Acquired immune deficiency syndrome by Dr Bashir Associate Professor Medicine...Prof Dr Bashir Ahmed Dar
The most important way to stop HIV/AIDS is education. People can get HIV from sex and from blood. Children can also get HIV from their mothers (when they grow inside pregnant mothers and when they drink breast milk.) Sex is one way to get HIV. If people use condoms when they have sex, there is a much smaller chance of catching HIV.
A very brief & concise ppt. for HIV... Includes a video from YouTube explaining the Replication cycle of HIV. {actually was a class project ;)}. Hope you people like it.
Here's the link to the video: https://www.youtube.com/watch?v=RO8MP3wMvqg
Acquired immune deficiency syndrome by Dr Bashir Associate Professor Medicine...Prof Dr Bashir Ahmed Dar
The most important way to stop HIV/AIDS is education. People can get HIV from sex and from blood. Children can also get HIV from their mothers (when they grow inside pregnant mothers and when they drink breast milk.) Sex is one way to get HIV. If people use condoms when they have sex, there is a much smaller chance of catching HIV.
A very brief & concise ppt. for HIV... Includes a video from YouTube explaining the Replication cycle of HIV. {actually was a class project ;)}. Hope you people like it.
Here's the link to the video: https://www.youtube.com/watch?v=RO8MP3wMvqg
Structure of Virus, modes of transmission, pathogenesis, clinical features, biochemical basis of clinical symptoms, laboratory diagnosis, treatment and prevention.
Clinical features of HIV
Baseline investigations
Laboratory diagnosis of HIV
Algorithm for the use of the diagnosis of HIV-1 or HIV-2 infection.
PRINCIPLES OF THERAPY OF HIV INFECTION
medications used in treatment
Secondary prophylaxis of opportunistic infections
Prevention of HIV
reference Davidsons Priniciples and Practice of Medicine
and Harrisons Manual Of Internal Medicine
This powerpoint, deals with HIV pathophysiology, signs and symptoms, mode of transmission and diagnostic parameters.
Purely based on clinical pharmacist perspective.
HIV infection
Mode of transmission, pathogenesis, clinical manifestations, laboratory diagnosis, treatment, prevention, prognosis, scope of AIDS vaccine.
Structure of Virus, modes of transmission, pathogenesis, clinical features, biochemical basis of clinical symptoms, laboratory diagnosis, treatment and prevention.
Clinical features of HIV
Baseline investigations
Laboratory diagnosis of HIV
Algorithm for the use of the diagnosis of HIV-1 or HIV-2 infection.
PRINCIPLES OF THERAPY OF HIV INFECTION
medications used in treatment
Secondary prophylaxis of opportunistic infections
Prevention of HIV
reference Davidsons Priniciples and Practice of Medicine
and Harrisons Manual Of Internal Medicine
This powerpoint, deals with HIV pathophysiology, signs and symptoms, mode of transmission and diagnostic parameters.
Purely based on clinical pharmacist perspective.
HIV infection
Mode of transmission, pathogenesis, clinical manifestations, laboratory diagnosis, treatment, prevention, prognosis, scope of AIDS vaccine.
Yarn printing is also known as “Space Dyeing”. Although the printing of yarns for true patterned effects proved very difficult tom control, the random space-dyed effects that can be more readily attained by a variety of yarn-printing methods have continued to be popular. The patent literature abounds with systems for producing colored flecked effects on yarns but the two most successful methods entail either warp printing or color application to a tubular knitted ‘sock’. The essential process sequence begins with dye liquor application, followed by steam fixation, washing-off and drying .
Discussions on
Dr. S. GOKULA KRISHNAN, 2 Associate Professor @NSM
Definition of Power
Bases of Power
Dependence: The Key to Power
Power Tactics
Politics: Power in Action
Causes and Consequences of Political Behavior
Reference:
Stephen P Robbins, Timothy A Judge & NeharikaVohra, Organizational Behaviour, 15thed., p. 439-466
What is HIV? How an HIV infections advances to AIDS? What is AIDS? What are the medicine to stop HIV replication? What are the diagnostic tests? What are the medical managements for AIDS? What are the categories of HIV infection? Symptoms of HIV infection? What should be the nurse care plan for an AIDS patient? How can people prevent HIV infection? All these questions are answered in this presentation.
Introduction to HIV/AIDS
Epidemiology
Structural information of HIV
Life cycle of HIV
Symptoms & causes of AIDS due to HIV
Pathophysiology
Pharmacological Classification along with mechanism of action
Novel targets for Anti-retroviral Drugs
Summary
References
Vote of thanks
The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS).
