1. Mykel from Africa presented with fever, headache, vomiting and jaundice. A possible diagnosis is yellow fever, which can be confirmed through isolation of the virus from blood, demonstration of viral antigen or genome by various lab tests, or demonstration of specific IgM antibodies. If he came to Egypt, quarantine measures like vaccination certificates and isolation may be required.
2. A man from Qalioubia had lymph node enlargement and swelling of limbs, possible suggesting filariasis. It spreads through mosquito bites, and microfilariae can be seen on blood smears at night. Treatment involves drugs that kill the microfilariae like DEC or ivermectin.
3.
NATIONAL AIDS CONTROL PROGRAM
1992- - NACP 1 launched to show down the spread of HIV infection
- national AIDS control board constituted
- NACO setup
1999- - NACP 2 begins focusing on behaviour change , increased decentralization and NGO involvement.
- state AIDS control societies developed .
2002- - national AIDS control policy adopted.
- national blood policy adopted.
2004- - antiretroviral treatment initiated .
2006- - national council on AIDS constituted under chairmanship of prime minister.
- national policy on paediatric ART formulated.
2007- - NACP 3 launched for years (2007-2012)
2012- - NACP 4 launched for next 5 years
Chikungunya (chik-un-GUN-yuh) is a viral illness transmitted by mosquitoes that causes the sudden onset of fever and severe joint pain. Other signs and symptoms may include fatigue, muscle pain, headache and rash. Signs and symptoms of chikungunya usually appear within two to seven days after being bitten by an infected mosquito.
NATIONAL AIDS CONTROL PROGRAM
1992- - NACP 1 launched to show down the spread of HIV infection
- national AIDS control board constituted
- NACO setup
1999- - NACP 2 begins focusing on behaviour change , increased decentralization and NGO involvement.
- state AIDS control societies developed .
2002- - national AIDS control policy adopted.
- national blood policy adopted.
2004- - antiretroviral treatment initiated .
2006- - national council on AIDS constituted under chairmanship of prime minister.
- national policy on paediatric ART formulated.
2007- - NACP 3 launched for years (2007-2012)
2012- - NACP 4 launched for next 5 years
Chikungunya (chik-un-GUN-yuh) is a viral illness transmitted by mosquitoes that causes the sudden onset of fever and severe joint pain. Other signs and symptoms may include fatigue, muscle pain, headache and rash. Signs and symptoms of chikungunya usually appear within two to seven days after being bitten by an infected mosquito.
Presentation from Manolis Kogevinas, Head of the Cancer Programme at ISGlobal, on occupational cancer.
Epidemiology in Occupational Health Conference - EPICOH 2017
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Presentation from Manolis Kogevinas, Head of the Cancer Programme at ISGlobal, on occupational cancer.
Epidemiology in Occupational Health Conference - EPICOH 2017
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Many such vectors are haematophagous, which feed on blood at some or all stages of their lives.
A lecture by Dr. Naya Hassan about Monkeybox; which is a viral zoonotic infection that results in a rash similar to smallpox and started to spread around the world since May 2022.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
How to Give Better Lectures: Some Tips for Doctors
Cases of-arthropod-borne-diseases
1. Cases application on
Arthropod borne diseases
By Dalia Bahaa
Under supervision of
Prof Dr Mona Aboserea
Faculty of medicine –Zagazig University
2. 1-Mykel is 35 years old wood cutter in
Africa, he complained from sudden onset of
fever, headache, muscle pain, vomiting and
prostration, on examination the pulse was
slow and there was some jaundice
3. a)What is the possible diagnosis
Yellow Fever
b) How can you confirm
A. Symptoms
B. Travel history
C. Lab investigations as:
*Isolation of the virus from blood
*Demonstration of viral antigen in the blood by ELISA.
*Demonstration of viral genome in blood and liver tissue by PCR.
*Serologic diagnosis by demonstration of specific IgM in early sera or rise in titre of
specific antibodies
4. c)If the traveler comes to Egypt, what are
the measures that should be taken?
International measures: It is one of the quarantinable diseases and
the following measures should be done to prevent introduction of yellow
fever from endemic area (Yellow Fever belt) into receptive area (areas
free of yellow fever, but the vector is present and the population is
susceptible e.g. in Egypt) :
Notification within 24 hours by governments to WHO.
Disinfection of any aircraft leaving an endemic area for receptive area,
by aerosol spray of suitable insecticide, shortly before departure and
also on arrival
5. Valid vaccination certificate:
a. Is required from all international travelers including children coming from
or going to endemic areas "Yellow Fever belt."
b. Validity starts 10 days after primo-vaccination and lasts for 10 years.
c. Validity starts on same day after re-vaccination and lasts for 10 years.
d. If no certificate is available: traveler is isolated for 6 days from date of
leaving endemic area.
e. If traveler arrives before 10 days of vaccination, i.e. certificate is not valid
yet: traveler is isolated until certificate becomes valid or until the end of
international incubation period calculated from the day of leaving the last
endemic area.
f. Traveler is quarantined in mosquito-proof accommodation in airport.
g. This certificate is required by many countries including Egypt
6. 2-A 50 y old male patient, from Qaliobyia, suffers
from progressive enlargement of his limb. By
history he was suffering from repeated attacks of
enlarged painful lymph nodes in the past 10 years
7. a)What is possible diagnosis?
