Herpes simplex and herpes zoster are caused by human herpes viruses that cause primary infection followed by lifelong latency in neuronal or lymphoid tissues. Herpes simplex virus types 1 and 2 cause herpes infections including oral and genital lesions. Varicella zoster virus causes chickenpox primary infection and shingles upon reactivation. These viruses are treated with antiviral medications such as acyclovir to reduce symptoms and transmission risk, especially in at-risk groups.
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
Three subfamilies (genome structure, tissue tropism, cytopathologic effect, site of latent infection)
Alphaherpesvirinae:
Human herpesvirus 1 Herpes simplex type 1 HSV-1
Human herpesvirus 2 Herpes simplex type 2 HSV-2
Human herpesvirus 3 Varicella-zoster virus VZV
Gammaherpesvirinae
Human herpesvirus 4 Epstein-Barr virus EBV
Human herpesvirus 8 Kaposi’s sarcoma related virus HHV-8
Betaherpesvirinae
Human herpesvirus 5 Cytomegalovirus CMV
Human herpesvirus 6 Herpes lymphotropic virus HHV-6
Human herpesvirus 7 Human herpesvirus 7 HHV-7
Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. Diphtheria causes a thick covering in the back of the throat. It can lead to difficulty breathing, heart failure, paralysis, and even death. CDC recommends vaccines for infants, children, teens and adults to prevent diphtheria. The presentation consists of basic concepts regarding the bacteria and its infection. It has explanation in detail about signs and symptoms of Diptheria
Genital herpes is a common sexually transmitted infection that affects both men and women. Characteristics of genital herpes include pain, itching and sores in your genital area. Unfortunately, you may not encounter any signs or symptoms of genital herpes.
The Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is one of eight known human herpesvirus types in the herpes family, and is one of the most common viruses in humans.
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary).
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
Three subfamilies (genome structure, tissue tropism, cytopathologic effect, site of latent infection)
Alphaherpesvirinae:
Human herpesvirus 1 Herpes simplex type 1 HSV-1
Human herpesvirus 2 Herpes simplex type 2 HSV-2
Human herpesvirus 3 Varicella-zoster virus VZV
Gammaherpesvirinae
Human herpesvirus 4 Epstein-Barr virus EBV
Human herpesvirus 8 Kaposi’s sarcoma related virus HHV-8
Betaherpesvirinae
Human herpesvirus 5 Cytomegalovirus CMV
Human herpesvirus 6 Herpes lymphotropic virus HHV-6
Human herpesvirus 7 Human herpesvirus 7 HHV-7
Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. Diphtheria causes a thick covering in the back of the throat. It can lead to difficulty breathing, heart failure, paralysis, and even death. CDC recommends vaccines for infants, children, teens and adults to prevent diphtheria. The presentation consists of basic concepts regarding the bacteria and its infection. It has explanation in detail about signs and symptoms of Diptheria
Genital herpes is a common sexually transmitted infection that affects both men and women. Characteristics of genital herpes include pain, itching and sores in your genital area. Unfortunately, you may not encounter any signs or symptoms of genital herpes.
The Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is one of eight known human herpesvirus types in the herpes family, and is one of the most common viruses in humans.
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, and tertiary).
herpes simplex virus is a double stranded DNA virus causing many symptoms all over the body. it affects globally all over the world .
neonatal hsv attacks even the baby and made them to a fatal conditions.
For more information, visit: http://theultimateherpesprotocolscam.com/
The herpes simplex is a contagious disease and it carries ability to reoccur again after ever few months. The ultimate herpes protocol works to help get rid of herpes in a natural way. The methods are based on ancient natural techniques, so they are completely safe to use.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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.
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
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.
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!
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.
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
2. *Human herpes virus includes:
1.Herpes simplex virus type 1.
2.Herpes simplex virus type 2.
3.Varicella Zoster virus
4.Epestien – Bar virus.
5.Cytomegalovirus.
6.HHV 6,7,8
3. They are DNA viruses characterized
by tendency to produce :
Primary infection----Latency ( neurons
or lymphoid tissue). ----Reactivation
(recurrence)
It replicate intranuclear ,and once
patient become infected ,infection
remain for life.
7. Type – 1 HSV1: Found mainly in
lesions of the lips ,mouth ,face and non
genital areas(70-90%) ,may also cause
genital lesions.
