The document summarizes the Expanded Program on Immunization (EPI) which aims to reduce illness, disability and mortality from 8 childhood diseases through immunization. It provides details on each disease such as causative agent, symptoms, prevention methods including specific vaccines. It explains vaccine administration including doses, ages and routes. The diseases covered are tuberculosis, polio, diphtheria, pertussis, tetanus, measles, mumps, rubella, hepatitis B, and Hib. The document emphasizes the importance and effectiveness of immunization programs.
It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
It gives all the important definitions used in infectious disease epidemiology and continues to elaborate on dynamics of disease transmission followed by prevention and control of infectious diseases.
NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors.
The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
NCDs, also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors.
The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
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.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
2. What is Expanded Program of
Immunization (EPI)?
• The Expanded Program on Immunization (EPI) is a disease
prevention activity aiming at reducing illness, disability and
mortality from childhood diseases preventable by immunization.
• These diseases are referred as 8 EPI target diseases and cause
millions of ailments, disabilities & deaths each year.
1. Poliomyelitis
2. Neonatal Tetanus
3. Measles
4. Diphtheria
5. Pertussis (Whooping Cough)
6. Hepatitis-B
7. Hib Pneumonia & Meningitis
8. Childhood Tuberculosis
• Universal immunization for all children by 1990; an essential
element of the WHO strategy to achieve health for all by 2000.
• First established in 1978
3. Why is immunization important?
• Immunization is a proven tool for controlling and even
eradicating infectious diseases
• An immunization campaign carried out by the World Health
Organization (WHO) from 1967 to 1977 resulted in the
eradication of smallpox. When the programme began, the
disease still threatened 60% of the world's population and
killed every fourth victim
• 1000 deaths in less than 5 year children will daily occur in
Pakistan, if EPI is discontinued
• Immunization is one of the most successful and cost
effective health interventions
4. Disease Cause of infection Vaccine Type Doses Age of Administration Route of Administration
Childhood
T.B
Bacteria BCG Live 1 Soon after Birth Intra-dermal
Poliomyelitis Virus OPV
[Temp Sensitive]
-20 C
Live
Attenuated
4 OPV-0 : Soon after Birth
OPV-1: 6 wks
OPV-2 : 10 wks
OPV-3 : 14 wks
Orally
Diphtheria Bacteria Pentavalent
Vaccine
[DTP + Hep B +
Hib]
D & T : Toxoid
P : Killed
3 Penta-1 : 6wks
Penta-2 : 10 wks
Penta-3 : 14 wks
Intra - Muscular
Pertussis Bacteria
Hepatitis B Virus Hep B :
Recombinant
Hib :
Conjugate
Hib Pneumonia and
meningitis
Bacteria
Measles Virus Measles [Temp
Sensitive]
-20 C
Live 2 Measles - 1: 9 mo
Measles - 2 : 15 mo
Sub - Cutaneous
5. Diphtheria
In Urdu Diphtheria is known as Khunnaaq
• Causative Agent : Corynebacterium
Diphtheria
• Diagnostic feature : Leathery, raised
greyish-green membrane on tonsils
firmly adherent and is surrounded by a
zone of inflammation
• Prevention : Active immunization
• Carriers : Convalescent Carriers
What is a convalescent carrier? : a person
who is clinically recovered from an
infectious disease but still capable of
transmitting the infectious agent to
others.
6. Pertussis (whooping cough)
Pertussis in Urdu is known as Kaali Khansi
Why is it called whooping cough? : cough with
loud crowing inspiration
• Causative agent : Bordetella pertussis
• Stages of infection :
1. Catarrhal Stage - conjunctivitis, rhinitis,
unproductive cough
2. Paroxysmal Stage – severe bouts of cough
and whoop
3. Convalescent stage - decreased cough
• Route of infection : People with whooping
cough usually spread the disease by coughing
or sneezing while in close contact with others,
who then breathe in the bacteria that cause
the disease
• Complications : bronchitis, Broncho-
pneumonia and bronchiectasis
7. Tetanus
Tetanus is known in urdu as Tashannaj
• Infective agent : Clostridium tetani
• Reservoir : Soil and dust and is not transmitted
from man to man
• Prevention : Active Immunization
How is tetanus in neonates prevented : By giving 2
tetanus injections to pregnant females 1 month
apart in their 2nd trimester
• Life long prevention of tetanus :
• 0 day 1st dose
• After 1 month 2nd dose
• After 6 month 3rd dose
• After 1 year 4th dose
• After 5 years 5th dose
Booster dose is provided after every 10 years
8. Measles
• Measles in urdu is called Khasra
• Causative agent : RNA virus of paramyxovirus group
• Clinical Features : Fever, respiratory catarrhal symptoms
[runny/blocked nose, sneezing, itchy nose and difficulty breathing],
Koplik spots and rash
What are Koplik Spots : small, bluish spots 1- 2 mm with a red
background on buccal mucosa
• Complications : pneumonia, otitis media, diarrhea, encephalitis
• Common cause of death : death usually results from superimposed
infection e.g. pneumonia
• Vaccine needs to be stored and transported at -20 C
• Why is measles given at 9 months : before 9 months, mothers
antibodies protect the child
• Can be given separately or in combination with MMR [Measeles,
mumps, rubella] at 12 – 15 months of age
• Contraindication for immunization : Hypersensitivity to eggs or
neomycin
9. Mumps
Mumps in urdu is known as Kan Pairay
• Causitive agent : Paramyxovirus parotiditis
• Mode of Transmission : Droplet infection
• Clinical Features : Painful swelling of one or
both parotid glands
• Most common complications :
Meningioencephalitis and Orchitis
• Rare complication : Sensorineural deafness
10. Rubella
Rubella in urdu is known as Bara khasra
• Causative Agent : RNA virus [toga virus group]
• Mode of Transmission : Droplet Infection
What is congenital Rubella? : infection that is
contracted in 1st trimester and leads to congenital
abnormalities of the fetus
• Prevention of Rubella : Active immunization of
pre-shoolers 12-15 mo and then again at 4 years
of age.
