Dengue is a febrile illness caused by a flavivirus transmitted by Aedes aegypti or Aedes albopictus mosquitoes while taking a blood meal. There are four dengue virus (DENV) types (DENV-1, DENV-2, DENV-3, and DENV-4), all of which are capable of inducing severe disease (dengue hemorrhagic fever [DHF]/dengue shock syndrome [DSS]). Dengue is endemic in more than 125 countries in tropical and subtropical regions and causes an estimated 390 million infections annually worldwide, of which 96 million are clinically apparent
In dengue-endemic regions, suspected, probable, and confirmed cases of dengue infection should be reported to the relevant authorities as soon as possible, so that appropriate measures can be instituted to prevent dengue transmission
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.
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.
Pediatric dengue management - Dr. Arunkumar, MD(Paed)Arun Kumar
A presentation on clinical management of dengue fever and severe dengue in children.
By
Dr. Arunkumar. A, MD(Pediatrics)
consultant pediatrician,
KMCH Erode.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
Pediatric dengue management - Dr. Arunkumar, MD(Paed)Arun Kumar
A presentation on clinical management of dengue fever and severe dengue in children.
By
Dr. Arunkumar. A, MD(Pediatrics)
consultant pediatrician,
KMCH Erode.
A mosquito-borne viral disease occurring in tropical and subtropical areas.
Those who become infected with the virus a second time are at a significantly greater risk of developing severe disease.
Symptoms include high fever, headache, rash and muscle and joint pain. In severe cases there is serious bleeding and shock, which can be life threatening.
Treatment includes fluids and pain relievers. Severe cases require hospital care.
dengue fever is a disease endemic to southeast asia, americas, africa. an early diagnosis and appropiate classification of the syndrome, helps the physician to provide the most adequate treatment.
La muerte del primer paciente es algo que marcara la vida de todo medico. El estar preparado y saber que esto te va a pasar, ayudara mucho al futuro medico para tener herramientas para sobrellevar el duelo
Most of the prescriptions for antibiotics occurs in Primary care. Careful utilization of current antibiotics can decrease the growing problem about antibiotic resistance
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
dengue virus.pptx
1. Duration: 40 min Electives Infectious disease St Luke
Dengue
Ivan De Paz, MD
2. Records of dengue-like illness date back more than 200 years and the viral etiology of dengue virus (DENV) was established in
the 1940s. Given estimates of 390 million infections worldwide each year and over 2.5 billion individuals at risk for infection, the
DENVs remain important arthropod-borne viruses from a medical and public health perspective.
Find out what dengue is.
Learn to recognize and manage a dengue virus infection
Dengue, Dengue Fever, Severe dengue
Learning objectives
Keywords
Lesson overview
3. DENGUE VIRUS
Member of the family FLAVIVIRIDAE
The DENV complex comprises at least four
antigenically related but distinct viruses, designated
DENV types 1 through 4
All DENVs are mosquito-borne human pathogens
that exclusively cause acute infection
4. From: Dengue: A Growing Problem With New Interventions
Pediatrics. 2022;149(6). doi:10.1542/peds.2021-055522
Map showing the risk of dengue by country as of 2020. “Frequent or Continuous” risk indicates that there are either frequent outbreaks or
ongoing transmission. “Sporadic or Uncertain” indicates that risk is either variable and unpredictable or that data from that country are not
available. For updated information, visit https://www.cdc.gov/dengue/areaswithrisk/around-the-world.html.
Figure Legend:
5. What dengue is?
Breakbone fever
Most important arthropod transmitted human viral disease (Aedes)
Dengue is a systemic and dynamic infectious disease
6. Spectrum of disease
After an incubation period of 4 to 10 days, infection by any of the
four DENV serotypes can be asymptomatic or symptomatic.
The disease can occur as dengue fever (with or without warning
signs) or severe dengue, according to the current clinical
classification
9. DENGUE INFECTION
Primary infection is characterized by detectable levels of IgM antibodies by
days five or six after onset of fever; levels peak at about 14 to 15 days and
can remain high up to 30 to 60 days later, and then decline gradually over
time.
IgG antibodies against dengue are elevated after the eighth or ninth day of
the onset of fever and are detectable for life.