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
ISI 2024: Application Form (Extended), Exam Date (Out), EligibilitySciAstra
The Indian Statistical Institute (ISI) has extended its application deadline for 2024 admissions to April 2. Known for its excellence in statistics and related fields, ISI offers a range of programs from Bachelor's to Junior Research Fellowships. The admission test is scheduled for May 12, 2024. Eligibility varies by program, generally requiring a background in Mathematics and English for undergraduate courses and specific degrees for postgraduate and research positions. Application fees are ₹1500 for male general category applicants and ₹1000 for females. Applications are open to Indian and OCI candidates.
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
Phenomics assisted breeding in crop improvementIshaGoswami9
As the population is increasing and will reach about 9 billion upto 2050. Also due to climate change, it is difficult to meet the food requirement of such a large population. Facing the challenges presented by resource shortages, climate
change, and increasing global population, crop yield and quality need to be improved in a sustainable way over the coming decades. Genetic improvement by breeding is the best way to increase crop productivity. With the rapid progression of functional
genomics, an increasing number of crop genomes have been sequenced and dozens of genes influencing key agronomic traits have been identified. However, current genome sequence information has not been adequately exploited for understanding
the complex characteristics of multiple gene, owing to a lack of crop phenotypic data. Efficient, automatic, and accurate technologies and platforms that can capture phenotypic data that can
be linked to genomics information for crop improvement at all growth stages have become as important as genotyping. Thus,
high-throughput phenotyping has become the major bottleneck restricting crop breeding. Plant phenomics has been defined as the high-throughput, accurate acquisition and analysis of multi-dimensional phenotypes
during crop growing stages at the organism level, including the cell, tissue, organ, individual plant, plot, and field levels. With the rapid development of novel sensors, imaging technology,
and analysis methods, numerous infrastructure platforms have been developed for phenotyping.
The ability to recreate computational results with minimal effort and actionable metrics provides a solid foundation for scientific research and software development. When people can replicate an analysis at the touch of a button using open-source software, open data, and methods to assess and compare proposals, it significantly eases verification of results, engagement with a diverse range of contributors, and progress. However, we have yet to fully achieve this; there are still many sociotechnical frictions.
Inspired by David Donoho's vision, this talk aims to revisit the three crucial pillars of frictionless reproducibility (data sharing, code sharing, and competitive challenges) with the perspective of deep software variability.
Our observation is that multiple layers — hardware, operating systems, third-party libraries, software versions, input data, compile-time options, and parameters — are subject to variability that exacerbates frictions but is also essential for achieving robust, generalizable results and fostering innovation. I will first review the literature, providing evidence of how the complex variability interactions across these layers affect qualitative and quantitative software properties, thereby complicating the reproduction and replication of scientific studies in various fields.
I will then present some software engineering and AI techniques that can support the strategic exploration of variability spaces. These include the use of abstractions and models (e.g., feature models), sampling strategies (e.g., uniform, random), cost-effective measurements (e.g., incremental build of software configurations), and dimensionality reduction methods (e.g., transfer learning, feature selection, software debloating).
I will finally argue that deep variability is both the problem and solution of frictionless reproducibility, calling the software science community to develop new methods and tools to manage variability and foster reproducibility in software systems.
Exposé invité Journées Nationales du GDR GPL 2024
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Travis Hills' Endeavors in Minnesota: Fostering Environmental and Economic Pr...Travis Hills MN
Travis Hills of Minnesota developed a method to convert waste into high-value dry fertilizer, significantly enriching soil quality. By providing farmers with a valuable resource derived from waste, Travis Hills helps enhance farm profitability while promoting environmental stewardship. Travis Hills' sustainable practices lead to cost savings and increased revenue for farmers by improving resource efficiency and reducing waste.
DERIVATION OF MODIFIED BERNOULLI EQUATION WITH VISCOUS EFFECTS AND TERMINAL V...Wasswaderrick3
In this book, we use conservation of energy techniques on a fluid element to derive the Modified Bernoulli equation of flow with viscous or friction effects. We derive the general equation of flow/ velocity and then from this we derive the Pouiselle flow equation, the transition flow equation and the turbulent flow equation. In the situations where there are no viscous effects , the equation reduces to the Bernoulli equation. From experimental results, we are able to include other terms in the Bernoulli equation. We also look at cases where pressure gradients exist. We use the Modified Bernoulli equation to derive equations of flow rate for pipes of different cross sectional areas connected together. We also extend our techniques of energy conservation to a sphere falling in a viscous medium under the effect of gravity. We demonstrate Stokes equation of terminal velocity and turbulent flow equation. We look at a way of calculating the time taken for a body to fall in a viscous medium. We also look at the general equation of terminal velocity.
