1) A 7-year-old girl presents with 4 days of continuous fever, diarrhea, and abdominal pain after travelling to a village. Examination finds a rash, enlarged liver and spleen, and stool with blood and leukocytes.
2) Typhoid fever is caused by the bacterium Salmonella Typhi and is characterized by prolonged fever, abdominal pain, diarrhea, rash, and potential complications of intestinal bleeding and perforation. It spreads through ingestion of contaminated food, water, or contact with infected people or animals.
3) Treatment involves supportive care and antibiotics such as fluoroquinolones. Prevention includes handwashing, sanitation, proper food handling, and vaccination. Complications increase
Leptospirosis is a worldwide public health problem. In humid tropical and subtropical areas, where most developing
countries are found, it is a greater problem than in those with a temperate climate. The magnitude of the problem in
tropical and subtropical regions can be largely attributed to climatic and environmental conditions but also to the
great likelihood of contact with a Leptospira-contaminated environment caused by, for example, local agricultural
practices and poor housing and waste disposal, all of which give rise to many sources of infection. In countries with
temperate climates, in addition to locally acquired leptospirosis, the disease may also be acquired by travellers
abroad, and particularly by those visiting the tropics.
Leptospirosis is a potentially serious but treatable disease. Its symptoms may mimic those of a number of other
unrelated infections such as influenza, meningitis, hepatitis, dengue or viral haemorrhagic fevers. Some of these
infections, in particular dengue, may give rise to large epidemics, and cases of leptospirosis that occur during such
epidemics may be overlooked. For this reason, it is important to distinguish leptospirosis from dengue and viral
haemorrhagic fevers, etc. in patients acquiring infections in countries where these diseases are endemic. At present,
this is still difficult, but new developments may reduce the technical problems in the near future. It is necessary,
therefore, to increase awareness and knowledge of leptospirosis as a public health threat.
Leptospirosis is a worldwide public health problem. In humid tropical and subtropical areas, where most developing
countries are found, it is a greater problem than in those with a temperate climate. The magnitude of the problem in
tropical and subtropical regions can be largely attributed to climatic and environmental conditions but also to the
great likelihood of contact with a Leptospira-contaminated environment caused by, for example, local agricultural
practices and poor housing and waste disposal, all of which give rise to many sources of infection. In countries with
temperate climates, in addition to locally acquired leptospirosis, the disease may also be acquired by travellers
abroad, and particularly by those visiting the tropics.
Leptospirosis is a potentially serious but treatable disease. Its symptoms may mimic those of a number of other
unrelated infections such as influenza, meningitis, hepatitis, dengue or viral haemorrhagic fevers. Some of these
infections, in particular dengue, may give rise to large epidemics, and cases of leptospirosis that occur during such
epidemics may be overlooked. For this reason, it is important to distinguish leptospirosis from dengue and viral
haemorrhagic fevers, etc. in patients acquiring infections in countries where these diseases are endemic. At present,
this is still difficult, but new developments may reduce the technical problems in the near future. It is necessary,
therefore, to increase awareness and knowledge of leptospirosis as a public health threat.
TYPHOID FEVER
- Acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue and the gall bladder.
- Classified as “enteric fever.”
Mode of Transmission
Poor hygiene habits
Public sanitation conditions
Flying insects feeding on feces
Ingestion of food or water contaminated with the organism
Food or water that has been contaminated with the fecal matter or, less commonly, urine of an infected person or carrier.
Shellfish from contaminated beds
KAWASAKI DISEASE
History of Kawasaki disease
Epidemiology and etiology
Presentation and diagnosis
Treatment
Chronic cardiovascular manifestations
Follow up of patients
Questions in the chronic management
TYPHOID FEVER
- Acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue and the gall bladder.
- Classified as “enteric fever.”
Mode of Transmission
Poor hygiene habits
Public sanitation conditions
Flying insects feeding on feces
Ingestion of food or water contaminated with the organism
Food or water that has been contaminated with the fecal matter or, less commonly, urine of an infected person or carrier.
Shellfish from contaminated beds
KAWASAKI DISEASE
History of Kawasaki disease
Epidemiology and etiology
Presentation and diagnosis
Treatment
Chronic cardiovascular manifestations
Follow up of patients
Questions in the chronic management
The slide is about enteric fever, also called typhoid fever. It explains the relevant anatomy, pathogenesis, pathophysiology, presentation, diagnosis and treatment of the disease. It also specifies the prevention by way of lifestyle and vaccines
Defined as inflammation of the mucous membrane of stomach and intestine usually causing nausea ,vomiting and diarrhea.
Gastro-intestinal infections represent a major public health and clinical problem worldwide. Many species of bacteria, viruses and protozoa cause gastro-intestinal infection.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
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
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.
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.
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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.
2. CaseScenario:
A 7- year old girl, who recently travelled to a village with her
family, presents with 4 day history of continuous fever, diarrhea,
and tenesmus and toxic look.There are palpable small
erythematous rash on the trunk only. Liver and spleen enlarged.
Stool examination revealed blood and leukocytes.
3. INTRODUCTION
Typhoid fever is one of the commonest cause of PUO
(pyrexia of unknown origin)
It’s a bacterial disease caused by typhoid bacillus.
Characterized mainly by prolonged fever, abd pain,
diarrhea, rose spots, delirium, splenomegaly, intestinal
bleeding and perforation.
