MLST) of large pathogen populations has provided insights into the population structure, evolution, and epidemiology of bacterial pathogens like Neisseria meningitidis. MLST data has shown clonal dominance of certain lineages and evidence of recombination in pathogen populations. Analysis of population structure has implications for vaccine design and understanding disease potential.
Protective Immune responses and immunopathology of SchistosomiasisTANYIPRIDEBOBGA
This document presents an outline for a presentation on the protective immune responses and immunopathology of schistosomiasis. It discusses the life cycle of schistosomiasis, the origin of immunopathology, and the spectrum of clinical disease. It describes how the immune response shifts from Th1 to Th2 dominance, causing pathology. Granuloma formation around eggs is explained as well as how regulatory T cells help control immunopathology. Delayed concomitant immunity and praziquantel treatment providing passive vaccination are presented as protective immune mechanisms. Current vaccine research targeting different parasite antigens is summarized. In conclusion, a multi-antigen vaccine may be needed to induce long-term protection given the parasite's complexity
1. Six cases of Japanese encephalitis were reported in Sukma district of Chhattisgarh, including three deaths, signaling an outbreak of the disease.
2. The cases were clustered in villages near the border of Malkangiri district of Odisha, which was experiencing an ongoing JE outbreak.
3. Japanese encephalitis virus is transmitted by Culex mosquitoes. Pigs serve as an amplifier host between the mosquitoes and human cases.
This document summarizes the current Ebola virus outbreak in West Africa, treatments under development, and prevention strategies. It reports that as of September 2014 over 5,000 cases of Ebola virus disease have been identified, with a 50% fatality rate. Promising vaccine candidates include recombinant Vesicular Stomatitis Virus-based vaccines and adenovirus-based vaccines, which have shown complete protection in non-human primates. Antibody cocktails like ZMAPP have also demonstrated post-exposure effectiveness in preventing Ebola in primates. While there is currently no licensed vaccine, numerous candidates are in development and undergoing clinical trials.
1. Herpes zoster, also known as shingles, results from reactivation of the varicella-zoster virus and presents with a painful rash that follows dermatomal patterns.
2. Two mock case presentations demonstrate the prodromal and acute phases of herpes zoster. The first case involves a 63-year-old with headache, photophobia and malaise preceding a rash. The second case involves a 62-year-old with a painful unilateral rash presenting for 7 days.
3. Herpes zoster can cause postherpetic neuralgia, a chronic neuropathic pain condition that is more common in older adults and a major source of morbidity.
Group B Streptococcus (GBS) is a leading cause of stillbirths and infant mortality worldwide. About 50% of colonized mothers transmit GBS to their newborns, putting them at risk for early-onset and late-onset invasive infections like pneumonia, sepsis, and meningitis. Current prevention strategies rely on intrapartum antibiotics and screening of pregnant mothers, which have limitations. Vaccination offers the most promising prevention by inducing transplacental antibody transfer from mothers to newborns. Proposed multivalent GBS conjugate vaccines targeting the capsular polysaccharides show potential but have limitations. Alternative vaccine designs focusing on conserved surface proteins show promise for inducing broad protection against multiple GBS serotypes.
This document provides an overview of chronic granulomatous disease (CGD), including its history, epidemiology, pathogenesis, and clinical features. CGD is a primary immunodeficiency caused by defects in the NADPH oxidase complex that generates superoxide in phagocytes. This impairs the ability to kill certain bacteria and fungi, leading to life-threatening infections. The condition was first described in the 1950s and genetic causes involving mutations in CYBB, CYBA, NCF1, NCF2, and NCF4 genes that encode phagocyte oxidase subunits were identified starting in the 1980s. CGD has an incidence of approximately 1 in 200,000 individuals.
The document outlines the immune response to viral infections. It discusses that viruses are obligate intracellular parasites that cannot replicate without hijacking a host cell. The innate immune response includes epithelial barriers, interferons like IFN-α and IFN-β, natural killer cells, and macrophages. Adaptive responses involve antiviral antibodies that can neutralize viruses or mediate antibody-dependent cellular cytotoxicity, as well as cytotoxic T lymphocytes that identify and kill infected cells. Overall, the immune system employs diverse innate and adaptive mechanisms to recognize, control and clear viral infections.
This document provides an overview of Autoimmune Polyendocrinopathy-Candidiasis–Ectodermal Dysplasia (APECED), also known as Autoimmune Polyendocrinopathy Syndrome Type 1 (APS-1). It discusses the epidemiology, pathogenesis, clinical manifestations, diagnosis, and management. The pathogenesis involves mutations in the autoimmune regulator (AIRE) gene leading to loss of central tolerance and autoimmunity against various endocrine and other tissues. Common clinical manifestations include chronic mucocutaneous candidiasis, hypoparathyroidism, adrenal insufficiency, and others. Diagnosis is based on clinical criteria and AIRE gene mutation analysis can confirm. Management requires treatment of
Johannes Vogel is a senior group leader and professor at the Institute of Veterinary Physiology at the University of Zurich. He was born in 1964 in Bonn, Germany. He received his medical degree from the University of Bonn in 1992 and has since held positions at the University of Heidelberg and University of Zurich. His research focuses on the physiological and pathophysiological roles of erythropoietin. He has authored or co-authored over 25 publications in peer-reviewed journals.
