This document provides an overview of dengue, including its epidemiology, life cycle, pathogenesis, clinical features, diagnosis, management, prognosis, and prevention. Some key points:
- Dengue is a self-limited viral infection transmitted by mosquitoes that infects 50-100 million people yearly and is a major public health challenge due to lack of vaccines or treatments.
- There are four serotypes of the dengue virus. Infection causes an acute febrile illness that in some cases progresses to severe dengue with plasma leakage and potential complications including shock.
- Diagnosis is based on virus detection, serology, or PCR. Management focuses on supportive care and fluid management. Prevention emphasizes mosquito control
Dengue & Chikungunya - All You Need To Know!Akshit Arora
A presentation on Dengue & Chikungunya and preventive measures! Received via one Instant Messenger application. Don't know about the credibility whether it's actually from the WHO or not! But good enough for education.
Dengue fever- a medical study ( definition, management ,prevention ,risks ,pa...martinshaji
#Dengue fever is a mosquito-borne disease that occurs in #tropical and #subtropical areas of the #world. Mild dengue fever causes high fever, #rash, and #muscle and #joint pain. A severe form of dengue #fever, also called dengue #hemorrhagic fever, can cause severe #bleeding, a sudden drop in #blood pressure (#shock) and #death.
#Millions of cases of dengue infection occur #worldwide each year. Dengue fever is most common in #Southeast #Asia and the #western #Pacific #islands, but the #disease has been increasing rapidly in #Latin #America and the #Caribbean
please comment
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Dengue & Chikungunya - All You Need To Know!Akshit Arora
A presentation on Dengue & Chikungunya and preventive measures! Received via one Instant Messenger application. Don't know about the credibility whether it's actually from the WHO or not! But good enough for education.
Dengue fever- a medical study ( definition, management ,prevention ,risks ,pa...martinshaji
#Dengue fever is a mosquito-borne disease that occurs in #tropical and #subtropical areas of the #world. Mild dengue fever causes high fever, #rash, and #muscle and #joint pain. A severe form of dengue #fever, also called dengue #hemorrhagic fever, can cause severe #bleeding, a sudden drop in #blood pressure (#shock) and #death.
#Millions of cases of dengue infection occur #worldwide each year. Dengue fever is most common in #Southeast #Asia and the #western #Pacific #islands, but the #disease has been increasing rapidly in #Latin #America and the #Caribbean
please comment
thank you
Introduction
Some Recent Dengue Out breaks
Clinical manifestations of dengue
Problem statement
Epidemiological determinants
Transmission of disease
Clinical and Laboratory diagnosis
WHO classification and Grading of severity of dengue infection.
Guidelines for treatment:
Management of DHF Grade I, II, III and IV.
Indications for red cell and platelet transfusion.
Global and National strategies.
Conclusion &References.
MedicYatra provides the safe & best DENGUE Fever treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
Introduction
Some Recent Dengue Out breaks
Clinical manifestations of dengue
Problem statement
Epidemiological determinants
Transmission of disease
Clinical and Laboratory diagnosis
WHO classification and Grading of severity of dengue infection.
Guidelines for treatment:
Management of DHF Grade I, II, III and IV.
Indications for red cell and platelet transfusion.
Global and National strategies.
Conclusion &References.
MedicYatra provides the safe & best DENGUE Fever treatment and procedure at its affiliate & trusted hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified doctors are extensively trained and vastly experienced and have performed hundreds of such cases at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
This lecture was prepared as a continuing medical education (CME) activity for the Philippine Obstetrical and Gynecological Society (POGS) Cebu chapter to update maternal health providers regarding the danger of Zika virus infection, particularly during pregnancy. This is a compilation of different literature materials available on the ongoing outbreaks of Zika virus infection in Latin America.
We will discuss briefly common tropical diseases found in INDIA. The presentation is basic for undergraduate students. we are covering dengue, malaria, chikungunya, and rickettsia in this presentation.