• Combined with mumps and measles vaccine
• Why is it given in combination of MMR vaccine
[known as triple vaccine] : Because it is most
cost effective
• What is the difference between Triple Vaccine
and Trivalent Vaccine? : Triple vaccine is against
three different diseases and Trivalent vaccine is
against three different strains of same disease
[e.g. OPV for polio]
11. Tuberculosis
• Tuberculosis in urdu is known as Sil or Tap-e-
diq
• Causative agent : Mycobacterium
tuberculosis
• Mode of Transmission : Droplet infectioin
• Signs and Symptoms of disease : productive
cough, fever with chills, night sweats
• Vaccine : Live [freeze dried] vaccine given
intra dermally soon after birth called Bacille
Calmette-Guerin (BCG)
12. Poliomyelitus
• Causative agent : polio virus type -1, type -2 and type -3
• Reservoir : Man is the only reservoir
• Mode of transmission : 1. Feco oral 2. Droplet infection
• Prevention : Oral Polio Vaccine at birth then at 6, 10, 14 weeks
• Two kinds of Vaccines : Inactivated Polio Vaccine and Oral Polio
Vaccine
• IPV :
• first introduced in 1955 and is
• produced from wild-type poliovirus strains of each serotype that
have been inactivated (killed) with formalin
• It can be administered alone or in combination with other vaccines
• Adverse events following administration of IPV are very mild and
transient
• OPV :
• first introduced in 1961 and
• consists of a mixture of the three live attenuated poliovirus
serotypes (Sabin types 1, 2 and 3), selected for their lower
neurovirulence and reduced transmissibility
• Following oral administration OPV strains produce a local immune
response in the lining of the intestines which is the primary site for
poliovirus replication. Mucosal immunity decreases the replication
and excretion (shedding) of the virus, and thus provides a potential
barrier to its transmission.
• This mechanism, combined with the ease of oral administration and
the very low cost of the vaccine, have made it the vaccine of choice
for the global eradication programme
13. OPV
• Prevention : Safe and clean water and proper disposal of feces
• Benefits of Oral Polio Vaccine : Once the virus strains multiply in the
host and induce immunity, they are also excreted and spreads to
household contacts and in the community thus even no vaccinated
people become immunized
• Vaccine is stored at : -20 C
• Side affects : Extremely rare to get disease from vaccine [1 case per
2.6-5 million doses of OPV ]
• If a mother complains that her children get diarrhea and she wont
allow for the vaccine, you must still administer it as there is no
evidence of diarrhea following OPV
14. Hepatitis B
• Hep B in Urdu is known as Bara or Kala Yarkaan
• Mode of Transmission :
• Blood transfusion
• sharing of needles
• sexual transmission
• vertical transmission [from mother to child]
• Prevention : Vaccination at 6, 10, 14 weeks after
birth
• Baby born to a known Hep B Mother : Baby
should be given Hep B immunoglobulins. Two
doses 30 days apart
• Hep B Vaccine : Hepatitis B vaccines (HBV) are
composed of highly purified preparations of
hepatitis B "surface" antigen (HBsAg)
• Given as Pentavalent [along with DPT and Hib
vaccine] given at 6, 10, 14 weeks.
15. H Influenza type B
• Haemophilus influenzae type b (Hib) disease
is a serious disease caused by bacteria.
• Hib disease is the leading cause of bacterial
meningitis among children under 5 years old
Symptoms:
• Fever.
• Headache.
• Stiff neck.
• Nausea with or without vomiting.
• Photophobia (eyes being more sensitive to
light)
• Altered mental status (confusion)