This document provides information on dengue virus, its transmission via the Aedes aegypti mosquito, clinical manifestations of dengue fever and dengue hemorrhagic fever, laboratory diagnosis, and treatment and prevention. It discusses how dengue virus is an RNA virus transmitted by Aedes aegypti mosquitoes, which causes flu-like symptoms and potentially severe bleeding in dengue hemorrhagic fever. Clinical evaluation involves monitoring for bleeding, hydration status, and vascular permeability. Laboratory tests include virus isolation, serology, and monitoring cell and platelet counts. Treatment focuses on rehydration and monitoring for warning signs while avoiding NSAIDs. Prevention emphasizes vector control through larvicide use and eliminating mosquito breeding sites.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Pharma Pcd Franchise in Jharkhand - Yodley Lifesciences
dengue21.pptx
1. Dr. Sachin Verma MD, FICM, FCCS, ICFC
Fellowship in Intensive Care Medicine
Infection Control Fellows Course
Consultant Internal Medicine and Critical Care
Web:- http://www.medicinedoctorinchandigarh.com
Mob:- +91-7508677495
References;
1. Harrison´s principle of internal medicine -16th ed
2. Park´s textbook of preventive and social medicine -17th ed
3. www.cdc.org
3. Virus vector and transmission
Dengue Virus
Causes dengue and dengue hemorrhagic fever
Is an arbovirus
Transmitted by mosquitoes
Composed of single-stranded RNA
Has 4 serotypes (DEN-1, 2, 3, 4)
4. Dengue Viruses
Each serotype provides specific lifetime
immunity, and short-term cross-immunity
All serotypes can cause severe and fatal
disease
Genetic variation within serotypes
Some genetic variants within each serotype
appear to be more virulent or have greater
epidemic potential
5. Aedes aegypti
Dengue transmitted by
infected female mosquito
Primarily a daytime feeder
Lives around human
habitation
Lays eggs and produces
larvae preferentially in
artificial containers.
Diseases- yellow fever, filaria
dengue, chikungunya fever,
rift valley fever.
9. Population at
risk (billions)
% of total
population
Population increase only
2050s 3.2 34
2080s 3.5 35
Population increase plus
climate change (HADCM2)
2050s 4.1 44
2080s 5.2 52
10. Replication and Transmission
of Dengue Virus
1. Virus transmitted
to human in mosquito
saliva
2. Virus replicates
in target organs
3. Virus infects white
blood cells and
lymphatic tissues
4. Virus released and
circulates in blood
3
4
1
2
11. Replication and Transmission
of Dengue Virus
5. Second mosquito
ingests virus with blood
6. Virus replicates
in mosquito midgut
and other organs,
infects salivary
glands
7. Virus replicates
in salivary glands
6
7
5
12. Transmission of Dengue Virus
by Aedes aegypti
Viremia Viremia
Extrinsic
incubation
period
0 5 8 20 24 28
12 16
DAYS
Human #2
Illness
Mosquito feeds /
acquires virus
Mosquito refeeds /
transmits virus
Intrinsic
incubation
period
Illness
Human #1
13. Clinical Manifestations of Dengue and
Dengue Hemorrhagic Fever
Undifferentiated fever
Classic dengue fever
Dengue hemorrhagic fever
Dengue shock syndrome
14. Undifferentiated Fever
May be the most common manifestation of
dengue
Prospective study found that 87% of patients
infected were either asymptomatic or only mildly
symptomatic
Other prospective studies including all age-
groups also demonstrate silent transmission.
