This document summarizes key details about several types of viruses including incubation period, transmission method, potential for chronic infection or fulminant disease, and age effects. It provides information on hepatitis A, B, C, D, and E viruses such as their RNA genomes, typical incubation periods ranging from 14 to 180 days, modes of transmission including fecal-oral, parenteral, sexual or perinatal, and chronic infection risks. It also outlines recommendations for hepatitis A vaccination dosages and schedules based on age at infection or medical status.
Hepatitis: inflammation of the liver.
Causes of viral hepatitis:
Common:
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
hepatitis C virus (HCV)
Hepatitis D virus (HDV)
Hepatitis E virus (HEV)
HBV-associated delta agent
Hepatitis B virus is a partially double-stranded DNA virus that can be transmitted both horizontally through infected blood or body fluids and vertically from mother to child. It has a 42nm enveloped virion structure containing DNA and antigen proteins. HBV replicates through reverse transcription and has 4 overlapping reading frames that encode the surface, core and polymerase proteins. HBV infection may be acute and self-limiting or develop into chronic lifelong infection. Diagnosis involves detecting hepatitis B antigens and antibodies. Current treatments include interferon which stimulates immunity, and nucleoside analogues like lamivudine and adefovir which inhibit viral replication but resistance can develop. Prevention is through vaccination and immunoglobulin administration to exposed newbor
This document summarizes information about hepatitis B virus (HBV) genotypes, pathogenesis, transmission routes, clinical phases of acute and chronic HBV infection, treatment options, vaccination schedules, and post-exposure prophylaxis. It discusses that HBV genotype C is associated with more severe liver disease outcomes compared to genotype B. It recommends entecavir or tenofovir as preferred treatments for immune-active chronic hepatitis B and outlines vaccination schedules, treatment in pregnancy/cirrhosis, and a new drug called Myrcludex B that is under clinical trial.
Hepatitis: inflammation of the liver.
Causes of viral hepatitis:
Common:
Hepatitis A virus (HAV)
Hepatitis B virus (HBV)
hepatitis C virus (HCV)
Hepatitis D virus (HDV)
Hepatitis E virus (HEV)
HBV-associated delta agent
Hepatitis B virus is a partially double-stranded DNA virus that can be transmitted both horizontally through infected blood or body fluids and vertically from mother to child. It has a 42nm enveloped virion structure containing DNA and antigen proteins. HBV replicates through reverse transcription and has 4 overlapping reading frames that encode the surface, core and polymerase proteins. HBV infection may be acute and self-limiting or develop into chronic lifelong infection. Diagnosis involves detecting hepatitis B antigens and antibodies. Current treatments include interferon which stimulates immunity, and nucleoside analogues like lamivudine and adefovir which inhibit viral replication but resistance can develop. Prevention is through vaccination and immunoglobulin administration to exposed newbor
This document summarizes information about hepatitis B virus (HBV) genotypes, pathogenesis, transmission routes, clinical phases of acute and chronic HBV infection, treatment options, vaccination schedules, and post-exposure prophylaxis. It discusses that HBV genotype C is associated with more severe liver disease outcomes compared to genotype B. It recommends entecavir or tenofovir as preferred treatments for immune-active chronic hepatitis B and outlines vaccination schedules, treatment in pregnancy/cirrhosis, and a new drug called Myrcludex B that is under clinical trial.
The document provides information on the management of Hepatitis B. It discusses the virology of HBV, epidemiology, natural history, goals of treatment, criteria for treatment, treatment options and monitoring. Key points include:
- HBV is a DNA virus that causes both acute and chronic hepatitis. Approximately 240 million people globally have chronic HBV infection.
- Natural history depends on when infection is acquired. Risk of chronic infection is highest with infection at birth.
- Treatment goals are to prevent progression of disease and development of complications like cirrhosis and liver cancer.
- Treatment is recommended for those with HBeAg-positive chronic hepatitis B with HBV DNA >20,000 IU/mL and elevated
Interpretation of Hepatitis B Serologic Test Resultsru5dy
With the Laboratory Results you need to have interpretation of the patients who have check their blood for Hepatitis B test. This slide will guide you through how to interpretation of Hepatitis B Test Laboratory Results.