A Case Report Analyzing Guillain-Barre Syndrome in COVID:JamesJohnson566920
This case report describes a woman who developed Guillain-Barre syndrome (GBS) after receiving the first dose of an mRNA COVID-19 vaccine. Tests showed she had antibodies to the SARS-CoV-2 spike protein from the vaccine but not to the nucleocapsid protein, indicating her GBS was likely precipitated by the vaccine rather than a natural COVID-19 infection. While COVID-19 and vaccines can both potentially cause GBS via molecular mimicry, the report concludes that vaccine benefits outweigh this rare risk and the case helps elucidate mechanisms of adverse vaccine reactions.
This document discusses human genetics research into infectious diseases. It summarizes that:
1) Genetic factors contribute to variability in individual responses to infection exposure and clinical outcomes. Rare single gene mutations can cause highly selective predispositions to specific pathogens like Herpes simplex virus-1 or mycobacteria.
2) Research has identified genetic causes of severe infectious diseases like Herpes simplex encephalitis and Mendelian susceptibility to mycobacterial disease. Defects in the TLR3 and IL-12/IFN-γ pathways increase risk.
3) Genome-wide studies of common infections like tuberculosis have found limited roles for common variants but suggest searching for rare variants using deep sequencing. Gen
CNS Iinfection dengue, Teaching Slides, Dr M D Mohire, Kolhapur, Maharashtra,...Mahavir Mohire
1) A study of 210 patients with infectious acute encephalitis syndrome (AES) in India found that 62% had a specific etiological diagnosis. The most common causes were herpes virus (12 patients) and Japanese encephalitis virus (8 patients) for neurological AES, and scrub typhus (42 patients) and dengue virus (20 patients) for systemic AES.
2) Using a syndromic approach, neurological AES could be differentiated from systemic AES with 100% specificity based on the absence of myalgia or rash. Thalamic involvement on imaging predicted Japanese encephalitis with 100% specificity for neurological AES cases.
3) Targeted testing and treatment based on the syndromic approach substantially reduced
The document discusses the history and early studies of transfer factors, which are immune system regulators found in colostrum that can transfer immunity. Early studies showed transfer factors from blood were effective against various infections and diseases but posed contamination risks. Researchers then found transfer factors in bovine colostrum that were non-species specific and more effective. Later studies showed bovine colostrum transfer factors reduced relapse in Burkitt's lymphoma, showed preliminary benefits for AIDS patients, and helped treat recurrent cystitis.
This document describes the development of a DNA vaccine for Chikungunya virus (CHIKV). CHIKV is an emerging pathogen spread by mosquitoes that causes fever and joint pain. The developed vaccine expresses three CHIKV envelope proteins (E3, E2, and E1) from a single DNA construct. Mice and nonhuman primates immunized with the vaccine developed antibodies against the envelope proteins and neutralizing antibodies. The vaccine induced both humoral and cellular immune responses providing protection in mice. This DNA vaccine shows potential as an effective vaccine against CHIKV by eliciting protective immunity.
Mucormycosis is a rare but serious fungal infection that can involve the central nervous system. It most commonly spreads to the CNS by direct extension from infected paranasal sinuses or through hematogenous dissemination from the lungs. Patients may present with neurological deficits alone or with rhino-orbital-cerebral syndrome. Diagnosis involves clinical, radiological, and microbiological examination of infected tissues. Treatment requires antifungal therapy combined with surgical debridement, but cerebral mucormycosis continues to have high mortality and morbidity rates.
This document discusses Japanese encephalitis (JE), a viral disease transmitted by mosquitoes that causes brain inflammation. It provides historical information on JE outbreaks globally and in India since the 1870s. Specific details are given about recent outbreaks in Gorakhpur, India in 2005 and the current situation in Karnataka. The epidemiological triad of JE transmission and clinical features are summarized. Prevention, treatment, vaccination approaches, and challenges to control are also reviewed.
Seroprevalence and risk factors of Coxiella burnetii (Q fever) infection amon...ILRI
Presentation by D.K. Mwololo, P.M. Kitala, S.K. Wanyoike and B. Bett at the 9th biennial scientific conference and exhibition of the Faculty of Veterinary Medicine, University of Nairobi, 3-5 September 2014.
Immune Responses: Whole Cell and Acellular Pertussis Vaccines - Slide set by ...WAidid
Many antigens for Bordetella pertussis.
Prof. Edwards analyzes the response to Acellular and Whole Cell Pertussis vaccines, with a special focus on maternal vaccination.
To learn more, visit: www.waidid.org
Population genomics and public health examines how population genomics, which synthesizes genomics, population biology, and evolution, can help answer public health questions about bacterial pathogens. Martin Maiden discusses how high-throughput sequencing and multi-locus sequence typing (MLST) of large pathogen populations has provided insights into the population structure, evolution, and epidemiology of bacterial pathogens like Neisseria meningitidis. MLST data has shown clonal dominance of certain lineages and evidence of recombination in pathogen populations. Analysis of population structure has implications for vaccine design and understanding disease potential.