ESR spectroscopy in liquid food and beverages.pptxPRIYANKA PATEL
With increasing population, people need to rely on packaged food stuffs. Packaging of food materials requires the preservation of food. There are various methods for the treatment of food to preserve them and irradiation treatment of food is one of them. It is the most common and the most harmless method for the food preservation as it does not alter the necessary micronutrients of food materials. Although irradiated food doesn’t cause any harm to the human health but still the quality assessment of food is required to provide consumers with necessary information about the food. ESR spectroscopy is the most sophisticated way to investigate the quality of the food and the free radicals induced during the processing of the food. ESR spin trapping technique is useful for the detection of highly unstable radicals in the food. The antioxidant capability of liquid food and beverages in mainly performed by spin trapping technique.
Toxic effects of heavy metals : Lead and Arsenicsanjana502982
Heavy metals are naturally occuring metallic chemical elements that have relatively high density, and are toxic at even low concentrations. All toxic metals are termed as heavy metals irrespective of their atomic mass and density, eg. arsenic, lead, mercury, cadmium, thallium, chromium, etc.
2. Definition
• The acquired immune deficiency
syndrome (AIDS) is the state of profound
immunosuppression produced by
chronic infection with human
immunodeficiency virus (HIV).
2
3. Epidemiology
• In June 1981, five cases of Pneumocystis jiroveci (formerly known as
carinii) pneumonia (PCP) were reported.
• Reports of other unusual conditions, such as Kaposi's sarcoma (KS),
followed shortly.
• In each of these patients, there was found to be a marked impairment
of cellular immune response, and so the term acquired immune
deficiency syndrome, or AIDS, was coined.
• In 1984, a new human retrovirus, subsequently named human
immunodeficiency virus (HIV), was isolated and identified as the
cause of AIDS.
3
4. Isolation of HIV
• The virus has been isolated from a number of body fluids, including:
i. blood,
ii. saliva,
iii. Tears,
iv. urine,
v. semen,
vi. vaginal secretions,
vii. breast milk,
viii. peritoneal fluid and
ix. cerebrospinal fluid (CSF).
4
5. Routes of HIV Transmission
• Predominant routes of transmission:
i. Copulation
ii. Sharing of unsterilized needles or syringes
iii. Blood or blood products (unscreened/unsterilized)
iv. Vertical transmission in utero
v. During labor
vi. Through lactation
5
7. HIV Life-Cycle
1. Binding:
On the surface of T-cell, HIV binds to a CD4 receptors by the
help of gp-41 and one of the two co-receptors- CXCR4 or CCR5
2. Fusion:
The virus fuses with the host cell membrane and releases its
genetic material (RNA) and enzymes into the cell.
3. Reverse Transcription:
The single-stranded HIV RNA is converted into double-
stranded HIV by the reverse transcriptase enzyme. 7
8. 4. Integration:
After the HIV DNA enters the cell’s nucleus, the enzyme integrase cuts the
cell’s DNA and inserts the HIV into it forming a provirus.
5. Transcription and Translation:
The enzyme RNA polymerase makes RNA copies of DNA, HIV RNA is either
inserted into new virus particles or processed and translated into HIV proteins.
6. Assembly:
The long protein chains are cut into individual proteins by the enzyme
HIV protease. A new virus is assembled with these proteins and HIV RNA.
7. Release:
The new virus particle is released from the host cell, taking with it part of
the cells membrane, and capable of infecting other cells.
8
10. Disease Progression
• Immediately after primary HIV Infection (PHI, also known as
‘seroconversion’), there is a very high rate of viral turnover.
• Equilibrium is then reached, at which stage the infection may appear
to be clinically latent, but in fact, as many as 10,000 million new
virions are produced each day.
• Over time, as chronic infection ensues, cells possessing CD4
receptors, particularly the T-helper lymphocytes, are depleted from
the body.
10
11. Disease Progression
• The individual becomes susceptible to a myriad of infections and
tumors.
• The rate at which this immunosuppression progresses is variable and
the precise interaction of factors affecting it is still not fully
understood.
• It is likely that a combination of viral, host (genetic) and
environmental factors contributes to this variation.
11
12. Clinical Manifestations
The sequelae of untreated HIV infection can be broadly considered in five
categories:
1. Opportunistic infections, e.g., P. jiroveci pneumonia (PCP) and cytomegalovirus
(CMV).
