A 45-year-old woman presented with fatigue, weakness, and appetite loss. Laboratory tests found elevated liver enzymes, bilirubin, and HCV RNA. A liver biopsy showed severe inflammation and fibrosis. She was diagnosed with hepatitis C based on her history of blood transfusion and laboratory results. Treatment with antiviral therapy is recommended to prevent further liver damage from the hepatitis C infection.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
Hepatitis C
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV): the virus can cause both acute and chronic hepatitis, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
Hepatitis C continues to infect individuals in Saskatchewan. While Hep-C may be treatable, untreated Hep-C is a significant health threat. Transmission routes include shared drug equipment, dry blood contact, exposure during vacations, tattoos or piercing, and exposure through personal items such as razors and toothbrushes.
The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.
Outline:
Introduction
Epidemiologic Determinants
Mode of transmission
Burden of Hepatitis-B
Prevention and treatment
Challenges
Recent Advances in Hepatitis B research
Strategies
References
La hepatitis C es una enfermedad del hígado causada por el virus del mismo nombre; ese virus puede causar una infección, tanto aguda como crónica, cuya gravedad varía entre una dolencia leve que dura algunas semanas, y una enfermedad grave de por vida.
El virus de la hepatitis C se transmite a través de la sangre, y las causas de infección más comunes son las prácticas de inyección poco seguras, la esterilización inapropiada de equipo médico en algunos entornos de atención sanitaria y la transfusión de sangre y productos sanguíneos sin analizar.
Hepatitis C continues to infect individuals in Saskatchewan. While Hep-C may be treatable, untreated Hep-C is a significant health threat. Transmission routes include shared drug equipment, dry blood contact, exposure during vacations, tattoos or piercing, and exposure through personal items such as razors and toothbrushes.
The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.
Outline:
Introduction
Epidemiologic Determinants
Mode of transmission
Burden of Hepatitis-B
Prevention and treatment
Challenges
Recent Advances in Hepatitis B research
Strategies
References
La hepatitis C es una enfermedad del hígado causada por el virus del mismo nombre; ese virus puede causar una infección, tanto aguda como crónica, cuya gravedad varía entre una dolencia leve que dura algunas semanas, y una enfermedad grave de por vida.
El virus de la hepatitis C se transmite a través de la sangre, y las causas de infección más comunes son las prácticas de inyección poco seguras, la esterilización inapropiada de equipo médico en algunos entornos de atención sanitaria y la transfusión de sangre y productos sanguíneos sin analizar.
Hepatitis C
Patología de origen viral; a cargo del Virus de Hepatitis C (VHC), este agente afecta al hígado dando asi las manifestaciones clínicas. Esta es una enfermedad de carácter crónico, lo que le hace diferente a las otras hepatitis virales y se le asocia directamente con la cirrosis hepática y CA.
Esta presentación tiene un fin educativo y de enseñanza espero les sea útil.
Lifestyle Disease or NCD (non communicable diseases / diseases of civilization) are diseases that appear to increase in frequency as countries become industrialized and life span increases.
Acute gastro-enteritis caused by the ingestion of the food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poison delivered from plants and animals.
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
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
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
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 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
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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.
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.
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.
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
2. Clinical case……
A 45-year-old woman with a history of blood transfusion is seen in
the clinic for complaints of tiredness, fatigue, anorexia, and
weakness.
On Physical examination, nothing was remarkable.
Laboratory values reported today include AST 150 IU/mL, ALT
250 IU/mL , SCr 0.9 mg/dL,
Bilirubin: 2.0 mg/dL, albumin 2.5 g/dL.
Serum Anti HCV : + HCV RNA level: 1, 220200 IU/mL
A liver biopsy has revealed severe inflammation and fibrosis.
What is the diagnosis ?
What is the best course of action?
3.
4. INTRODUCTION
Hepatitis C is a contagious liver disease that results from
infection with HCV.