Protective Immune responses and immunopathology of SchistosomiasisTANYIPRIDEBOBGA
This document presents an outline for a presentation on the protective immune responses and immunopathology of schistosomiasis. It discusses the life cycle of schistosomiasis, the origin of immunopathology, and the spectrum of clinical disease. It describes how the immune response shifts from Th1 to Th2 dominance, causing pathology. Granuloma formation around eggs is explained as well as how regulatory T cells help control immunopathology. Delayed concomitant immunity and praziquantel treatment providing passive vaccination are presented as protective immune mechanisms. Current vaccine research targeting different parasite antigens is summarized. In conclusion, a multi-antigen vaccine may be needed to induce long-term protection given the parasite's complexity
1. Six cases of Japanese encephalitis were reported in Sukma district of Chhattisgarh, including three deaths, signaling an outbreak of the disease.
2. The cases were clustered in villages near the border of Malkangiri district of Odisha, which was experiencing an ongoing JE outbreak.
3. Japanese encephalitis virus is transmitted by Culex mosquitoes. Pigs serve as an amplifier host between the mosquitoes and human cases.
This document summarizes the current Ebola virus outbreak in West Africa, treatments under development, and prevention strategies. It reports that as of September 2014 over 5,000 cases of Ebola virus disease have been identified, with a 50% fatality rate. Promising vaccine candidates include recombinant Vesicular Stomatitis Virus-based vaccines and adenovirus-based vaccines, which have shown complete protection in non-human primates. Antibody cocktails like ZMAPP have also demonstrated post-exposure effectiveness in preventing Ebola in primates. While there is currently no licensed vaccine, numerous candidates are in development and undergoing clinical trials.
1. Herpes zoster, also known as shingles, results from reactivation of the varicella-zoster virus and presents with a painful rash that follows dermatomal patterns.
2. Two mock case presentations demonstrate the prodromal and acute phases of herpes zoster. The first case involves a 63-year-old with headache, photophobia and malaise preceding a rash. The second case involves a 62-year-old with a painful unilateral rash presenting for 7 days.
3. Herpes zoster can cause postherpetic neuralgia, a chronic neuropathic pain condition that is more common in older adults and a major source of morbidity.
Herpes zoster infection in neurology: management updates and prevention懿恩 施
Varicella zoster cause a huge burden among patients with Post-herpetic nerlagia.
This lecture leads audience to deeper understanding of the disease nature and its association with multiple disciplines.
This document reviews the association between atopic conditions like asthma, allergic rhinitis, and atopic dermatitis with an increased risk of respiratory and non-respiratory tract infections. It discusses several potential mechanisms for this association, including dysfunction in innate immunity, humoral immunity, and cell-mediated immunity in atopic individuals. Specific examples are provided of impaired responses to pathogens like bacteria and viruses in those with asthma or allergies. The role of corticosteroid use and asthma severity/control in modifying infection risk is also examined.
Respiratory tract infections power point presentationbusoma312
Viral respiratory infections are the most common infectious illnesses worldwide. Rhinoviruses cause the majority of these infections and are responsible for the common cold. Rhinovirus infections peak in the fall and spring. They can lead to acute bronchitis, sinusitis, and otitis media. Rhinovirus infections are also associated with exacerbations of asthma and increased symptoms in immunocompromised individuals like the elderly. Proper control of underlying asthma may help reduce exacerbations triggered by viral respiratory infections.
- There are two arboviruses, Chikungunya virus (CHIKV) and Zika virus (ZIKV), that have attracted interest in recent years due to increasing incidence and geographical range.
- CHIKV infection can cause long-term joint pain and arthritis in around 50% of cases. ZIKV is associated with Guillain-Barré syndrome in a small percentage of cases.
- A study of 29 patients with Guillain-Barré syndrome and recent ZIKV infection found clinical features similar to other causes of Guillain-Barré syndrome. Around 40% had anti-ganglioside antibodies. The incidence of Guillain-Barré
PERTUSSIS PROTECTION - CURRENT SCHEDULES IN EUROPEWAidid
Slide set by Professor Susanna Esposito, president WAidid, presented at the 3rd ESCMID Conference on Vaccines, held in Lisbon (Portugal), 6- 8 March 2015. Learn more: http://goo.gl/8GUwwL
This document summarizes research on genetic and environmental risk factors for multiple sclerosis (MS). It finds that MS is influenced by both hereditary and non-hereditary factors. Major genetic risk factors identified include the HLA-DRB1*1501 locus, the interleukin 7 receptor gene, and the interleukin 2 receptor gene, which together account for about 50% of MS's hereditability. Environmental factors associated with increased risk include Epstein-Barr virus, human herpesvirus 6, low vitamin D levels, and smoking.
Far from being a historic medical curiosity, plague caused by Yersinia pestis persists as a threat worldwide. The disease is typically transmitted between rodents and humans by flea bites. Prompt diagnosis and immediate antibiotic treatment are essential since mortality rates are high if left untreated. While historically devastating pandemics occurred, modern recognition and management have reduced plague's impact, though it remains a public health concern in some regions.
