The document discusses HIV/AIDS and cryptococcal meningitis. It provides information on HIV/AIDS including that it is caused by the HIV virus and weakens the immune system. It then discusses cryptococcal meningitis as an opportunistic infection, describing its symptoms. The remainder of the document discusses a case of a 45-year-old male patient admitted with fever, vomiting and headache who is diagnosed with cryptococcal meningitis and treated with antifungal drugs like amphotericin B and fluconazole.
Now a days TBM is super most disease in Indian children.
Tuberculous meningitis (TBM) is difficult to diagnose, and a high index of suspicion is needed to make an early diagnosis.
Leptospirosis is an infection caused by corkscrew-shaped bacteria called Leptospira. Signs and symptoms can range from none to mild such as headaches, muscle pains, and fevers; to severe with bleeding from the lungs or meningitis. If the infection causes the person to turn yellow, have kidney failure and bleeding, it is then known as Weil's disease.If it causes lots of bleeding into the lungs then it is known as severe pulmonary hemorrhage syndrome.
Up to 13 different genetic types of Leptospira may cause disease in humans. It is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents.[7] It is often transmitted by animal urine or by water or soil containing animal urine coming into contact with breaks in the skin, eyes, mouth, or nose. In the developing world the disease most commonly occurs in farmers and poor people who live in cities. In the developed world it most commonly occurs in those involved in outdoor activities in warm and wet areas of the world.Diagnosis is typically by looking for antibodies against the bacterium or finding its DNA in the blood
A brief description of a very common illness affecting babies and children. Characterized by fever, heart complications, lymphadenopathy, skin rash and strawberry tongue. Useful information for doctors, medical students, dermatologists, residents, nurses. Helpful for students appearing for USMLE, MRCP, FCSP and MCPS exams. References include Rooks, Textbook of Dermatology
Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs.
The disease can be either localized to the skin or involve other organs in addition to the skin.
Symptoms may include areas of thickened skin, stiffness, feeling tired, and poor blood flow to the fingers or toes with cold exposure.
Now a days TBM is super most disease in Indian children.
Tuberculous meningitis (TBM) is difficult to diagnose, and a high index of suspicion is needed to make an early diagnosis.
Leptospirosis is an infection caused by corkscrew-shaped bacteria called Leptospira. Signs and symptoms can range from none to mild such as headaches, muscle pains, and fevers; to severe with bleeding from the lungs or meningitis. If the infection causes the person to turn yellow, have kidney failure and bleeding, it is then known as Weil's disease.If it causes lots of bleeding into the lungs then it is known as severe pulmonary hemorrhage syndrome.
Up to 13 different genetic types of Leptospira may cause disease in humans. It is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents.[7] It is often transmitted by animal urine or by water or soil containing animal urine coming into contact with breaks in the skin, eyes, mouth, or nose. In the developing world the disease most commonly occurs in farmers and poor people who live in cities. In the developed world it most commonly occurs in those involved in outdoor activities in warm and wet areas of the world.Diagnosis is typically by looking for antibodies against the bacterium or finding its DNA in the blood
A brief description of a very common illness affecting babies and children. Characterized by fever, heart complications, lymphadenopathy, skin rash and strawberry tongue. Useful information for doctors, medical students, dermatologists, residents, nurses. Helpful for students appearing for USMLE, MRCP, FCSP and MCPS exams. References include Rooks, Textbook of Dermatology
Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs.
The disease can be either localized to the skin or involve other organs in addition to the skin.
Symptoms may include areas of thickened skin, stiffness, feeling tired, and poor blood flow to the fingers or toes with cold exposure.
Tuberculosis Treatment Symposia - The CRUDEM Foundation presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Its INC initiates to educate with services of all nurse working in clinical case management of AIDS, Malaria, Filaria, Tuberculosis,other leading infectoious diseases to prevent and control aspect of health of individual/community/society.
GFATM for nurses The Global Fund provides 30% of all international financing for HIV programs and has invested US$24.2 billion in programs to prevent and treat HIV and AIDS and US$5 billion in TB/HIV programs as of June 2022.12- make more awareness for nursinfg officer
Pulmonary tuberculosis
The bacterium Mycobacterium tuberculosis causes tuberculosis (TB), a contagious, airborne infection that destroys body tissue. Pulmonary TB occurs when M. tuberculosis primarily attacks the lungs. However, it can spread from there to other organs.
New treatment regimen is mentioned here.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
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Antifertility, Toxicity studies as per OECD guidelines
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
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Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2. AIDS (Acquired immune deficiency syndrome) is a disease
caused by a virus called HIV (Human Immunodeficiency Virus).
The illness alters the immune system, making people much
more vulnerable to infections and diseases.
India has a population of 1.2 billion people, around half of
whom are adults in the sexually active age group
The first AIDS case in India was detected in 1986 and since then
HIV infection has been reported in all states and union
territories..
3. HIV is the virus which attacks the T-cells in the immune
system.
AIDS is the syndrome which appears in advanced
stages of HIV infection.
HIV is a virus.
AIDS is a medical condition
4.