2. Infections that can occur in immune-competent patients but tend to occur
more frequently, more severely, for example, Salmonella, herpes simplex and
Mycobacterium tuberculosis.
3. Malignancies, for example, Kaposi's sarcoma and non-Hodgkin's lymphoma.
4. Direct manifestations of HIV infection, for example, HIV encephalopathy, HIV
myelopathy and HIV enteropathy.
5. Consequences of chronic immune activation including premature
cardiovascular disease, neurocognitive dysfunction, bone mineral density loss.
12
13. Symptoms
• In addition, approximately 70% of individuals develop a flu-like illness
at seroconversion.
• This primary HIV infection (PHI) is characterised by:
• fever,
• arthralgia,
• pharyngitis,
• rash
• lymphadenopathy.
13
14. Patients’ Classification According to Clinical Status
• Patients can be classified into one of three groups according to their
clinical status:
1. Asymptomatic
2. Symptomatic
3. AIDS
14
15. • Symptomatic disease is characterized
1. By non-specific symptomatology such as
a) Fever,
b) Night sweats
c) Lethargy
d) Weight loss, or
2. By complications including
a) oral candidiasis
b) oral hairy leukoplakia
c) recurrent herpes simplex or herpes zoster infections.
15
16. • AIDS is defined by the diagnosis of one or more specific
conditions including
i. P. jiroveci pneumonia (PVP),
ii. M. tuberculosis infection &
iii. CMV disease.
16
17. Investigations and Monitoring
1. Current and Previous Infections
2. CD4 Count
3. Viral Load (HIV RNA)
4. Resistance Testing
5. Tropism Tensting
17
18. 1. Current & Previous Infections
Detection of antibodies
against HIV
Within 3-4 weeks of
infection
‘Window Period’ of 3
months is req. for
confirmation
Test for prior exposure to
number of potential
pathogens
Syphilis, Hepatitis A, B and
C, CMV, Varicella zoster
virus, T. gondii.
This can enable subsequent
Treatment
(in case of undiagnosed
syphilis)
Vaccination
(if no prior exposure to
hepatitis A, B, or VZV),
Prevention
(if no prior exposure to
Toxoplasma and CMV)
Prophylaxis
(if previous exposure to
Toxoplasma)
Diagnosis
(according to CMV or
Toxoplasma status).
18
19. 2. CD4 count
Level of
immunosuppression is
estimated
By measuring the
number of CD4-positive
T-lymphocytes
In the sample of
peripheral blood
Normal range can vary
between 500 and 1500
cells/mm3
Particular complications
of HIV infection usually
begin to occur at CD4
counts specified in graph
Can assist in differential
diagnoses
And enable the use of
prophylactic therapies.
CD4 count can be used
as the major indicator of
when to consider
starting antiretroviral
therapy.
19
21. 3. Viral Load (HIV RNA)
Estimates amount of
circulating virus in the
blood
Correlates with
prognosis
High viral load predicts
faster disease
progression
Reduction in viral load
after commencement of
antiviral therapy is
associated with clinical
benefit
Helps in making
decisions regarding
when to start and when
to change antiviral
therapies
And enabling more
effective use of antiviral
agents
21
22. 4. Resistance Testing
Due to the implications of transmitted (primary) resistance,
A genotypic HIV resistance test is recommended;
Soon after diagnosis.
This ensures that appropriate initial therapy is selected.
22
23. 5. Tropism Testing
• Viruses may enter the cell using:
1. CCR5 co-receptor (CCR5-tropic viruses)
2. CXCR4 co-receptor (CXCR4-tropic viruses)
3. Both co-receptors (dual-tropic viruses)
4. Where a mixture of virus population is present, the
term mixed-tropic is used.
23
24. 5. Tropism Testing
• Different methods of determining tropism are currently under
evaluation.
• Real time testing; as viral tropism changes as the disease progresses.
• Importance:
If CCR5 inhibitors are to be used, it is essential to determine that the
virus is CCR5-tropic, that is, that there is no significant use of the CXCR4
receptor.
24
25. Aims of Drug Therapy
1. Treating or preventing opportunistic complications
2. Alleviating HIV-related symptoms
3. Reducing the HIV viral load
4. Reducing the potential consequences of co-morbidities
5. Restoring immune function
25
26. Goals of Therapy
• The goals of therapy in HIV-positive individuals are to:
1. Improve the quality and duration of life;
2. Prevent deterioration of immune function and/or
restore immune status;
3. Treat and/or prevent opportunistic infections;
4. Relieve symptoms.
26
27. Anti-Retroviral Therapy
General Principles:
1. A combination of 3 anti-retrovirals should usually be prescribed to
i. increase efficacy and
ii. reduce the development of drug-resistant virus.