In secondary infection, very high levels of IgG antibodies against dengue are
observed from the second or third day of fever. IgM antibody levels can be
less elevated in secondary infections and are sometimes not detectable
12. PATHOPHYSIOLOGY
Capillary leak syndrome — Plasma leakage, due to an increase in capillary
permeability, is a cardinal feature of dengue hemorrhagic fever (DHF) but
is absent in dengue fever (DF)
Blood and bone marrow — Leukopenia, thrombocytopenia, and a
hemorrhagic diathesis are the typical hematologic findings in DENV
infections
13. PATHOPHYSIOLOGY
Liver — Elevations of serum aminotransferases that are usually mild are
common in DENV infections
Central nervous system — Rare cases of encephalopathy have been
attributed to DENV infections. True encephalitis has been reported, with
detection of DENV in brain tissue
16. DENGUE INFECTION
FEVER WITH UPPER RESPIRATORY TRACT
SYMPTOMS
https://www.cdc.gov/dengue/healthcare-providers/dengue-or-covid.html
Respiratory symptoms, such as cough, sore throat, and rhinorrhea, can
occur.
Difficult to differentiate from COVID-19
22. FEBRILE PHASE
It lasts 2-7 days
High fever
Accompanied by facial flushing, skin erythema, generalized body ache,
myalgia, arthralgia, headache and retroorbital pain
GI symptoms are common
The liver may also be enlarged and tender
In the early febrile phase it can be difficult to clinically differentiate
dengue from other acute febrile diseases
Monitoring for warning signs and other clinical parameters is crucial to
recognizing progression to the critical phase
23. FEBRILE PHASE
When fever suddenly falls, the dengue patient may either improve
and recover from the disease or present clinical deterioration and
serious warning signs
24. CRITICAL PHASE
If the temperature drops and stays at 37.5 ºC or less during the first 3 to 7
days, some patients may experience an increase in capillary permeability,
as well as increased hematocrit levels.
This marks the beginning of the critical phase
The phase of clinical manifestations due to plasma leakage, which usually
lasts 24 to 48 hours
May be associated with epistaxis and gingivorrhagia, as well as
transvaginal bleeding in women of childbearing age (metrorrhagia or
hypermenorrhea)
25. CRITICAL PHASE
Leukopenia with neutropenia and lymphocytosis with 15 to 20% atypical
forms, followed by a rapid decrease in platelet count usually precedes
plasma leakage
At this point, patients without a large increase in capillary permeability
improve, whereas those with greater capillary permeability may worsen as
a result of loss of plasmatic volume and may present warning signs
If volemia is not promptly and properly restored, “a few hours later” these
patients tend to present signs of tissular hypoperfusion and hypovolemic
shock
26. CRITICAL PHASE
Pleural effusion and ascites may be clinically detectable depending on the degree of
plasma leakage and the volume of administrated fluids
Chest x-ray, abdominal ultrasound, are useful tools for early diagnosis of serous cavity
effusions, as well as gallbladder wall thickening from the same cause
The intensity of the progression of plasma leakage is also reflected in progressively
rising hematocrit levels, making an impact on the patient’s hemodynamics. In the first
stage, this could last hours and be expressed as a change in blood pressure due to the
narrowing of differential blood pressure or pulse pressure, accompanied by
tachycardia and other early signs of shock without a drop in blood pressure
27. CRITICAL PHASE
Shock occurs when a critical volume of plasma is lost through leakage and
is usually preceded by warning signs
The body temperature may be subnormal when shock occurs
SIRS and multiple organ damage may occur, accompanied by metabolic
acidosis and consumptive coagulopathy
Bleeding in this phase occurs mainly in the digestive system (hematemesis,
melena), but can also affect the lungs, central nervous system, or any
other organ
28. FATALITIES
A study in Puerto Rico looked at a series of deaths from confirmed cases of
dengue and found that they had presented a set of known warning signs,
including
- intense abdominal pain
- persistent vomiting
- sharp drop in fever
- altered state of consciousness
29. RECOVERY PHASE
Once patients survive the critical phase, they move on to the recovery
phase, during which there is a gradual reabsorption of the leaked fluid
from the extravascular to the intravascular compartment
This reabsorption period may last from 48 to 72 hours
33. MANAGEMENT
There is no specific drug for the treatment of patients infected with DENV,
CHIKV, or ZIKV. Therefore, clinical care is symptomatic, with constant
monitoring and evaluation of the patient during the symptomatic phase of
the disease and, in the case of dengue, for two more days after the fever
has subsided
Since infection by a given DENV serotype confers prolonged immunity only against that serotype, an individual can contract up to four dengue virus infections throughout their lifetime