Este documento resume las características principales de las hepatitis virales A, B, C, D. Describe la etiología, epidemiología, fisiopatología, mecanismos de transmisión, clínica, diagnóstico y tratamiento de cada tipo de hepatitis. Se enfoca en explicar las diferencias entre las hepatitis agudas y crónicas para cada virus.
Transmission risk factors, symptoms, diagnosis and treatment of hepatitis B. This is a deliberate presentation made to be easily understood by lay persons to appreciate the thinking of the doctors when it comes to treatment for hepatitis B
Hepatitis B, C & D Viruses
This document summarizes key information about hepatitis B, C, and D viruses. It discusses the etiology, pathology, clinical features, diagnosis, treatment and prevention of each virus. Hepatitis B virus is a hepadnavirus that can cause both acute and chronic infection. Hepatitis C virus is a flavivirus that often leads to chronic infection. Hepatitis D virus can only infect those also infected with hepatitis B and increases the severity of liver disease. Vaccination and blood screening are important prevention strategies for these viral hepatitises.
Este documento resume información sobre las hepatitis A, B, C, D y E. Describe las características generales de cada virus, incluyendo su vía de transmisión, periodo de incubación, si causa infección aguda o crónica, y su evolución en el embarazo. También compara los patrones serológicos, manifestaciones clínicas, diagnóstico, prevención y tratamiento de cada hepatitis.
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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.
The document provides information on the management of Hepatitis B. It discusses the virology of HBV, epidemiology, natural history, goals of treatment, criteria for treatment, treatment options and monitoring. Key points include:
- HBV is a DNA virus that causes both acute and chronic hepatitis. Approximately 240 million people globally have chronic HBV infection.
- Natural history depends on when infection is acquired. Risk of chronic infection is highest with infection at birth.
- Treatment goals are to prevent progression of disease and development of complications like cirrhosis and liver cancer.
- Treatment is recommended for those with HBeAg-positive chronic hepatitis B with HBV DNA >20,000 IU/mL and elevated
Interpretation of Hepatitis B Serologic Test Resultsru5dy
With the Laboratory Results you need to have interpretation of the patients who have check their blood for Hepatitis B test. This slide will guide you through how to interpretation of Hepatitis B Test Laboratory Results.
Este documento resume las características principales de las hepatitis virales A, B, C, D. Describe la etiología, epidemiología, fisiopatología, mecanismos de transmisión, clínica, diagnóstico y tratamiento de cada tipo de hepatitis. Se enfoca en explicar las diferencias entre las hepatitis agudas y crónicas para cada virus.
Transmission risk factors, symptoms, diagnosis and treatment of hepatitis B. This is a deliberate presentation made to be easily understood by lay persons to appreciate the thinking of the doctors when it comes to treatment for hepatitis B
Hepatitis B, C & D Viruses
This document summarizes key information about hepatitis B, C, and D viruses. It discusses the etiology, pathology, clinical features, diagnosis, treatment and prevention of each virus. Hepatitis B virus is a hepadnavirus that can cause both acute and chronic infection. Hepatitis C virus is a flavivirus that often leads to chronic infection. Hepatitis D virus can only infect those also infected with hepatitis B and increases the severity of liver disease. Vaccination and blood screening are important prevention strategies for these viral hepatitises.
Este documento resume información sobre las hepatitis A, B, C, D y E. Describe las características generales de cada virus, incluyendo su vía de transmisión, periodo de incubación, si causa infección aguda o crónica, y su evolución en el embarazo. También compara los patrones serológicos, manifestaciones clínicas, diagnóstico, prevención y tratamiento de cada hepatitis.
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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.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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5. Viruses Type Incubation
period
(days)
Transmission Chronic
infection
Fulminant
disease
HAV RNA 15-19 Faeco-oral No Rare
HBV DNA 60-180 Parenteral,
sexual,
perinatal
Yes Yes
HCV RNA 14-160 Parenteral,
sexual
Yes Rare
HDV RNA 21-42 Parenteral,
sexual,
perinatal
Yes Yes
HEV RNA 21-63 Faeco-oral No Yes
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22. Age at infection
Acquire infection
perinatally:
Poor prognosis
30 % children, 5 %
neonates full recovery
Adults or older
children:
Good prognosis
95% full recovery
Older age:
Poor prognosis
virion consisting of a 42-nm spherical, double-shelled particle composed of small spheres and rods and with an average width of 22 nm. It is an exceedingly resistant virus, capable of withstanding extreme temperatures and humidity.