5. Stages of HIV
Stage 1
(Asymptomatic)
Asymptomatic
Persistent generalized
lymphadinopathy
Stage 2 (Mild)
Unexplained moderate weight
loss (<10%)
Recurrent respiratory tract
infections
Herpes zoster
Recurrent oral ulceration
Papular pruritic eruptions
Fungal nail infections
Staging of HIV is based
on OIs:
•STAGE 1
•STAGE 2
•Stage 3
•Stage 4
6. Stages of HIV
Advanced:
Unexplained severe weight loss
(>10%)
Unexplained chronic diarrhea for
longer than one month
Unexplained persistent fever (above
37.5oC intermittent or constant for
longer than one month)
Persistent oral candidiasis
Pulmonary tuberculosis
Severe bacterial infections,
bacteraemia)
Unexplained anaemia (<8 g/dl),
neutropenia (<0.5 X 109/litre) and or
chronic thrombocytopenia(<50 X
109/litre3)
•Stage 1
•Stage 2
•STAGE 3
•Stage 4
7. Stages of HIV
Severe:
HIV wasting syndrome
Pneumocystis pneumonia
Recurrent severe bacterial
pneumonia
Chronic herpes simplex infection
Oesophageal candidiasis (or
candidiasis of trachea, bronchi or
lungs)
Extrapulmonary tuberculosis
Cytomegalo virus infection
Toxoplasmosis
HIV encephalopathy
Extrapulmonary cryptococcosis
including meningitis
Disseminated non-tuberculous
mycobacteria infection
•Stage 1
•Stage 2
•Stage 3
•STAGE 4
8. First line ART regimens for adults, adolescents, pregnant and
breastfeeding women and children (June-2013 WHO CONSOLIDATED guidelines)
FIRST LINE ART PREFERRED FRIST
LINE REGIMENS
ALTERNATIVE FIRST LINE
REGIMENS
Adults
(Including pregnant women
and breastfeeding women and
adults with TB and HBV co
infection)
TDF+3TC+EFZ
ZDV + 3TC + EFV
ZDV + 3TC + NVP
TDF + 3TC + NVP
Adolescents (10 to 19 years)
≥35 kg
ZDV + 3TC + EFV
ZDV + 3TC + NVP
TDF + 3TC + NVP
ABC + 3TC + EFV (or NVP)
Children 3 years to less than
10
years and adolescents <35 kg ABC + 3TC + EFZ
ABC + 3TC + NVP
ZDV + 3TC + EFZ/NVP
TDF + 3TC + NVP/EFZ
Children <3 years ABC or
ZDV + 3TC + LPV/r
ABC + 3TC + NVP
ZDV + 3TC + NVP
9. Rationale and supporting evidence
(The move to TDF+3TC+EFZ as preferred first
line option)
A systematic review comparing 6 regimens showed that a once daily combination
of TDF+3TC+EFZ is less frequently associated with severe adverse events and has
a better virological and treatment response compared with other once/twice
regimens. People receiving NVP are twice likely to discontinue treatment bcoz of
ADRs compared to EFZ
(www.who.int/hiv/pub/guidelines/arv2013/annexes)
10. When to start ART in Adults and adolescents
(June-2013 WHO CONSOLIDATED guidelines)
ART should be initiated in all individuals with Severe and advanced HIV
clinical disease(WHO clinical stages 3 or 4) and individuals with cd4 count
less than on equal to 350cells/mm3.
ART should be initiated in all individuals with HIV and CD4 count grater
than 350cells/mm3 and less than or equal to 500cells/mm3 regardless of
WHO clinical staging.
ART should be initiated regardless of CD4 and Clinical staging in following
conditions:
1. Individuals with HIV and active TB
2. HIV and HBV infection with evidence of chronic liver disease.
3. Pregnant and breastfeeding women with HIV
11. Cryptococcal Meningitis?
Cryptococcal meningitis is one of the most important opportunistic infections
and a major contributor to high mortality before and after ART is initiated.
The infection is not contagious.
General symptoms includes:
Headache
Fever
Neck pain
Nausea and vomiting
Sensitivity to light
Altered mental status (Includes confusion to coma)
26. Goals of the treatment
Clinical goals: Prolongation of life and improvement in quality of life
Virologic goals: Greatest possible reduction in viral load as long as possible
Therapeutic goals:limiting drug toxicity and facilitating adherence.
28. Cryptococcal meningitis
Administer Amphotericin-B at 0.7-1mg/kg/day for 2 weeks with/without 2 weeks of
Flucytosine at 100mg/kg/day in 4 divided doses, followed by fluconazole at 400mg/day
for minimum of 8-10 weeks.
Alternate initial therapy includes lipid formulation of Amphotericin-B in doses of 4-
6mg/kg/day for 3 weeks with fluconazole 400mg BID.
{Treat Cryptococcal meningitis first, start ART when patient is stabilized or OI
treatment is completed}.
29. Goals Achieved
Vomiting decreased by day 2
Fever decreased by day 3
Reduction in Hearing difficulty by day 6
30. Monitoring Parameters
Disease:
Viral load (every 6 months after ART and every 12 months thereafter)
{June-2013 WHO guidelines}
CD4 count if viral load not available.
Drugs:
Renal function tests (TDF,3TC, Fluconazole, Amphotericin-B)
Serum transaminases, cholesterol (EFZ,)
Liver function tests (Fluconazole, Amphotericin-B)
Potassium levels (Fluconazole, Amphotericin-B)
32. Patient counseling
About disease
This particular virus can only infect human beings
HIV weakens immune system by destroying important cells that fight disease and
infection. A "deficient" immune system can't protect the person.
33. About drugs:
Importance of medication adherence.
Mobile phone text messages could be considered as a reminder tool
for promoting adherence to ART as part of a package of adherence
interventions (June 2013 WHO guidelines)
If missed doses (even 2 doses in a month) DRUG
RESISTANCE can develop. This is bad for the patient
(These drugs will stop working.)
Drugs must be taken twice daily, and miss no doses.
If forget a dose, do not take a double dose.
Drugs MUST NOT be shared with family and friends.