Chronic hepatitis C is caused by the hepatitis C virus (HCV). It was previously called "non-A, non-B hepatitis". HCV has 6 major genotypes. Genotype 1 is the most common in the United States and has the lowest response rates to treatment. Standard treatment was pegylated interferon and ribavirin for 48 weeks for genotype 1 and 24 weeks for genotypes 2 and 3. New direct acting antivirals like sofosbuvir have improved treatment outcomes with higher cure rates and fewer side effects while allowing treatment without interferon for most patients. Sofosbuvir inhibits the HCV RNA polymerase and costs around $1,800 for a 24 week course in developing countries, compared to $84,
A very brief & concise ppt. for HIV... Includes a video from YouTube explaining the Replication cycle of HIV. {actually was a class project ;)}. Hope you people like it.
Here's the link to the video: https://www.youtube.com/watch?v=RO8MP3wMvqg
A very brief & concise ppt. for HIV... Includes a video from YouTube explaining the Replication cycle of HIV. {actually was a class project ;)}. Hope you people like it.
Here's the link to the video: https://www.youtube.com/watch?v=RO8MP3wMvqg
ATAC-seq (Assay for Transposase-Accessible Chromatin using sequencing) is a technique used in molecular biology to study chromatin accessibility. The key part of the ATAC-seq procedure is the action of the transposase Tn5 on the genomic DNA of the sample.
This slide is about the basics of mRNA-based therapy. The content includes: definition of mRNA, timeline of mRNA therapeutics, action mechanism and development strategies of mRNA drugs, therapeutic mRNA applications, and the related services provided by Creative Biolabs.
A simple version of the CRISPR/Cas system, CRISPR/Cas9, has been modified to edit genomes. By delivering the Cas9 nuclease complexed with a synthetic guide RNA (gRNA) into a cell, the cell's genome can be cut at a desired location, allowing existing genes to be removed and/or new ones added.
As the COVID-19 pandemic continues, people are becoming infected at an alarming rate, individuals are unknowingly spreading disease, and more lives are lost every day. There is
an immediate need for a simple, rapid, early, and sensitive point-of-care testing for COVID-
19 disease. Recently,
clustered regularly interspaced short palindromic repeats (CRISPR)-based detection methods have received substantial attention for nucleic acid-based molecular testing due to their simplicity, high sensitivity and specificity. This review explores the various CRISPR-based COVID-19 detection methods and related diagnostic devices. As with any emerging technology, CRISPR/Cas-based nucleic acid testing methods have several
challenges that must be overcome for practical applications in clinics and hospitals. More importantly, these detection methods are not limited to COVID-19 but can be applied to detect any type of pathogen, virus, and fungi that may threaten humans, agriculture, and food industries in resource-limited settings. CRISPR/Cas-based detection methods have the potential to become simpler, more reliable, more affordable, and faster in the near future, which is highly important for achieving point-of-care diagnostics.
Tuberculosis is a raging problem round the globe. Eradicating TB is a herculean task but is possible is efforts from all corners from the world. The diagnostics have taken a big leap and with effective medications, our dream of TB free world may come true. But unlimited efforts are need to reach our goal.
Genome editing with the CRISPR-Cas9 system has become one of the major tools in modern biotechnology. This slide share discusses the fundamentals in a simple, easy to understand format.
Acute Pancreatitis - Diagnosis and ManagementRobert Robinson
Overview of the diagnosis and management of acute pancreatitis with a target audience of first year internal medicine residents at SIU Medicine in Springfield IL, USA.
ATAC-seq (Assay for Transposase-Accessible Chromatin using sequencing) is a technique used in molecular biology to study chromatin accessibility. The key part of the ATAC-seq procedure is the action of the transposase Tn5 on the genomic DNA of the sample.
This slide is about the basics of mRNA-based therapy. The content includes: definition of mRNA, timeline of mRNA therapeutics, action mechanism and development strategies of mRNA drugs, therapeutic mRNA applications, and the related services provided by Creative Biolabs.