It can range in severity from mild illness lasting a few
weeks to serious life long illness.
Spread through transfusion of blood and blood products
Transmitted sexually and perinatally also.
No vaccine available to prevent hepatitis C.
5. HISTORY
Identified in 1989.
Blood test became available in 1992.
Used to be known as “non-A, non-B” hepatitis (NANB)
Also named as perinatally transmitted NA-NB Hepatitis
(PT-NANB).
6. EPIDEMOLOGY
Globally, an estimated 130–170 million persons (2%–3% of the
world's population) are living with hepatitis C virus (HCV)
infection.
150 million are chronically infected and at risk of developing liver
cirrhosis and liver cancer.
More than 350000 people die from hepatitis C related liver diseases
every year.
The epidemiology and burden of HCV infection varies throughout
the world, with country-specific prevalence ranging from <1% to
>10%.
7. Developed countries
Transmission primarily through injection
drug use
Australia and Western Europe - <2%
Eastern Europe, Latin America, Africa,
Middle East, South Asia, countries of
former Soviet Union - >3%
Egypt with highest prevalence - >10%
Developing countries
Unsafe injections in health care settings
resulting in 2 million new HCV infection
each year.
China has highest estimated number of
HCV infected IDU in the world.
In Mexico. Pakistan and Thailand, >80% of
IDU are anti-HCV positive.
8.
9.
10.
11. EGYPT
• The reuse of syringes during a
schistosomiasis eradication program in the
1960s and 1970s is the purported cause of
the widespread introduction and spread of
HCV in that country.
• However, Egypt is experiencing continued
HCV transmission associated with unsafe
injection practices, poor infection control in
hospitals, and widespread use of unscreened
blood for transfusion.
• Up to 500 000 new infections are estimated
to occur annually.
PAKISTAN
• Ongoing transmission in
Pakistan, where HCV
infection is highly
endemic, also is associated
with unsafe injections.
• At a mean of 13 injections
per person annually,
Pakistan has the highest
documented rate of
injections in the world.
12.
13. HEPATITIS C VIRUS
Family – Flaviviridae
Genus – Hepacivirus
55-65 nm, enveloped positive sense single stranded RNA genome.
7 genotypes with several subtypes.
Subtypes 1a and 1b are found world wide and cause 60% of all
cases.
Half life of the virus particles in the serum is around 3 hours and
may be as short as 45 minutes.
In an infected person, about 1012 virus particles are produced each
day.
Replication in hepatocytes and lymphocytes.
14. The hepatitis C virus is gradually inactivated outside the body of a
host.
The presence of heat can greatly reduce the virus's lifespan outside
the body.
The virus can remain infectious outside a host for about sixteen days
at 25 °C and two days at 37 °C.
It can remain active for more than six weeks at temperatures less
than or equal to 4 °C.
When heated to temperatures of 60 °C and 65 °C, the hepatitis C
virus can be inactivated in eight and four minutes.
15. STRUCTURE
• Core genetic material(RNA)
• Surrounded by protective
shell of protein
• Encased in a lipid envelope
of cellular origin
• 2 viral envelope
glycoproteins E1 and E2
embedded in lipid envelope.
16.
17. TRANSMISSION
Exposure to infectious blood
• Receipt of contaminated blood
transfusions, blood products and
organ transplants.
• Injection given with contaminated
syringes and needle site injuries in
health care settings.
• Injection drug use
• Being born to hepatitis C infected
mother
20. 20
Sexual 15%
Other* 5%
Unknown 10%
Injecting drug use 60%
Transfusion 10%
(before screening)
*Nosocomial; Health-care work; Perinatal
Source: Centers for Disease Control and Prevention
27. EXTRA HEPATIC MANIFESTATIONS
Arthralgia is a common symptom of hepatitis C that is
characterized as joint pain.
Hepatitis C-related arthritis (HCVrA) is estimated to affect
about 4% of the HCV population.