The importance of pertussis booster vaccine doses throughout life - Slideset ...WAidid
Pertussis is still a worldwide problem: every year there are almost 20-50 million cases and 300.000 deaths.
The incidence is increasing especially between adults and adolescents, with consequences on infants. For this reason, the increasing of a vaccination strategy for adolescent and adult is needed...
To learn more, please visit www.waidid.org.
The document discusses whether osteoarthritis (OA) should be considered one disease or many, as there is evidence that OA is a heterogeneous condition influenced by different risk factors, molecular pathways, and disease mechanisms. Genome-wide association studies have linked over 100 genetic loci to OA risk, indicating different pathways can contribute to OA in different patients. While some genes have been shown to play different roles in different mouse models of OA, together this suggests OA may comprise distinct subtypes that could require targeted treatment approaches.
An overview on ebola virus disease (evd) or ebola hemorrhagic fever (ehf)pharmaindexing
Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, is a severe and often fatal illness in humans caused by the Ebola virus. The virus is transmitted through contact with infected animals like fruit bats or non-human primates, and then spreads between humans through contact with bodily fluids. Symptoms include fever, headache, muscle pain and weakness followed by vomiting, diarrhea and rash, with fatality rates reaching 90% in some outbreaks. There is no approved vaccine or treatment, though several are in development.
This document summarizes a research article that investigated the genomic determinants of Mycobacterium tuberculosis transmission. The study identified regions of the M. tuberculosis genome, through analysis of over 200 strains, that were associated with transmission and the occurrence of secondary tuberculosis cases. These regions encoded proteins or influenced immune responses. Specifically, the study found mutations in five genomic regions, including three genes and two intergenic regions, that were statistically associated with transmission. Mutations in two of these genes were found to decrease immune system cytokine production in a way that could influence transmissibility. This research helps further the understanding of the genetic factors that influence the transmissibility of M. tuberculosis strains.
Scrub typhus in a tertiary care hospital in the eastern part of OdishaApollo Hospitals
Our hospital, tertiary care hospital in the capital of the State of Odisha, had been witnessing pyrexia of unknown origin, associated with breathlessness, renal and liver impairment, which did not respond to high antibiotics like Carbapenems but to Doxycycline therefore, the present study was undertaken to identify whether scrub typhus is the aetiological agent and thereafter their characteristic features were further evaluated as an effort in supporting its diagnoses and treating patients accordingly.
This study retrospectively analyzed 127 cases of tuberculosis of the spine treated surgically between 2007-2017. Most patients were young adults between 11-30 years old and more were male. Surgical decompression without stabilization was performed in 72 patients for pain or symptoms but no neurological deficit. Surgical decompression with stabilization using implants was performed in 55 patients with neurological deficit, paraplegia, or bone destruction. Histopathology confirmed the diagnosis. Complications were rare. The study concludes early diagnosis and treatment, whether medical or surgical, improves prognosis for spinal tuberculosis.
This document summarizes research on Powassan virus (POW), a rare but serious tick-borne virus. It discusses the virus's distribution and prevalence based on studies of deer populations. POW causes encephalitis and meningitis and has a 10% fatality rate. While cases are rare, rates have increased in areas where the transmitting ticks (Ixodes species) are common. Climate change may be expanding the ticks' habitats. The document reviews the virus's pathogenesis, symptoms, and current prevention strategies like tick repellents and body checks. More research is needed due to the virus's rarity.
Neurological Complications of Sinusitis Ade Wijaya
Sinusitis is inflammation of the sinuses that can rarely lead to intracranial complications. These complications are most commonly caused by bacterial or fungal infections spreading from the sinuses into the brain. Common causative organisms include Streptococcus, Staphylococcus, and various fungi like Aspergillus. Treatment involves aggressive medical therapy with antibiotics or antifungals as well as surgical drainage, with the goal of early diagnosis and a multidisciplinary approach to improve outcomes and reduce the high morbidity and mortality associated with these complications.
This document describes foot and mouth disease (FMD), a viral disease that affects cloven-hoofed animals. It discusses the etiology, clinical signs, transmission, diagnosis, prevention, vaccination, occurrence, and objectives and methods for studying an FMD outbreak in Afghanistan. Specifically, it aims to describe the descriptive epidemiology of the outbreak and identify potential risk factors through a case-control study comparing 137 confirmed positive cases to 137 matched controls. Data will be collected through interviews and statistically analyzed to determine relationships between time, place, and person and identify factors associated with positive cases.
This document provides an overview of multiple sclerosis (MS), including what it is, who gets it, possible causes, symptoms, and treatment options. MS is an autoimmune disease where the body's immune system attacks the protective myelin sheath surrounding the nerve fibers in the central nervous system. It is unpredictable and varies widely in symptoms and progression between individuals. While the exact cause is unknown, genetic and environmental factors like vitamin D levels and certain infections are thought to play a role. Common symptoms include fatigue, numbness, vision issues, and mobility problems. Treatment aims to reduce relapses and slow progression using medications, therapy, and lifestyle changes. No cure exists, so self-management is important given the lifelong impact of the
Rotavirus vaccine presentation Rotateq 28 june 2013Gaurav Gupta
This document discusses rotavirus, a leading cause of severe diarrhea among children under 5 years old globally. It provides an overview of the disease burden in India, differences between the two available rotavirus vaccines (Rotarix and RotaTeq), challenges with vaccine serotype diversity and efficacy, and recommendations from WHO and IAPCOI to include rotavirus vaccination in national immunization programs in developing countries due to the potential for significant impact even with moderate vaccine efficacy.