A simple version of the CRISPR/Cas system, CRISPR/Cas9, has been modified to edit genomes. By delivering the Cas9 nuclease complexed with a synthetic guide RNA (gRNA) into a cell, the cell's genome can be cut at a desired location, allowing existing genes to be removed and/or new ones added.
As the COVID-19 pandemic continues, people are becoming infected at an alarming rate, individuals are unknowingly spreading disease, and more lives are lost every day. There is
an immediate need for a simple, rapid, early, and sensitive point-of-care testing for COVID-
19 disease. Recently,
clustered regularly interspaced short palindromic repeats (CRISPR)-based detection methods have received substantial attention for nucleic acid-based molecular testing due to their simplicity, high sensitivity and specificity. This review explores the various CRISPR-based COVID-19 detection methods and related diagnostic devices. As with any emerging technology, CRISPR/Cas-based nucleic acid testing methods have several
challenges that must be overcome for practical applications in clinics and hospitals. More importantly, these detection methods are not limited to COVID-19 but can be applied to detect any type of pathogen, virus, and fungi that may threaten humans, agriculture, and food industries in resource-limited settings. CRISPR/Cas-based detection methods have the potential to become simpler, more reliable, more affordable, and faster in the near future, which is highly important for achieving point-of-care diagnostics.
Tuberculosis is a raging problem round the globe. Eradicating TB is a herculean task but is possible is efforts from all corners from the world. The diagnostics have taken a big leap and with effective medications, our dream of TB free world may come true. But unlimited efforts are need to reach our goal.
Genome editing with the CRISPR-Cas9 system has become one of the major tools in modern biotechnology. This slide share discusses the fundamentals in a simple, easy to understand format.
Acute Pancreatitis - Diagnosis and ManagementRobert Robinson
Overview of the diagnosis and management of acute pancreatitis with a target audience of first year internal medicine residents at SIU Medicine in Springfield IL, USA.
Advancement in treatment of viral hepatitisprabaldas16
The topic of my presentation is "Advancement in treatment of viral hepatitis" which aim to discuss the different types of viruses causing hepatitis, pathogenesis, their prevention, novel vaccines and current as well as newer modalities of treatment of viral hepatitis.
viral markers in diagnosis monitoring and treatment of hepatitis b and c.pptxPathKind Labs
Hepatitis B Virus and Hepatitis C Virus infections are transmitted by parentral route. Early diagnosis and treatment can prevent cirrhosis of liver in HCV cases as drugs which can cure the infection are now available.
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.
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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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
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!
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Hepatitis C - Recent advances
1. CHRONIC HEPATITIS C
- CURRENT STATUS
Dr. Subhasish Deb
Burdwan Medical College
Dept. General Medicine
Dr Subhasish Deb, BMCH
2. Background on Hep C
• Before identification was called “non A non
B hepatitis”
• Linear, single strand, positive sense, RNA
virus
• Genome codes for a virus polyprotein
• Cleaved to 10 viral proteins (proteases)
Dr Subhasish Deb, BMCH
3. Background on Hep C
• 6 genotypes
• Genotype 1:
• m/c in USA
• Lowest response rates
• Longest treatment duration
• Many intragenotypic variations = Quasispicies
• HLA allele linked with self limited disease and better
response to t/t – CC haplotype of IL28B gene
• IL28B present in ch 19 codes for interferon lambda 3, a
component of innate immune antiviral defense
Dr Subhasish Deb, BMCH
5. Hep C Genome
• The 5’ end contains an untranslated region
– Internal Ribosomal Entry Site (IRES)
• Adjacent to IRES are the 3 Structural
genes:
1. Neucleocapsid core protein C
2. Envelope protein E1
3. Envelope protein E2
• E1 & E2 are hypervariable areas – evade
host immunity
Dr Subhasish Deb, BMCH
7. Epidemiology
• 170 million
Infected
• Highest in Asia
and Africa
• Egypt>15%
• Prevalance more common in the ‘baby bloomer” – birth
cohort 1945-1965
Dr Subhasish Deb, BMCH
18. Treatment
• Goal of treatment is to achieve a SVR (Sustained virologic
response)
• SVR – HCV RNA reduction to undetectable levels >= 6
months after completion of therapy
• Standard of care (SOC) – is the use of
1. Peginterferon alpha 2a or 2b and
2. Ribavirin
• Duration of t/t –
1. Genotype 1,4,5,6 = 48 weeks
2. Genotype 2,3 = 24 weeks
Dr Subhasish Deb, BMCH
19. • Chance of inducing SVR with SOC t/t in genotype 1 = 40-
50%
• Since half of these pts with genotype 1 do not achieve
SVR, so alternative treatments continue to be tested.