2. Wherever possible, a regimen should contain at least one drug that
penetrates CNS and confers protection against HIV-related infections.
3. Treatment strategies should be adopted keeping in mind the potential
cross resistance and future therapy options.
4. Given the crucial importance of a high level of adherence to these
therapies, the regimen adopted should be tailored to suit the daily
lifestyle.
27
28. Anti-Retroviral Therapy
• When to start therapy?
when CD4 count drops below 350cells/mm3
• Therapy Strategies:
3 NRTIs
2 NRTIs + 1 NNRTI
2 NRTIs + Boosted PI
‘Boosted PI’ refers to a combination of one PI combined with a low dose
(usually 100–200mg OD or BD) of ritonavir*, another PI.
* Ritonavir ↑ C max & t½, by inhibiting cytochrome P450
28
29. Resistance to Anti-Retrovirals
• The aim of initial therapy is to
oachieve viral load suppression in the plasma to levels below the
detection limits accompanied by an elevation in CD4 count.
• Suppression over many years is usually possible, viral rebound
may occur and is often accompanied by the development of
resistance to one or more agents in the combination.
• Resistance test is performed which will help to identify the
oresistant agents
oextent to which such resistance may cause cross-resistance to other
available drugs
29
30. Resistance to Anti-Retrovirals
• A second-line regimen is then constructed, wherever possible utilizing
a new class of drug to which the individual has not previously been
exposed.
ADRs:
• Anti-retrovirals, particularly the PIs and NNRTIs, are CYP450 inhibitors
thus exhibit a wide range of interactions, especially with drugs that
are metabolized by this enzyme system leading to severe toxicity.
• E.g., Cushing's syndrome by concomitant use of budesonide inhaler or
nasal spray with a PI.
30
33. Class MOA Drug Dose ADRs
NRTIs
(Nucleoside Reverse
Transcriptase
Inhibitors)
They are phosphorylated
intracellularly and then inhibit
reverse transcriptase by acting
as a false substrate.
Lamivudine
150 mg P.O.
BID
Anemia
Lactic Acidosis
NNRTIs
(Non-Nucleoside
Reverse
Transcriptase
Inhibitors)
Inhibit reverse transcriptase by
binding to its active site. No
phosphorylation is req. They
can act on cell-free virions as
well as infected cells.
Delavirdine
400 mg P.O.
TID
Well tolerated
Mild Rash
PIs
(Protease Inhibitors)
Bind to protease enzyme and
prevents maturation of the
newly produced virions so that
they remain non infectious.
Squinavir 600 mg P.O.
TID
Prolonged QC
interval
Raised LFTs
33
34. Class MOA Drug Dose ADRs
Fusion
Inhibitor
Block the structural
rearrangement of HIV-1 gp41 &
stops the fusion of viral cell
membrane with the target cell
membrane, preventing its entry
into the cell.
Enfuvirtide 90mg P.O.
BID
Injection site
reactions
Eosinophilia
CCR5
Antagonist
Selectively bind to the human
chemokine receptor CCR5,
preventing CCR5-tropic HIV-1
from entering cells.
Maraviroc
150mg BID
(if g/w significant
enzyme inhibitors)
300mg BID
(if not g/w significant
inhibitors)
Raised creatine
kinase
Constipation
Integrase
Inhibitor
Bind to the integrase enzyme,
thus blocking the integration of
viral DNA into host DNA.
Raltegravir 400mg P.O.
BID
Insomnia
Raised LFTs
34
35. Treating Opportunistic Infections
Infection Drug
PCP Clindamycin or
Co-trimoxazole
CMV Cidofovir
MAI Rifabutin or
Azithromycin
Herpes zoster /
Herpes simplex
Acyclovir
Oral Candidiasis Nystatin
35
36. Impact of HAART on opportunistic infections
• Decreased incidence of opportunistic infections.
• HAART has resulted in reduction in
vast majority of opportunistic infections
mortality rates
hospital admissions
36
37. Considerations
All infected people should be:
1. Treated as individuals
2. Given appropriate information to enable them
• To participate in healthcare decision making process
• Adhere to regimen
3. Given appropriate advice regarding prevention
4. Monitored regularly to detect
• treatment failure
• non-adherence
• drug toxicity
37
38. Pharmacist Role
The pharmaceutical care needs for HIV+ individuals are:
P = Poly-pharmacy
A = ADRs
N = New Drugs
D = Drug Interactions
A = Adherence
*They are prescribed large number of drugs (up to 12 tabs/caps per day)
38