Similar to ABC of PREVENTION HERPES ZOSTER IN ADULT WOMEN (20)
PCOS -INDIAN STORY (IFS Good clinical practice recommendations) Dr. Sharda ...DGFPublicAwareness
PCOS is very common in India, affecting up to 2 in 5 adolescents and 1 in 5 adult women. Factors contributing to its high prevalence in India include urbanization, earlier menarche, genetic predisposition, and early malnutrition. Common symptoms include hirsutism in 44% of cases, acne in 20%, and glucose intolerance in 16.3% of women. PCOS is associated with increased risks of depression, diabetes, cardiovascular disease, non-alcoholic steatohepatitis, and obstructive sleep apnea. Diagnosis requires one biochemical and one clinical criterion. Lifestyle modifications like diet and exercise are the first line treatment, while bariatric surgery may be recommended for severe obesity.
45X LOSS OF WHOLE OR PART OF X XP DELETION OR XQ DELETION OR ISO CHROMOSOME XP OR XQ OR RING CHROMOSOME X
CLINICAL FEATURES- FEMALE INFANTILISM
• Webbed neck * Coarctation and other cardiac AS A R
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• Broad chest * Hypothyroidism
• Wide carrying angle arm * High LH FSH
• Infantile ovaries
HEAVY MENSTRUAL BLEEDING IN ADOLESCENTS DR. Sharda Jain , Dr. Meenakshi Dr. M...DGFPublicAwareness
CAUSES: Anovulatory bleeding :
Early menarche earlier is the commonest cause to cycles become ovulatory: if menarche 13 year it takes 4,5 year for cycle to become ovulatory due to unopposed estrogen thick endometrium thin stromal layer causes AUB in adolescence
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This document discusses nutrition guidelines for pregnant women. It recommends eating a balanced diet with extra calories, protein, fats, vitamins, minerals and fiber. Food sources of these nutrients are listed. Some myths about foods to avoid are debunked. Healthy eating patterns, general guidelines and tips are provided such as maintaining an optimal weight gain, staying hydrated, limiting salt and caffeine, and exercising. Women are advised to eat small, frequent meals and not skip any.
PANEL DISCUSSION
MANAGEMENT OF PCOS - WOMB to TOMB
MODERATOR : Sharda Jain
PANELISTS : Dr.Chitra setia
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Dr. Ila Gupta
Dr. Rupam Arora
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Dr. Sangeeta Gupta
Dermatologists
Dr. V.K. Upadhyay
Dr. S. Kandhari
This document summarizes a panel discussion on HPV vaccination in India. Some key points:
- Cervical cancer is a major problem in India, with over 122,000 new cases and 67,000 deaths annually.
- HPV is the primary cause of cervical cancer. Vaccination induces high antibody levels to protect against HPV types 16 and 18, which cause 70% of cervical cancers.
- The best age for vaccination is 11-12 years, before sexual debut. Catch-up vaccination is recommended through age 26.
- Common side effects of HPV vaccination are mild and temporary. Rare severe allergic reactions may occur.
- Vaccination is recommended even for sexually active women and women in monogamous relationships to
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D.G.F. Guidelines on Immunization for Indian Adolescents Girls DGFPublicAwareness
The document provides guidelines on immunization for Indian adolescents. It discusses how immunization is important not just for infants and children, but adolescents as well. It recommends vaccines for different age groups, including Tdap, HPV, meningococcal, and annual influenza vaccines for ages 11-12. The guidelines emphasize delivering immunization services to adolescents to protect their health and future. Barriers to adolescent immunization rates are also addressed, along with ways providers can improve communication and access to help more adolescents get recommended vaccines.
D.G.F. Guidelines on Adult Immunization for Indian Women DGFPublicAwareness
This document provides guidelines on adult immunization for Indian women. It summarizes the key adult vaccines recommended in India including tetanus, diphtheria, pertussis (Tdap), human papillomavirus (HPV), influenza, measles, mumps, rubella (MMR), and varicella. For each vaccine, it outlines the target populations, dosing regimens, contraindications and precautions. The guidelines aim to promote awareness of the importance of adult immunization for preventing disease and maintaining health.
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Insight AUB Presentations based on FOGSI AUB GUIDELINES DGFPublicAwareness
This document provides guidelines for evaluating and managing abnormal uterine bleeding (AUB) from an Indian perspective. It discusses the need for India-specific guidelines given the high prevalence of AUB in India and variability in clinical practices. The guidelines recommend using the FIGO PALM-COEIN classification system and provide algorithms for the diagnosis and management of AUB. Evaluation involves a thorough history, examination, and targeted investigations. Recommendations are provided on appropriate laboratory tests, imaging, and procedures for assessing the endometrium based on a woman's age and risk factors. Management algorithms outline evidence-based treatment approaches for different etiologies of AUB.