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
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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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
3. Contents
• Epidemiology
• Life cycle of Dengue virus
• Pathogenesis
• Clinical features
• Differential diagnosis
• Laboratory diagnosis
• Management
• Prognosis
• Prevention
4. Background
• Self-limited, systemic viral infection transmitted
between humans by mosquito
Public health challenge:
• lack of vaccines
• No specific treatment
• Inefficient vector control strategies
6. Average number of dengue and severe dengue cases reported to WHO
annually in 1955–2007 and number of cases reported in recent years, 2008–
2010
7.
8. DENGUE VIRUS
• SS RNA virus,
• Genus- Flavivirus
• Family- Flaviviridae
• 17-25 nm diameter
• Have antigens that overlap with Yellow fever,
Japanese Encephalitis and West Nile fever.
• Four serotypes
10. Vector - Aedes Mosquito
• A. aegypticus , A. albopictus- most commonly responsible
• A. polynesiensis, A.scutellaris, A. pseudoscutellaris, A.
nevius
• Day time feeder
• Water filled habitats, artificial containers within human
dwellings and indoors
• Highly anthrophillic - stays in close proximity to humans
- bites several times before oogenesis
13. Vector cont..
Mosquitos become infective from 8-11 days
after feeding
• Remains infective for life
• Epidemics start in rainy season
• Not found above 1000 metres
14. Pathophysiology
• Replicate primarily macrophages and monocytes,
lymphocytes
• Viremia 3-7 days after infection- persists in infected
mononuclear cells after clearance of viraemia -
clearance followed by defervescence
• Spread to liver/spleen/heart/bone
marrow/brain/kidney
• Endothelial cell activation
15. Immunopathogenesis of severe
Dengue in secondary infection
Cross reacting antibody binds to new dengue
strain, but does not neutralise it
Enhanced uptake of antibody coated virus
into macrophages and other mononuclear
cells
Elevated level of cytokines ,chemokine and
immunological response
Creates physiological environment, Increasing
capillary permeability
18. Clinical Features
• Incubation period- 3 to 7 days
• Clinically classify as-
1) Dengue
recover without major complication
2) Severe Dengue
Plasma leakage – shock, severe bleeding, organ
dysfunction
• Three clinical phase : Febrile , Critical & Recovery
19. Febrile Phase
• Lasts for 3-7 days
Symptoms
• Fever >38.5* C
• Headache, Vomiting, Myalgia,
• Transient macular rash, Bruising
• Hepatomegaly
Lab
- Mild Thrombocytopenia, Leucopenia
- Raised AST/ ALT
20. CRITICAL PHASE
• Around defervescence -
PHASE OF PLASMA LEAKAGE , lasts for 24-48 hour
• Increase capillary permeability -- increase hematocrit
• Progressive leukopenia followed by rapid decrease in
platelet count
• Shock occurs when critical volume of plasma is lost
through leakage, preceded by warning signs
• Tourniquet Test - positive
23. RECOVERY PHASE
• Lasts for 48- 72 hours, if patient survives critical phase
• Appetite returns, hemodynamically stable, diuresis
occurs
• Hematocrit becomes stable or even lower due to
dilutional effect of reabsorbed fluid
• WBC starts to rise but recovery of platelet is later than
that of WBC
24.
25.