17. Signs and Symptoms of
Encephalitis/Encephalopathy
Associated with Acute Dengue
Infection
Decreased level of consciousness:
lethargy, confusion, coma
Seizures
Nuchal rigidity
Paresis
18. Clinical Case Definition for
Dengue Hemorrhagic Fever
4 Necessary Criteria:
Fever, or recent history of acute fever
Hemorrhagic manifestations
Low platelet count (100,000/mm3 or less)
Objective evidence of “leaky capillaries:”
– elevated hematocrit (20% or more over
baseline)
– low albumin
– pleural or other effusions
19. Four Grades of DHF
Grade 1
– Fever and nonspecific constitutional symptoms
– Positive tourniquet test is only hemorrhagic
manifestation
Grade 2
– Grade 1 manifestations + spontaneous bleeding
Grade 3
– Signs of circulatory failure (rapid/weak pulse, narrow
pulse pressure, hypotension, cold/clammy skin)
Grade 4
– Profound shock (undetectable pulse and BP)
20. Danger Signs in
Dengue Hemorrhagic Fever
Abdominal pain - intense and sustained
Persistent vomiting
Abrupt change from fever to
hypothermia, with sweating and
prostration
Restlessness or somnolence
21. Clinical Case Definition for Dengue
Shock Syndrome
4 criteria for DHF
Evidence of circulatory failure manifested
indirectly by all of the following:
– Rapid and weak pulse
– Narrow pulse pressure ( 20 mm Hg) OR
hypotension for age
– Cold, clammy skin and altered mental
status
Frank shock is direct evidence of circulatory
failure
22. Risk Factors Reported for DHF
Virus strain :DHF risk is greatest for DEN-2, followed
by DEN-3, DEN-4 and DEN-1
Pre-existing anti-dengue antibody
– previous infection
– maternal antibodies in infants
Host genetics-females more affected,
malnutrition protective.
Age(<12)
23. Unusual Presentations
of Severe Dengue Fever
Encephalopathy
Hepatic damage
Cardiomyopathy
Severe gastrointestinal hemorrhage
24. Increased Probability of DHF
Hyperendemicity
Increased circulation
of viruses
Increased probability
of secondary infection
Increased probability of
occurrence of virulent strains
Increased probability of
immune enhancement
Increased probability of DHF
25. 1
Pathogenesis of DHF
STEP 1- Homologous Antibodies Form Non-
infectious Complexes
Dengue 1 virus
Neutralizing antibody to Dengue 1 virus
Non-neutralizing antibody
Complex formed by neutralizing antibody and virus
26. 2
STEP2- Heterologous Antibodies of first
serotype infection form Infectious Complexes
with second serotype
Dengue 2 virus
Non-neutralizing antibody to Dengue 1 virus
Complex formed by non-neutralizing antibody
and virus
2
2
27. 2
2
2
2
2
2
2
STEP3 - Heterologous Complexes Enter More
Monocytes, Where Virus Replicates
Dengue 2 virus
2
Non-neutralizing antibody
Complex formed by non-neutralizing
antibody and Dengue 2 virus
2
28. STEP4 –DHF pathogenesis
Infected monocytes release vasoactive
mediators, resulting in increased vascular
permeability and hemorrhagic manifestations
that characterize DHF and DSS
29. Clinical Evaluation in Dengue Fever
Blood pressure
Evidence of bleeding in skin or other sites
Hydration status
Evidence of increased vascular
permeability-- pleural effusions, ascites
Tourniquet test
31. Tourniquet Test
Inflate blood pressure
cuff to a point midway
between systolic and
diastolic pressure for 5
minutes
Positive test: 20 or more
petechiae per 1 inch2
(6.25 cm2)
32. Laboratory Tests
in Dengue Fever
Clinical laboratory tests
– CBC--WBC, platelets, hematocrit
– Albumin
– Liver function tests
– Urine--check for microscopic hematuria
Dengue-specific tests
– Virus isolation
– Serology
33. Laboratory Methods for Dengue Diagnosis-
Virus isolation to determine serotype of
the infecting virus
IgM ELISA test for serologic diagnosis
36. Collection and Processing of
Samples for Laboratory
Diagnosis
Type of
Specimen
Time of
Collection
Type of
Analysis
Acute-phase
blood
(0-5 days after onset)
When patient presents;
collect second sample
during convalescence
Virus isolation
and/or serology
Convalescent-phase
blood
( 6 days after onset)
Between days 6 and 21
after onset
Serology
37. Temperature, Virus Positivity