Type – 2 HSV2: Found mainly in the
genital lesions (70-90%) ,can also induce
oral lesions.
8. Transmission
HSV spread by direct contact, as
the virus is shed in saliva, tears and
genital secretions.
Infection results from a kiss given to a
child or adult from a person shedding the
virus.
The only way to contract HSV 2 is through
direct sexual contact with an infected
individual.[
9. Pathogenesis
[ HSV travels through tiny breaks in
the skin or mucous membranes in the
mouth or genital areas. Even
microscopic abrasions on mucous
membranes are sufficient to allow viral
entry.
10. Pathogenesis
Virus will replicate at the site of infection
inducing primary lesion ,travel by
retrograde axonal flow to the dorsal root
ganglion, and establish latency (virus exists
in a non infectious state) until reactivation
where the virus particles descend via
peripheral nerves to the skin and induces
recurrent lesions.
12. 1.The primary infection
:
-occurs in infants and children who have no
immunity.
-Asymptomatic infection
(subclinical) is the rule( 90%).
-Symptomatic primary infection (clinical)
(10%)occur after 3-7 days of exposure usually show
severe clinical picture with prodrome of fever
,malais, anorexia and painful tender
lympadenopathy, and cutaneous lesions. Resolution
of symptoms occurs within2-6 weeks.
13. Morphology of the primary lesion
Painful vesicles sometimes
umblicated on an erythematous base
,that is followed by progression to
pustules and erosion . Grouped and
scattered vesicles typically develop.
Crusting of lesions and resolution
occur within 2 to 6 weeks.
15.
• Primary Herpetic gingivostomatitis: .
Most cases occur in children between 1-5 years of
age. After an incubation period of 5 days, the
stomatitis begins with fever, malaise, restlessness
and excessive dribbling. Drinking and eating are
very painful and the breath is foul. The gums are
swollen, inflamed and bleed easily,vesicles on mm
that give white membrane covering erosions on the
tongue and oral mucosa. The regional lymph nodes
are enlarged and tender. The fever subsides after 3-5
days and recovery is usually complete in 2 weeks.
16.
17. • Keratoconjunctivitis: Primary
herpes infection of the eye causes a
severe and often purulent
conjunctivitis with superficial
ulceration of the cornea. The eyelids
are grossly oedematous and there may
be vesicles on the surrounding skin.
18. Herpetic whitlow
A herpetic whitlow is an infection of the herpes virus
around the fingernail. In children, this is often caused
by thumbsucking . It is seen in adult healthcare
workers such as dentists because of increased
exposure to the herpes virus. The use of rubber gloves
prevents herpes whitlow in healthcare workers
19.
20.
21. Kaposi varicelliform eruption
(Eczema herpeticum(
Infants or children with atopic eczema
can develop a potentially fatal HSV
infection in the area of skin that has the
eczema .Therefore, people with atopic
eczema should avoid being near
anyone with an active herpes infection.
22. Primary Genital Herpes
The Primary genital HSV infection
(genital herpes) can be severe and
prolonged, with multiple painful
blisters and ulcers in the genital area.
Fever and malaise are common, and
some people have burning during
urination, difficulty or pain during
defecation.
HSV2 more than HSV1
25. RECURRENT HERPES SIMPLEX
-Occurs in individuals who have specific
antibodies and exposed to activating factors.
- Recurrent infections differ from primary
herpes simplex in the smaller size of the
vesicles, their grouping, absence of
constitutional symptoms - usually mild and
heals within 7 days
29. Recurrent herpes libialis
Cold sore.
Develops on the lips. Starts by
tingling sensation , followed by
redness and swelling. Usually, fluid-
filled blisters form on the erythematous
base and break ,open and leaving
sores. The sores quickly form a scab.
After about a week, the scab falls off
and the episode ends..
32. Recurrent Genital Herpes
Simplex
Burning sensation in the genitalia, buttocks, and thighs
Small blisters or open sores on genitals or inner thighs; in
women, often occur inside the vagina
May be painful or not
In women, vaginal discharge
Fever, muscle aches
Headache
Painful urination
Swollen lymph glands in the groin
33. If a patient is diagnosed with genital
herpes, testes for other sexually
transmitted diseases such as
Chlamydia and gonorrhea should be
performed.