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ACOG refers to IUFD as the demise occurring at or later than 20weeks.
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IOL..first mentioned HIPPOCRATES
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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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.
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ABC of PREVENTION HERPES ZOSTER IN ADULT WOMEN
1. DELHI GYANAECOLOGIST FORUM DRIVE
FOR Adult women vaccination
DR. SHARDA JAIN
Sec. Gen. D.G.F.
HERPES ZOSTER
ABC of PREVENTION
IN ADULT WOMEN
2. DELHI GYNAECOLOGIST FORUM HAS STARTED ITS
ACCOUNT in slideshare.net
SEE FOR PPTs on
Preventing the preventable… DGF Series
3. Varicella is the Primary Infection Caused by
Varicella-Zoster Virus1
Varicella
(Chickenpox) CDC Public Health Image Library (ID#1878).
Credit: CDC/PHIL, Dr. Erskine Palmer, B.G. Partin0
Varicella-Zoster Virus (VZV)
Primary Disease
1. Weaver BA. J Am Osteopath Assoc. 2009;109(suppl 2):S2–S6.
2. Gershon AA et al. Clin Microbiol Rev. 2013;26:728–743.
Child image courtesy of: Weaver BA. Herpes zoster overview: natural history and incidence.
J Am Osteopath Assoc. 2009;109(suppl 2):S2–S6. Reprinted with permission.
4. Most Adults Worldwide Are Seropositive
For VZV by Age 40 Years
0
20
40
60
80
100
0–4 5–9 10–14 15–19 20–29 30–39 40–49 >50
Argentina1 Australia2
Brazil3 Canada4
Italy5 Malaysia6
Mexico7 Netherlands8
Philippines6 South Korea9
Thailand10 Turkey11
UK12 US13
Seroprevalence of VZV by Age1–13
Age (years)
Seroprevalence(%)
Argentina1
Brazil3
Italy5
Mexico7
Philippines6
Thailand10
UK12
Australia2
Canada4
Malaysia6
Netherlands8
South Korea9
Turkey11
US13
VZV=varicella-zoster virus.
1. Dayan GH et al. J Clin Microbiol. 2004;42:5698–5704. 2. O’Grady KA et al. Trop Med Int Health. 2000;5:732–736. 3. Lafer MM et al. Rev Inst Med Trop Sao
Paulo. 2005;47:139–142. 4. Brisson M et al. Epidemiol Infect. 2001;127:305–314. 5. Gabutti G et al. BMC Public Health. 2008;8:372. 6. Lee BW. Trop Med Int
Health. 1998;3:886–890. 7. Conde-Glez C et al. Vaccine. 2013;31:5067–5074. 8. van Lier A et al. Vaccine. 2013;31:5127–5133. 9. Lee H et al. J Korean Med Sci.
2013;28:195–199. 10. Migasena S et al. Int J Infect Dis. 1997;2:26–30. 11. Koturoglu G et al. Paediatr Perinat Epidemiol. 2011;25:388–393. 12. Kudesia G et al. J
Clin Pathol. 2002;55:154–155. 13. Kilgore PE et al. J Med Virol. 2003;70 Suppl 1:S111–S118.
8. Older Age is Associated With Greater Risk
of Developing HZ (Worldwide)
HZ=herpes zoster.
1. Stein AN et al. Vaccine. 2009;27:520–529. 2. Tanuseputro P et al. Vaccine. 2011;29:8580–8584. 3. Gonzalez Chiappe S et al. Vaccine. 2010;28:7933–7938. 4. Weitzman D et al. J
Infect. 2013;67:463–469. 5. Gialloreti LE et al. BMC Infect Dis. 2010;10:230. 6. Toyama N et al. J Med Virol. 2009;81:2053–2058. 7. Ultsch B et al. Eur J Health Econ. 2013;14:1015–
1026. 8. de Melker H et al. Vaccine. 2006;24:3946–3952. 9. Esteban-Vasallo MD et al. J Infect. 2014;68:378–386. 10. Lin YH et al. Vaccine. 2010;28:1217–1220. 11. Gauthier A et al.
Epidemiol Infect. 2009;137:38–47.
12. Yawn BP et al. Neurology. 2013;81:928–930.
0
5
10
15
0 10 20 30 40 50 60 70 80
Australia1 Canada2 France3
Israel4 Italy5 Japan6
Germany7 Netherlands8 Spain9
Taiwan10 UK11 US12
Worldwide HZ Incidence by Age1–12
Age (years)
AnnualIncidence
(per1,000person-years)
Australia1
Israel4
Germany7
Taiwan10
Canada2
Italy5
Netherlands8
UK11
France3
Japan6
Spain9
US12
9. 1. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat (2013).
World Population Prospects: The 2012 Revision. New York: United Nations.
esa.un.org/unpd/wpp/Documentation/pdf/WPP2012_Volume-I_Comprehensive-Tables.pdf. Accessed March 4, 2014.