26. DIAGNOSIS
• Detection of virus- serum/plasma/circulating
blood cells
– First 4-5 days
– Sophisticated
• Nucleic acid identification-RT-PCR
28. Diagnosis cont….
• HIGHLY SUGGESTIVE
– IgM in a single serum sample
– IgG in a single serum with high titre (1280 or higher)
• CONFIRMED
– Positive PCR
– Positive viral culture
– IgM seroconversion
– IgG seroconversion or 4 fold titre increase
31. Referred For Hospitalization
• Co-existing conditions - old age, pregnancy, diabetes,
renal failure
• Lab tests- full blood count, hematocrit
• T/t- encourage oral fluid, if not tolerated I.V. fluids at
maintenance rate
• Monitor for- temperature, fluid intake and loss, Urine
Output, warning sign, haematocrit, WBC & platelet
count
32. Admission Criteria
1. Signs and symptoms related to plasma leakage –
hypotension , pleural effusion, ascites
2. Spontaneous bleeding independent of platelet count
3. Organ impairment - liver, kidney, brain ,lungs
4. Lab parameter- rising hematocrit, thrombocytopenia
5. Coexisting condition- Pregnancy, DM, Hypertension,
peptic ulcer disease
6. Social circumstances- Living alone, living far from health
center , Without transport facility
33.
34.
35.
36.
37. Management
When the patient in critical phase :
Total fluid requirement in critical phase (48 hours)
• is calculated as M+5% (maintenance + 5% deficit)
• Maintenance (M) is calculated as follows
For the 1st 10 kg - 100 ml /kg
For the 2nd 10 kg - 50 ml/kg
From 20 kg and above up to 50 kg - 20 ml/kg
5% deficit is calculated as 50 ml/kg
38. Management of complication
Severe bleeding recognized by
Persistent and/or severe bleeding in presence of
unstable hemodynamic status
Decrease in hemotocrit level after fluid resuscitation
Refractory shock
Metabolic acidosis, abdominal distension and
tenderness
39. Management
• Whole blood or packed cell- bleeding
• 5-10 ml/kg of fresh packed cell, or 10-20 ml/kg of
fresh whole blood
• PRP- Thrombocytopenia
• Take care with Ryles tube and CVP while inserting
40. Treatment of complications
• Fluid overload
• Hypoglycemia and electrolyte imbalance
• Supportive treatment-e.g. dialysis, ionotropes
• Watch for other nosocomial infections
43. Prevention
• WHO joins the Association of Southeast Asian
Nations (ASEAN) to observe ASEAN Dengue
Day on 14 June 2013.
44. Global strategy for dengue prevention
and control, 2012–2020
• To estimate the true burden of disease by
2015.
• To reduce the mortality at least by 50% by
2020
• To reduce the morbidity at least by 25% by
2020
45. Global strategy for dengue prevention
and control, 2012–2020
1) Diagnosis and case management
2) Integrated surveillance and outbreak prevention
3) Preparedness
4) Sustainable Vector control
5) Future Vaccine implementation
6) Basic operational and implementation Research
D I P V V R
46. Personal Protection –
Wear N,N diethyl 3- methyl benzamide mosquito
repellant
Wear protective clothing - impregnated with
permethrin insecticide
Well screened room
Prevention cont…
47. Vector control
• Eliminating small accumulations of stagnant
water around human habitats
• Release of genetically modified male mosquito
• Introduction of Wolbachia bacteria into A.
aegypti
Prevention cont..
49. References
• WHO publication 2012, Neglected Tropical
Diseases (NTD )
• NEJM 2012; 366: 1423-32, Cameron et al.
• Text Book of Microbiolgy . Anant Narayan
• Srilankan guideline , 2010; published by ministry
of Health
• Dengue: Guidelines for treatment, prevention
• and control. Geneva: WHO 2009.
• API- Text book of medicine; Ninth Edition
Febrile phase DHF V : D- dehydration ,, F – Fever , V – viremia , ig just appear at end of this phase
Critical phase : fever decreases , Thrombocytopenia , Increased hct , Organ impairment (Shock & bleeding) , increasing Ig
Recovery phase: IgM ,IgG at high titre , platelet count improving , Hct baseline , Resorption of fluid overload
Microvascular fragility may be demonstarted by positive torniquet test. Inflate cuff on arm midway between SBP & DBP for 5 min.pressure is released for at least 1 min and skin below the cuff is examined for petechiae.
findivg of 10 or more petechiae in 1 square inch area is positive test.