Cerebral Vasculitis is a disorder that is characterized by
inflammation and cell death of arteries in the brain.
The cause of cerebral vasculitis is unknown, but it is thought to
be caused by immune dysfunction.
28. Insulin Resistance (IR) is a condition caused by the
inability of cells to absorb glucose. HCV can induce IR.
Cryoglobulinemia is a blood disorder caused by
abnormal proteins in the blood called cryoglobulins that
precipitate or clump together when blood is chilled and
then dissolve when warmed.
These proteins can be deposited in the small and medium
sized blood vessels, which restricts blood flow and can
lead to further problems.
29. OCCULT INFECTION
Persons who have been infected with hepatitis C may appear to clear the
virus but remain infected.
The virus is not detectable with conventional testing but can be found with
ultra-sensitive tests.
The original method of detection was by demonstrating the
viral genome within liver biopsies, but newer methods include an antibody
test for the virus core protein and the detection of the viral genome after
first concentrating the viral particles by ultracentrifugation.
30.
31. DIAGNOSIS
Presence of antibodies against HCV indicates that a person
is or has been infected.
Diagnosis of chronic infection is made when antibodies to
HCV are present in the blood for more than 6 months.
HCV Recombinant Immunoblot Assay(RIBA) and HCV
RNA testing confirms the diagnosis.
Early diagnosis can prevent health problems that may
result from infection and prevent transmission to family
members and close contacts.
32. Molecular methods in Diagnosis of
hepatitis c infection
Qualitative reverse
transcription- polymerase
chain reaction (RT-PCR)
assays for HCV RNA are
simpler than quantitative
tests and sufficient for
confirmation of the
diagnosis of HCV
infection.
33. ALANINE AMINOTRANSFERASE
Serum ALT testing is inexpensive and noninvasive.
Insensitive means of monitoring disease activity.
A single determination gives limited information, and serial
measurements recommended.
Resolution of ALT elevation with antiviral therapy appears to
indicate disease response.
34. Serologic Pattern of Acute HCV Infection
with Recovery
Symptoms
+/-
Time after Exposure
Titer
anti-
HCV
ALT
Normal
0 1 2 3 4 5 6 1 2 3 4
YearsMonths
HCV RNA
Dr.T.V.Rao MD
34
35. Serologic Pattern of Acute HCV Infection
with Progression to Chronic Infection
Symptoms
+/-
Time after
Exposure
Titer
anti-
HCV
ALT
Normal
0 1 2 3 4 5 6 1 2 3 4
YearsMonths
HCV RNA
Dr.T.V.Rao MD
35
36. Who should be screened?
People who receive blood, blood products or organs
Current or former injecting drug users
People on long term haemodialysis
Health care workers
People living with HIV
People with abnormal liver tests or liver disease
Infants born to infected mothers
37. TREATMENT
Does not always require treatment.
Combination antiviral therapy with interferon and ribavirin has been
the mainstay of HC Rx.
Scientific advances have led to the development of new antiviral
drugs.
2 new therapeutic agents telaprevir and boceprevir have recently
been licensed in some countries.
38. Can we prevent hepatitis c infection
There is no vaccine for
Hepatitis C.
The best way to prevent
Hepatitis C is by avoiding
behaviors that can spread
the disease, especially
injection drug use.
39. PREVENTION
Primary prevention
Risk of infection can be reduced by avoiding-
Unnecessary and unsafe injections
Unsafe blood products
Unsafe sharp waste collection and disposal
Use of illicit drugs and sharing of injection equipment
Unprotected sex with HCV infected people.
Sharing sharp personal items contaminated with infected blood
Tattoos, piercing and acupuncture performed with contaminated
equipment
40. Secondary & tertiary prevention
• Education and counselling
• Immunization with HA and HB vaccines to prevent
co-infection from these viruses to protect their liver.
• Early and appropriate medical management including
antiviral therapy
• Regular monitoring for early diagnosis of chronic
liver disease.