35.5%
13.7%
23.3%
25.9%
23.1%
24.9%
18.3%
30.2%
23.8%
28.9%
25.2%
15.8%
6.4%
9.3%
9.5%
8.5%
12.5%
8.3%
10.5%
9.5%
11.2%
15.1%
0.0
Singapore
Philippines
Peru
Mexico
Malaysia
Korea
India
Costa Rica
Columbia
Brazil
Argentina
Percentage of Adults Aged ≥60 Years
(Latin America and Asia Pacific)
2013
2050
The Age Group at Greatest Risk for
Herpes Zoster is Growing Worldwide (continued)1
13. Degree of Pain in Herpes Zoster1
Katz J & Melzack R. Measurement of Pain. Surgical Clinics North America. 1999;;79(2):231-252.
Chronic pain
conditions
Mild pain
Severe pain
Abdominal
hysterectomy
Acute headache
Herpes zoster
Labor pain
Post-surgical pain
Mucositis
Angioplasty
sheath removal
Post-herpetic neuralgia
Chronic cancer pain
Fibromyalgia
Rheumatoid arthritis
Arthritis/osteoarthritis
Musculoskeletal pain
Atypical facial pain
Adapted from Katz J & Melzack R.
*SF-MPQ : Short-Form McGill Pain Questionnaire
Acute pain
conditions
0
10
20
30
14. Herpes Zoster Can Affect Almost Anyone
• Herpes zoster may occur in any person with a
history of varicella. There is no way to predict
– WHEN the varicella-zoster virus will reactivate1,2
– WHO will develop herpes zoster1,2
– HOW SEVERE an individual case may be1,3
– HOW LONG the pain will last1,2
1. Harpaz R et al. MMWR. 2008;57(RR-5):1–30.
2. Weaver BA. J Am Osteopath Assoc. 2009;109(suppl 2):S2–S6.
3. Oxman MN. J Am Osteopath Assoc. 2009;109(suppl 2):S13–S17.
16. POSTHERPETIC NEURALGIA (PHN)
• PHN is the most common complication of HZ1
• The prevalence of PHN varies greatly, depending on
the definition used1
– Pain beyond 30 days: 30% in people younger than 40 and
up to 74% in those 60 years and older
– Pain beyond 90 days: 6% in people younger than 40 and
12% in those 60 years and older
• Risk factors for PHN include advanced age, female
sex, presence of a prodrome, greater rash severity,
and greater acute pain severity1,2
HZ=herpes zoster.
1. O'Connor KM et al. Med Clin North Am. 2013;97:503–522.
2. Johnson RW. Herpes. 2007;14(suppl 2):30A–34A.
18. HZ and PHN Impact 4 Health Domains1
HZ=herpes zoster; PHN=postherpetic neuralgia.
1. Johnson RW et al. BMC Medicine. 2010;8:37–49.
Physical
Fatigue
Anorexia
Weight loss
Reduced mobility
Physical inactivity
Insomnia
Psychological
Depression
Anxiety
Emotional distress
Difficulty concentrating
Fear
Social
Withdrawal
Isolation
Attendance at fewer social
gatherings
Loss of independence
Change in social role
Functional
Dressing, bathing
Housework
Eating, cooking
Mobility
Traveling
Shopping
HZ=herpes zoster; PHN=postherpetic neuralgia.
1. Johnson RW et al. BMC Medicine. 2010;8:37–49.
Physical
Fatigue
Anorexia
Weight loss
Reduced mobility
Physical inactivity
Insomnia
Psychological
Depression
Anxiety
Emotional distress
Difficulty concentrating
Fear
Social
Withdrawal
Isolation
Attendance at fewer social
gatherings
Loss of independence
Change in social role
Functional
Dressing, bathing
Housework
Eating, cooking
Mobility
Traveling
Shopping
19. WHAT ABOUT THE TREATMENT OPTIONS?
HZ=herpes zoster; PHN=postherpetic neuralgia.
20. Treating Herpes Zoster and PHN
Can Be Difficult
• Treatment for HZ and PHN often requires a multifaceted approach1–3
HZ=herpes zoster; PHN=postherpetic neuralgia.
1. Cohen JI. N Engl J Med. 2013;369:255–263. 2. Johnson RW. J Infect Dis. 2002;186(Suppl 1):S83–S90. 3. Harpaz R et al. MMWR. 2008;57(RR-5):1–30. 4. Chen N et al. Cochrane Database Syst
Rev. 2014 Feb 6;2:CD006866. doi: 10.1002/14651858.CD006866.pub3. 5. Sacks GM. Am J Manag Care. 2013;19(1 Suppl):S3–S9. 6. Glauser TA et al. J Pain Res. 2011;4:407–415.