Filariasis (Bancroftian filariasis)
b) How can the disease be transmitted?
By the bite of infective mosquito.
In Egypt: female Culex pipiens, but it could be transmitted by the bite of Anopheles
gambia and Aedes. When the mosquito bites an individual the larvae can enter the
punctured skin
Many mosquito bites over several months to years are needed to get lymphatic
filariasis.
People living for a long time in tropical or sub-tropical areas where the disease is
common are at the greatest risk for infection. Short-term tourists have a very low
risk
8. c)How can you confirm diagnosis
Identification of microfilariae in a blood smear by microscopic examination
during maximum presence (nocturnal), thick smear should be made and
stained with Giemsa
*Patients with active filarial infection typically have elevated levels of antifilarial
IgG4 in the blood and these can be detected using routine assays.
*Because lymphedema may develop many years after infection, lab tests are
most likely to be negative with these patients
9. d)What is the treatment
Patients currently infected with the parasite
DEC (Banocid, Hetrazan). Treatment results in rapid suppression of most or all
microfilaria from the blood, and some adult worms. Low level of microfilaria may reappear
after treatment. Therefore, treatment must usually be repeated at yearly interval, and
laboratory follow up should be done for treated cases.
Ivermectin kills only the microfilariae, but not the adult worm; the adult worm is
responsible for the pathology of lymphedema and hydrocele.
Some studies have shown adult worm killing with treatment with Doxycycline
(200mg/day for 4–6 weeks).
Patients with clinical symptoms
Lymphedema and elephantiasis are NOT indications for DEC treatment because most
people with lymphedema are not actively infected with the filarial parasite.
The treatment for hydrocele is surgery
10. e)How can you prevent the disease
General:
1 .Environmental sanitation:
a. Eradication or control of mosquito vector
b.Human protection against mosquitoes: e.g. protective clothing, bed nets, repellents and stay
indoor.
The mosquitoes that carry the microscopic worms usually bite between the hours of dusk and
dawn. If you live in an area with lymphatic filariasis.
2 .Health education:About modes of transmission and Protection against mosquito bites to
reduce exposure to infection.
Specific:
Mass drug administration:
In areas where lymphatic filariasis is endemic: WHO currently recommends mass drug
administration, as an annual single dose, of combinations of diethylcarbamizine citrate (DEC)
6mg/kg body weight with 400 mg of albendazole for 4-6 years, or the regular use of DEC-
medicated cooking salt for 1-2 years. Mass administration of these drugs has the two fold
purpose of preventing future cases of lymphatic filariasis and helping those people who are
already suffering from the disease
11. 3-Ahmed is football player return with his
team from championship in Ethiopia with
sudden onset of fever for 3-5 days, intense
headache, rash. Epistaxis, gum bleeding
and petechiae
12. a)What is possible diagnosis
Dengue fever(Break Bone Fever)
b) How can the disease be transmitted
bite of infective Aedes aegypti mosquito
C) What is DD
1-yellow fever
2 -Rift valley fever
3-Encephilitis
13. d)How can you prevent the disease
General Prevention
1) Environmental sanitation:
A) Eradication or control of mosquito vector by:
i. Anti-larval and anti-pupal measures
ii. Anti-adult measures
iii. Jungle mosquitoes: control is impractical.
Human protection against mosquitoes: e.g. protective clothing, bed nets, repellents and stay
indoors.
2 )Health education about modes of transmission to reduce exposure to infection.
Specific: Dengue fever vaccine
14. 4-A butcher in El Sharkia come to hospital
with fever, influenza like picture and he was
diagnosed as influenza and take some fluids
and antipyretic then return to home after
few days he show hemorrhagic in gum,
impaired liver function, vision problem and
neurological manifestation
15. a)What is possible diagnosis?
Q fever
b) Causative agen?
Coxiella Burnetti
C).Reservoir?
Small wild mammals,cattle, sheep, goats, birds and man.
D)Mode of transmission?
-Occupational as veterinarians, meat processing, sheep and dairy workers and
farmers through direct contact with domestic animals especially while animals are
giving birth.
-Air borne by rickettsia present in dust contaminated by placental tissues, birth
fluids and excreta of infected animals.
-Ingestion of raw milk
16. e)How can you prevent the disease
General prevention:
Control of the disease in domestic animals either by vaccination or by antibiotics.
Milk pasteurized at high temperature.
Health education: about necessity for adequate disinfection and disposal of animal
products.
Specific prevention:
Immunization:
By inactivated vaccine Q 34, given in 1ml dose as 3 weekly subcutaneous. For high
risk workers as laboratory workers and workers in contacts with animals and animal'
products
17. 5-Many students in slum area come to
unit with abrupt onset of high fever,
rigors, body aches. Cyanotic face, dull
and confused. They show skin rash on
folds of axilla, anterior part of forearms
then trunk and back.