The S gene encodes the viral envelope.
The core antigen, HBcAg, is the protein that encloses the viral DNA., initiating a cellular immune response.
The e antigen, HBeAg, which is also produced from the region in and near the core gene, is a marker of active viral replication. It serves as an immune decoy and directly manipulates the immune system; it is thus involved in maintaining viral persistence.
The role of the X gene is to encode proteins that act as transcriptional transactivators that aid viral replication. Evidence strongly suggests that these transactivators may be involved in carcinogenesis.
The natural course of chronic HBV infection consists of 4 phases. The immune tolerance phase is characterized by the presence of HBeAg, high HBV DNA levels, and persistently normal ALT levels, but no evidence of active liver disease. The immune clearance phase is characterized by the presence of HBeAg and high/fluctuating HBV DNA and ALT levels. An outcome of the immune clearance phase is HBeAg seroconversion. Most patients then enter the inactive HBV carrier phase, which is characterized by the absence of HBeAg and the presence of anti-HBe, low or undetectable HBV DNA levels (<2000 IU/mL), normal ALT levels, and no/minimal inflammation on liver biopsy. The reactivation phase is characterized by the absence of HBeAg, intermittent/persistently increased ALT and HBV DNA levels, and inflammation on liver biopsy.
Because the symptoms of acute HBV infection and the laboratory indicators of hepatocellular dysfunction are indistinguishable from those of other forms of viral hepatitis,
HBV surface antigen (HBsAg) appears before the onset of symptoms, peaks during overt disease, and then declines to undetectable levels in 3-6 months. Acute HBV infection is characterized by the presence of HBsAg in the serum.
Hepatitis B e antigen HBeAg, HBV DNA, and DNA polymerase appear in the serum soon after HBsAg, and all signify active viral replication. Measuring HBV DNA with quantitative DNA polymerase chain reaction (PCR) is ideal for monitoring disease progression and effect of treatment
Immunoglobulin M (IgM) anti-HBc becomes detectable in serum shortly before the onset of symptoms, concurrent with the onset of elevation of serum aminotransferases. Over months, the IgM antibody is replaced by immunoglobulin G (IgG) anti-HBc. Detection of IgM HBcAb is diagnostic of acute HBV infection,
IgG anti-HBc does not rise until the acute disease is over and is usually not detectable for a few weeks to several months after the disappearance of HBsAg. Anti-HBs may persist for life, conferring protection;
During recovery from acut phase , HbBsAg level falls before the symtpoms wane, IgM HBcAg may be the only marker of infection
Hepatitis B surface antibody (HBsAb), but not hepatitis B core antibody (HBcAb), is detected in persons who have received the hepatitis B vaccine
The carrier state is defined by the presence of HBsAg in the serum for 6 months or longer after its initial detection.
During convalescence, HBsAg and HBeAg are cleared, and IgG antibodies to HBsAg, HBcAg, and HBeAg develop.f HBsAg in the serum for 6 months or longer after its initial detection.
Seroprevalence – level of pathogen in a population
HCV – most likely virus to cause chronic infection
< 15 % clear the virus
Rest develop chronic hepatitis
Chronic HCV infection is usually clinically silent until a compliation develops
Serum aminotransferases fluctauates and are sometimes normal but histologic inflammation is universal
20 % ultiamyte;y cirrhosis
Extra hepatic manifestations – mainly adults – curaneous vasculitis, membranoproliferative GN, peripheral vascultitis
Biopsy – recommended only before starting any treatment and to rule out other causes of overt liver disese
Histology - In patients with chronic HCV infection, inflammatory cells accumulate in the portal tracts. They may also have foci of inflammation accompanied by necrosis in the parenchyma.
Co infection – HDV along with HBV
Super infection – HDV in a person already infected with HBV
Candidates for postexposure prophylaxis include household and sexual contacts of infected patients, contacts in childcare centers during outbreaks, and, if the patient is a food handler, others who work at the same establishment
Vaccine – 720 ELISA untis and aluminuium hydroxide is the adjuvant. Efficacy of 95-100%
Cathc up – if seron negative fro HAV
> 13 yr – give adult vaccine 1440 units