HZ PHN
Non-narcotic
analgesics
Antivirals
Narcotic
analgesics
Anticonvulsants
for pain
management
Topical
agents
Corticosteroids
• Antiviral therapy for acute HZ should be initiated within 72 hours of
appearance of skin lesions1–3
– Antiviral therapy hastens the resolution of skin lesions but does not significantly
reduce the incidence of PHN1,4
• PHN is often refractory to treatment and treatment satisfaction is poor
– Patients often report intolerable treatment-related side effects with therapeutic
agents for PHN5
21. Treatment Considerations For Older Adults
• Many older adults have comorbidities and are taking medications
that may complicate treatment of HZ and PHN1–3
• Management of HZ and PHN in vulnerable and frail elderly
patients requires modified pharmacotherapeutic approaches and
augmented nonpharmacotherapeutic approaches3
– Available treatment options may require several weeks to reach target
dosing, during which time patients have inadequate pain control2
• Patients should be monitored for inadequate
response to treatment and functional decline3
HZ=herpes zoster; PHN=postherpetic neuralgia.
1. Harpaz R et al. MMWR. 2008;57(RR-5):1–30.
2. Sacks GM. Am J Manag Care. 2013;19(1 Suppl):S3–S9.
3. Dworkin RH et al. Clin Infect Dis. 2007;44(1 Suppl):S1–26.
Comorbidities
Poly-
pharmacy
Drug-drug
interactions
Adverse
effects
22. TAKE HOME MESSAGES
of Herpes Zoster disease
• Herpes zoster (HZ) is caused by reactivation of latent
varicella-zoster virus in dorsal root and cranial sensory
ganglia
• HZ causes pain and suffering for millions of people
worldwide each year
• There is no way to predict
– When the varicella-zoster virus will reactivate
– Who will develop HZ
– How severe an individual case may be
– How long the pain will last
• Almost all adults aged ≥50 years are at risk for this
often debilitating disease, with risk increasing with age
23. TAKE HOME MESSAGES
• Postherpetic neuralgia (PHN) is the most common
complication of herpes zoster
• PHN can be difficult to manage and refractory to
treatment and can persist for months or even years
• PHN and other less common complications can
cause prolonged disability, substantially reduce
quality of life, and interfere with activities of daily
living
– Herpes zoster and its complications can be a psychosocial and economic
burden to individuals,
their families, and society
25. ZOSTAVAX™ [ZOSTER VACCINE LIVE
(OKA/MERCK)] PRODUCT PROFILE
• Live, attenuated VZV vaccine
• Minimum of 19,400 PFU per dose1
– 14 times the minimum potency of VARIVAX™
[Varicella Virus Vaccine Live (Oka/Merck)]
• No preservative
• Lyophilized product
• Single subcutaneous dose
PFU=plaque-forming unit; VZV=varicella-zoster virus.
1. Oxman MN et al. N Engl J Med. 2005;352:2271–2284.
26. ZOSTAVAX™ [Zoster Vaccine Live (Oka/Merck)]
Indications and Contraindications
• ZOSTAVAX is indicated for vaccination of adults
aged 50 years and older for
– Prevention of herpes zoster (HZ)
– Prevention of postherpetic neuralgia (PHN)
– Reduction of acute and chronic HZ-associated pain
• History of anaphylactic/anaphylactoid reaction to
gelatin, neomycin, or any other component of the
vaccine
• Immunosuppression or immunodeficiency
• Active untreated tuberculosis
• Pregnancy
Indications
Contra-
indications
28. International Recommendations for
ZOSTAVAX™ [Zoster Vaccine Live (Oka/Merck)]
CDC=Centers for Disease Control and Prevention.
Please see Speaker Notes for reference list.
United States CDC Advisory Committee on Immunization Practices:
adults aged ≥60 years
Canada National Advisory Committee on Immunization:
adults aged ≥60 years, may be used in adults aged 50–59 years
Europe • UK: Joint Committee on Vaccines and Immunisation:
adults aged 70–79 years, and catch-up for adults aged 79 years
• Austria: Empfehlungen des Obersten Sanitätsrates:
adults aged ≥50 years
• France: Haut Conseil de la Santé Publique:
adults aged 65–74 years, and catch-up for adults aged 75–79 years
• Greece: National Vaccine Committee: adults aged ≥60 years
• Sweden: Dental and Pharmaceutical Benefits Agency (TLV):
reimbursement for adults aged ≥50 years
29. API recommendations on Adult
Immunization 2014
D, S., & V, R. (2015). Adult Immunization 2014 (2nd ed., p. 251). New Delhi: Jaypee brothers medical publishers (P) Ltd.
30. SUMMARY
• ZOSTAVAX™ [Zoster Vaccine Live (Oka/Merck)] is administered in a
single dose to adults over 50 or over 60 years of age—starting age
depends on guidance by local public health agencies
• ZOSTAVAX was shown to boost varicella-zoster virus (VZV)–specific
cellular immunity, which is thought to be the mechanism by which it
protects against herpes zoster and its complications
• In clinical trials, ZOSTAVAX reduced the incidence, severity, and
complications of herpes zoster
• In clinical trials, ZOSTAVAX had a demonstrated safety and tolerability
profile, with adverse events largely limited to injection-site reactions
31. www.delhigynaecologistforum.com
HEAD OFFICE : 11 Gagan Vihar, Near Karkari Morh
Flyover Delhi – 110051
Helpline No : 01122414049 , 8826638849
DR. SHARDA JAIN
Sec. Gen. D.G.F.
9650511339
9650588339
DR. URMIL SHARMA
President
9810068815
MS. MALTI
Admin Officer
8826638849
7533059677