18. a)What is possible diagnosis?
Epidemic typhus
b)How can you confirm diagnosis?
-suggestive clinical picture
-lab investigation as weil-felix reaction (agglutination
test).
19. c)How can you prevent and control the disease?
General prevention:
-Health education for personal cleanliness.
-Delousing of population by washing facilities & dusting with a suitable insecticide.
Specific prevention:
typhus vaccine (live attenuated vaccine), Madrid E typhus vaccine a single IM dose, giving
immunity for 5 years.
*Cases:
-Notification to LHO.
-Isolation in hospital after dusting.
-Terminal disinfection by dusting (to kill any lice) & steam disinfection for clothes & bedding
(to kill rickettsia).
-Treatment by tetracycline 500 mg / 6hs for seven days.
-Release after clinical recovery of the case.
20. *Contacts :-
-Delousing by bathing & dusting.
-Surveillance for 2 weeks, for case-finding.
*Epidemic measures :-
-Delousing of confined groups and underdeveloped communities
by washing facilities & dusting.
-Vaccination of high risk groups.
-Searching for the source of infection
21. 6-Emad is a cattle merchant return from Brazil
from one month he came to hospital with fever,
chills, malaise, headache, nausea, lassitude,
muscle and joint pain, rigor sensation and the
fever rapidly rising ending by profuse sweating.
The cycle of fever, chills, sweating is repeated
daily
22. a)What’s possible diagnosis?
Possible diagnosis: Malaria
b)How to Confirm diagnosis?
by:
•Demonstration of malaria parasites in thick blood film.
•Repeated microscopic examination every 12-24 hours may be necessary to
cover all parasite species.
•Several tests have been developed: The most promising are:
-Rapid diagnostic tests that detect plasmoidal antigens in the blood.
-PCR is the most sensitive method.
-Demonstrating antibodies which appear after first week of infection but may persist for
years denoting past malaria infection.
23. C) What are the Complications?
-Anemia.
-Splenomegaly.
-Abortion and fetal infection.
-Falciparum malaria may be associated with respiratory distress, jaundice,
liver failure, encephalopathy, pulmonary and cerebral edema, coma and death.
24. D)Prevention& Control:
1 .General preventive measures: of arthropod borne disease.
-Environmental sanitation, vector control and Health education:
*Elimination of the breeding sites of mosquito by filling of swamps, marches and small
collection of water.
*Eradication of larval stages by spraying crude oil and larvicides on water surface.
*Destruction of adult mosquitoes by using suitable insecticides (liquid aerosol, pyrethrium).
-Human protection:
*Screening of windows and doors, using bed nets and animal barrier between breeding
places and human habitation.
-using protective cloths.
-Apply of repellents to exposed skin between dusk
-Avoid going outdoors and down when anopheline mosquitoes commonly bite.
-Health education of the public, at risk groups and travelers for the mode of transmission,
protection from exposure and value of prophylaxis and treatment.
-Avoid taking blood from any individual giving history of malaria or a history of travel to, or
residence in, a malarious area
25. Specific measures:
Chemoprophylaxis for international travelers going to endemic areas.
■Chloroquine or hydrroxy chloroquine 5 mg /kg /week or chloroquine phosphate
(500 mg for average adult).
■The drug must be continued for 4-6 weeks after leaving endemic areas.
■In areas with chloroquine-resistant P. falciparum, mefloquine is recommended
(5mg/kg/week) for adults, 1-2 week before travel, during stay and 4 weeks after
leaving the endemic area
Control:
Case: Early case finding:
*By laboratory examination of clinically suspected persons.
*By periodic survey.
*Through malaria campaign.
Treatment: Using antimalarial drugs as chloroquine or mefloquine etc.
Contacts:• Investigation for early case findings.
26. 7-Female child in a village in upper Egypt
come with fever, headache, skeletal and
abdominal tenderness with palpable liver
and spleen, jaundice and purpura occur.
Hyperpyrexia, hypotension after
examination doctor found lice in her scalp
27. A) what is Possible diagnosis?
LOUSE- BORNE RELAPSING FEVER
b) How to Confirm of diagnosis?
by: Dark ground illumination or stained blood films.
Intraperitoneal inoculation or culture in lab animals
C) what is the Prognosis:
Hyperpyrexia, hypotension and cardiac failure
28. D)What’s the prevention and control?
General prevention:
)Delousing by residual insecticide powder as in typhus.
)Protection of susceptible: use of repellents and protective clothes.
Specific prevention:
chemoprophylaxis with tetracycline after exposure
Control
Cases:
Notification : to LHO
Isolation: precautions with blood and body fluids.
Concurrent disinfection : none
Treatment: procaine penicillin injection followed by oral tetracycline
Contacts: Case findings.
Epidemic measures:
Apply insecticides to clothes and houses