• Evaluation of virologic status: diagnosis of chronic Hep C
1. Anti HCV antibodies (by 3rd
generation EIA) AND
2. HCV RNA detected my PCR
• Severity by liver biopsy:
1. Grade of inflammation
2. Stage of fibrosis
Dr Subhasish Deb, BMCH
20. Pre Treatment Evaluation
1. Haematological –Hb, platelets, WBC
• Anticipating a fall
1. ANA and Thyroid function –
• Interferon exacerbates autoimmune disorders.
• m/c risk – thyroiditis
1. Psychiatric evaluation –
• 20% may develop depression on t/t
• Severe depression C/I interferon
1. HBsAg and HIV co infection –
• Regarding time of starting t/t (CD4 >200)
1. Pregnancy –
• Interferon C/I
Dr Subhasish Deb, BMCH
22. Interferon alpha
• Pegylated IFNs advantages:
• Longer half life
• Administered once a week rather than 3/week
• Sustained conc rather than peaks and troughs after each injection
• Twice as effective as standard IFN
PEG IFN alpha 2b PEG IFN alpha 2a
12 kD, linear 40kD, branched
DOSE: 1.5 micro gm /kg
(weight based)
180 ug
STORAGE: room temp refrigerated
Dr Subhasish Deb, BMCH
23. Contraindications of IFN
• Hypersensitivity
• Autoimmune hepatitis
• Decompensated liver disease (Child-Pugh >6 [class B
and C])
• Pregnant women
• Hemoglobinopathies (e.g., thalassemia major, sickle-cell
anemia)
• Creatinine clearance less than 50 mL/min
Dr Subhasish Deb, BMCH
24. Treatment: PEG IFN + Ribavirin
• Associated with t/t response
1. Favorable genotype 2,3 (opposed to 1,4)
2. Baseline HCV RNA level < 800,000 IU/L
3. Histologically mild hepatits & minimal fibrosis
4. Age < 40yr
5. Female
6. Non obese
7. Non insulin resistant
Dr Subhasish Deb, BMCH
25. Directly Acting Agents (DAA)
• 1st
generation protease inhibitors (2011-2013)
• Telaprevir and Boceprevir
• Serine protease inhibitors that target NS3-4A
• Approved for genotype 1
• Its use not been studied in other genotypes
• As resistance develops rapidly, it is used along
with PEG IFN + Ribavirin combination
• Regimens consists of periods of triple therapy
and periods of dual therapy (IFN + ribavirin)
Dr Subhasish Deb, BMCH
31. Sofosbuvir
• a nucleotide analog used in combination with
other drugs for the treatment of Hep C
• Sofosbuvir based regimens provide a higher cure
rate, fewer side effects, and a two- to four-fold
reduced duration of therapy
• allows most patients to be treated successfully
without the use of peginterferon,an injectable
drug with severe side effects
• MOA: inhibits the RNA polymerase that the
hepatitis C virus uses to replicate its RNA (NS5B)
Dr Subhasish Deb, BMCH
33. • Cost of treatment :
• $84,000 = Rs. 50.4 lacks for 24 weeks
• In September 2014, Gilead announced that it
would permit generic manufacturers to sell
sofosbuvir in 91 developing countries
• New price would be:
• About $1,800 = Rs. 1.1lacks (less than an
IVIG course for GB)
Dr Subhasish Deb, BMCH
Positive sense strand = 5’-3’. Same as mRNA so can be directly translated. Negative sense = 3’-5’. It has the complementary strand. Has to be transcribed to positive sense by rna dependant rna polymerase and then translated.