4. ETIOLOGY
Typhoid fever is caused by SalmonellaTyphi
Paratyphoid is caused by S. paratyphoid A, S. paratyphoid B ( S.
scottmuelleri) and S. paratyphoidC (S. hirschfeldii)
Salmonella organisms are gram negative bacilli and they contain
three types ofAg:
1. Somatic or cell wall lipopolysaccharide (O)
2. Flagellar (H)
3. Capsular or polysaccharide virulence (Vi)
5. EPIDEMIOLOGY
Adults and children of all ages and both sexes are equally
susceptible to infection. Most common in school age children and
young adults.
Major reservoirs for salmonella are animals, contaminated water,
infected fruits and veges, and infected humans.
Infection is transmitted by ingestion of contaminated food milk
water or contact with and infected animal.
Person to person spread occur by faecal oral transmission. 10^5 -
10^6 viable organisms must be ingested for a clinical disease to
occur.
Incubation period is usually 7-14 days. (Range 3-30 days)
7. PATHOGENE
SIS
Bacteria enters by ingestion of contaminated food or water.
After ingestion and surviving the acidity if stomach, it enters the
small intestine where it penetrates the mucous and enter
mononuclear phagocytes of ileal payers patches and mesenteric
LN.
Then theres necrosis of payers leading to ulcers which causes
bleeding. It may also erode the intestinal wall and causes
intestinal perforations.
Infection spreads to regional LN and multiply in mononuclear
cells.
Via lymphatics it reaches the liver, spleen, mesenteric LN, bone
marrow and proliferate them.
At the end of incubation period, they pass into bloodstream and
produce bacteremia and its associated symptoms.
Large no. Of salmonella produce in the wall of GB and reach
intestine through bile.
8. CLINICAL
FEATURES
First week: fever and chills gradually increasing and
persisting (95% cases), headache, abdominal
tenderness
Second week: rash, abdominal pain, diarrhea or
constipation, delirium, prostration, rose spots,
hepatosplenomegaly
Third week: complications of intestinal bleeding and
perforation, shock. Malena, ileus, rigid abdomen,
coma.
Fourth week and later: restoration of symptoms,
relapse, wt loss, reappearance of acute disease,
cachexia.
9. DIAGNOSIS
Isolation of causative organism ( culture )
1. Blood culture- positive early during the first 2 weeks
of illness in 40-60%
2. Bone marrow culture – positive during later sstage of
enteric fever, it’s the most sensitive procedure (
positive in 85-90%)
3. Urine and stool culture- it may be positive during the
incubation period
10. DIAGNOSIS
Serological tests
1. Widal test- it measure the AB response to somatic O
and flagellar H Ag of salmonella. O titers of greater
than 1:160 is suggestive. H ab signifies prev
infections or immunization and is difficult to
interpret in endemic areas.
- It may give false positive or false negative results. So its
not a reliable test to diagnose.
Polymerase chain reaction (PCR)
It gives results within few hours and its more specific abd
sensitive than blood culture.
11. DIAGNOSIS
Supportive tests
1. CBC: -Leucopenia, in younger children leukocytosis is
common and may reach 20,000- 25,000 cell/uL.
- normochromic normocytic anemia
- thrombocytopenia
1. LFTs: it may be deranged.
13. COMPLICATI
ONS
Intestinal perforations- usually in distal ileum
Intestinal hemorrhage
Toxic encephalopathy
Acute cholecystitis/ hepatitis
Pneumonia
Meningitis
Osteomyelitis
Septic arthritis
Toxic myocarditis
Most of the complications occur after 2nd week of the disease.
14. MANAGEMENT
Supportive:
Corticosteroids are given in pt with toxemia or
prolonged ss. A short course of dexamethasone
improves the survival rates of pt with shock or coma.
Initial dose is 3 mg/kg, followed by 1 mg/kg every 6H
for 48hours.
Blood transfusion in pt with anemia or severe intestinal
bleed.
Adequate nutrition, hydration and electrolytes
balance.
If intestinal perforations then surgical intervention
along with broad spectrum antibiotics.
In case of thrombocytopenia, platelet transfusion is
needed.
15. MANAGEMENT
Specific
Uncomplicated typhoid fever:
1. Fully sensitive:
Chloramphenicol, 50-75 mg/kg/d PO or 75mg/kg/day IV in 4
divided doses for 14-21 days
Amoxicillin 75-100 mg/kg/d Po in 3 divided doses for 14d
Fluoroquinolones e.g Ciprofloxacin 15-20mg/kg/d PO for 10-14d
1. Multi drug resistant:
Fluroquinolones
Azithromycin 10-20mg/kg/d po for 7d
Cefixime 20mg/kg/d Po for 7-14d
18. PREVENTION
Handwashing, improved personal hygiene and sanitary habits
Protective health measures like provision of clean water, adequate
seepage disposal, control of flies
Adequate temperature for cooking. Eggs should never be eaten
raw.Avoid preserving food at warm temp and avoid reheating it.
Passive immunization with vaccination, parented ViCPS (typhim
Vi) for IM use. Oral live attenuated Ty21a vaccine is supplied as
enteric coated capsules.
19. PROGNOSIS
Mortality rate is higher than 10% and its mainly due to delay in
diagnosis or treatment.
Enteric fever with complications is associated with high mortality
and morbidity.
Relapse may occur in 4-8% of the pt who haven’t got the
treatment, it may also occur in treated pt about 2 weeks after
stopping the antibiotics.
Children have risk of becoming carriers at a rate of 1-5%.
Chronic carriers are at increased risk to get biliary tract disease.