34. Patology
Epidermis
Intraepidermal supra basal vesicle produced by
Balooning degeneration
Reticular degeneration
of epidermal cells that show intarnuclear eosinophilic
inclusion bodies and multinucleated giant cells (2-15 nuclei)due to
fusion of cells
Dermis
cellular infiltration (neutrophils)
vasculities
35.
36. Prognosis
. Usually the number of outbreaks is
greatest in the first year and higher for
HSV-2 genital lesions than HSV-1 cold
sores. Each year after that, the number
of outbreaks usually goes down and
they become less severe
37. Complications
Herpetic keratitis –scarring within the cornea and
possible blindness
Secondary infection
Persistent herpes infection, with so close attacks.
Encephalitis and/or meningitis.
Lung infection.
38. Special Populations
Newborns – herpes infections contracted during delivery from
the mother can lead to meningitis, herpes infection in the
blood, skin infection, and may even be fatal
When the immune system is suppressed:
HIV
Chemotherapy for cancer
Long term use of high doses of corticosteroids
41. Diagnosis
Tzanc smear: to detect giant cells by opening
fresh vesicle and scrape its base.The most rapid
diagnosis is by detection of viral antigen by
immunofluorescence in scrapings from lesions or
the virus seen by electron microscopy in vesicle
fluid. Diagnosis by culture of the virus from vesicle
fluid requires only 1– 5 days. The detection of HSV
DNA in the cerebrospinal fluid( Lumber puncture)
42. Treatment
Antiviral therapy: . In primary
infection or troublesome recurrent
herpes simplex, antiviral therapy is
indicated. Acyclovir interferes with the
action of DNA polymerase. Acyclovir is
of proven clinical value against herpes
simplex and varicella zoster virus.
44. .The usual oral dose of
Acyclovir: is 200mg five times daily .
for 5 or more days.
Valacyclovir: 500mg three times daily
for 5 days
Famicyclivir: 125 mg three times daily
for 5 days.
45. Antiviral cream, applied every 2
hours during the attack can shorten
the healing time and duration of
symptoms of a cold sore .
46. Severe HSV infections, including
herpes encephalitis and infections in
newborns, are treated with
intravenous acyclovir. .
47. Prophilaxis: Preventing HSV infection is difficult because
people can spread the virus even when they don't have any symptoms
of an active outbreak.
Avoiding direct contact with an open lesion will lower the risk of
infection.
People with genital herpes should avoid sexual contact when they
have active lesions, the use of condoms, may lower the risk of
infection.
People with active HSV lesions should also avoid contact with
newborns, children with eczema, or people with suppressed immune
systems, because these groups are at higher risk for more severe
disease.
To decrease the risk of infecting newborns, a cesarean delivery (
C-section) is recommended for pregnant women who have an active
HSV infection at the time of delivery.
49. Aetiology
Varicella and Herpes zoster are caused by
the same virus, herpes virus varicellae
or varicella zoster virus (VZV).Varicella
is the primary infection , after which the
virus persists in nerve ganglion cells,
usually sensory.Herpes Zoster is the result
of reactivation of this residual latent virus
50. Epidemiology
Primary varicella is an endemic disease. Varicella is
one of the classic diseases of childhood, with the highest
prevalence occurring in the 4 - 10 years old age group.
Varicella is highly communicable, with an attack rate
of 90% in close contacts.
Most people become infected before adulthood but
10% of young adults remain susceptible.
Herpes zoster, in contrast, occurs sporadically and
evenly throughout the year.
51. Transimission
Varicella is transmitted by droplet
infection from the nasopharynx and dry
scales are not infectious. Patients are
infectious to others from 2 days before
to 5 days after the onset of the rash.
Sub clinical infections may occur
2..rash…..5--------------
52. Zoster patients are infectious, from virus
in the lesions and, in some instances, the
nasopharynx. Chickenpox occurs in
susceptible contacts of zoster patients.
54. Clinical features
Incubation period of 14-21 days.
: After 1-2 days of fever, development of small red papules
takes place which very rapidly become tense clear vesicles
that may turn to pustules, they are surrounded by red areolae.