and Anti-Dengue IgM , by
Fever Day
Mean Max. Temperature Virus Dengue IgM
20
40
60
80
100
Percent
Virus
Positive
0
-4 -3 -2 -1 0 1 2 3 4 5
Fever Day
6
39.5
39.0
38.5
38.0
37.5
37.0
Temperature
(degrees
Celsius)
Dengue
IgM
(EIA
units)
300
150
0
75
225
38. Management of dengue fever
Outpatient Triage
No hemorrhagic manifestations and patient is
well-hydrated: home treatment
Hemorrhagic manifestations or hydration
borderline: outpatient observation center or
hospitalization
Warning signs (even without profound shock) or
DSS: hospitalize
39. Warning Signs for Dengue Shock
:
Initial Warning Signals:
• Disappearance of fever
• Drop in platelets
• Increase in hematocrit
When Patients Develop DSS
• 3 to 6 days after onset of
symptoms
Alarm Signals:
• Severe abdominal pain
• Prolonged vomiting
• Abrupt change from fever
to
hypothermia
• Change in level of
consciousness (irritability
or
somnolence)
Four Criteria for DHF:
• Fever
• Hemorrhagic manifestations
• Excessive capillary permeability
• 100,000/mm3 platelets
40. Treatment of Dengue Fever
Fluids
Rest
Antipyretics (avoid aspirin and non-
steroidal anti-inflammatory drugs)
Monitor blood pressure, hematocrit,
platelet count, level of consciousness
41. Treatment of Dengue Fever
Continue monitoring after defervescence
If any doubt, provide intravenous fluids, guided
by serial hematocrits, blood pressure, and urine
output
The volume of fluid needed is similar to the
treatment of diarrhea with mild to moderate
isotonic dehydration (5%-8% deficit)
42. Rehydrating Patients Over 40 kg
Volume required for rehydration is twice the
recommended maintenance requirement
Formula for calculating maintenance volume:
1500 + 20 x (weight in kg - 20)
For example, maintenance volume for 55 kg
patient is: 1500 + 20 x (55-20) = 2200 ml
For this patient, the rehydration volume would
be 2 x 2200, or 4400 ml.
43. Treatment of Dengue Fever
Avoid invasive procedures when
possible
Unknown if the use of steroids,
intravenous immune globulin, or platelet
transfusions to shorten the duration or
decrease the severity of
thrombocytopenia is effective
Patients in shock may require treatment
in an intensive care unit
44. Indications for Hospital
Discharge
Absence of fever for 24 hours (without
anti-fever therapy) and return of appetite
Visible improvement in clinical picture
Stable hematocrit
3 days after recovery from shock
Platelets 50,000/mm3
No respiratory distress from pleural
effusions/ascites
45. Common Misconceptions about
Dengue Hemorrhagic Fever
Dengue + bleeding = DHF
Need 4 WHO criteria, capillary permeability
DHF kills only by hemorrhage
Patient dies as a result of shock
Poor management turns dengue into DHF
Poorly managed dengue can be more severe, but DHF is a
distinct condition, which even well-treated patients may
develop
Positive tourniquet test = DHF
Tourniquet test is a nonspecific indicator of capillary
fragility
46. DHF is a pediatric disease
All age groups are involved in the
Americas
DHF is a problem of low income
families
All socioeconomic groups are affected
Tourists will certainly get DHF with a
second infection
Tourists are at low risk to acquire DHF
47. Vector Control Methods:
Chemical Control
Larvicides (organophosphorus compounds –
fenthion ,abate) may be used to kill immature
aquatic stages
Ultra-low volume fumigation ineffective against
adult mosquitoes
Mosquitoes may have resistance to commercial
aerosol sprays
48. Vector Control Methods:
Biological and Environmental
Control
Biological control
– Largely experimental
– Option: place fish in containers to eat
larvae
Environmental control
– Elimination of larval habitats
– Most likely method to be effective in the
long term
49. Purpose of Control
Reduce female vector density to a level
below which epidemic vector
transmission will not occur
Based on the assumption that
eliminating or reducing the number of
larval habitats in the domestic
environment will control the vector
The minimum vector density to prevent
epidemic transmission is unknown