In 2-4 days a dry crust forms and soon separate, to leave a
shallow pink depression which heals without scarring.these
lesions are associated with pruritis that may be tense.
The vesicles appear in 3-5 crops over 2-4 days. They are most
numerous on the trunk, then on the face, scalp and limbs. Their
distribution is centripetal. A characteristic feature is the
presence of lesions at different stages in each site. Lesions are
common inside the mouth.
55.
56.
57.
58.
59. Complication
Most common complication is secondary
bacterial infection of the vesicles.
Severe complications which may be life
threatening include viral pneumonia,
encephalititis, and haemorrhagic
chickenpox.
61. Herpes Zoster (Shingles(
Herpes Zoster mainly affect a single dermatome of the
skin.
It may occur at any age but the vast majority of
patients are more than 50 years of age.
The latent virus reactivates in a sensory ganglion and
tracks down the sensory nerve to the appropriate
segment
Herpes zoster affecting the eye and face may cause
great problems
62.
63.
64. Triggering factors
1.Old age
2.Trauma to vertb. Column as fracture spine and
disc prolapse.
3.Lymphoma and neoplasm
4.Antimitotic drugs.
5.X-ray therapy.
6.Diabetes.
7.Infection.
8.Disturbed immunity.
65. CLINICAL FEATURES
Symptoms
Pain usually precedes, associates
or follows the eruptions .It ranges from
mild burning to severe agonizing pain
.It may be accompanied by fever,
headache, malaise, and tenderness
localized to areas on one or more
dermatom.
66. Morphology of the lesion
The disease is characterized by sudden
appearance of group of vesicles on
erythematous base on linear
distribution occuring along the
course of the affected nerve or
nerves,lesions are unilateral..The early lesion
contains a clear serum but after few days
become purulent,the wall ruptures and crust
forms.
67.
68.
69.
70. The pain subsides gradually as the
eruption disappears. Recovery is
complete in 2-4 weeks . Occasionally,
the pain is not followed by the eruption
(zoster sine eruption).
71. Clinical Types
Localization
1.Herpes zoster pectoralis (50%)---Inter costal nerves.
2.Herpes zoster cranialis ----Trigeminal nerve(15%)
a. HZ frontalis ----supraorbital nerve
b. HZ Ophtalmicus---eye affected ,vesicles at the side of the
nose,conjunctiva red and inflammed,superficial or deep keratitis.
c. HZ of the maxillary division—vesicles in the uvula and
tonsilar area
d.Hz of the mandibular division---vesicles on the posterior
part of the tongue ,the floor of the mouth and the buccal mm.
72.
73.
74.
75. e. Ramsy –Hunt syndrome
----geniculate ganglion,pain in the
ear,nausea vomiting nystagmus and loss
of hearing, and vesicles on the pinna of
the ear. Facial palsy is a frequent
complication.
76. 3.HZ cervicalis (10%) -----cervical nerves.
4.HZ abdominalis ---abdominal nerves.
5.Lumbosacral variety (10%):
Sacralis-----urinary bladder symptoms
dysuria,frequency and even retention of
urine may occur.
Femoralis----femoral nerve
80. Prevention
Preventive measures should be considered
for individuals at risk of contracting severe
varicella infection e.g. leukaemic children,
neonates, and pregnant women
Where urgent protection is needed, passive
immunization should be given. Zoster
immunoglobulin (ZIG) is the preparation of
choice but it is very expensive.
A live attenuated vaccine is available .
82. Varicella Vaccine
usually is given between the ages of 12 to
15 months. The Centers for Disease
Control and Prevention (CDC) also
recommends a booster shot at 4 to 6
years old for further protection. The CDC
also recommends that people 13 years of
age and older who have never had
chickenpox or received the chickenpox
vaccine get two doses of the vaccine.
83. Antiviral therapy
Acyclovir 400 5 times daily for 7 d. Famcyclovir
250mg 3 times daily for 7 d. Valcyclovir 1000 mg 3
times daily fo 7 days. Such treatment prevents
progression of the eruption, reduces the systemic
complications of varicella and zoster, lessens zoster
pain during treatment, reduces the risk of
development of post-herpetic neuralgia and if it
develops, it decreases its duration. Ophthalmic
zoster is treated by antiviral therapy together with
ophthalmologic supervision.