The Philippine Obstetrical and Gynecological Society (POGS) has a clinical practice guideline on Immunization for Filipino Women. Foremost is the recommendation on immunization for tetanus-diptheria, influenza and hepatitis B during pregnancy, and immunization with MMR and Varicella before discharge which has yet to be implemented. Lecturing to third year medical students, I hope that they may be encouraged to include immunzation in their clinical practice to eliminate vaccine-preventable diseases.
Papillomavirus is affected by Papillomas and mucosal epithelia in humans and animals. It is about transmission, testing, symptoms, prevention, vaccines.
Papillomavirus is affected by Papillomas and mucosal epithelia in humans and animals. It is about transmission, testing, symptoms, prevention, vaccines.
congenital cytomegalovirus infection is a major problem in children. severe morbidity also in some cases mortality can occur due to this infection. this presentation has highlighted updates on this topic in short.
Based on the current NACO guidelines for prevention of parent to child transmission of HIV in India. Also describes the medication, testing and followup of children born to HIV positive mothers.
This presentation focuses on Acute Bacterial Meningitis.
Viral and fungal cause is mentioned but focus is on bacterial meningitis in Pediatrics Patient.
Feel free to correct if there is any error.
Refer to other reference books for clarity.
Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
congenital cytomegalovirus infection is a major problem in children. severe morbidity also in some cases mortality can occur due to this infection. this presentation has highlighted updates on this topic in short.
Based on the current NACO guidelines for prevention of parent to child transmission of HIV in India. Also describes the medication, testing and followup of children born to HIV positive mothers.
This presentation focuses on Acute Bacterial Meningitis.
Viral and fungal cause is mentioned but focus is on bacterial meningitis in Pediatrics Patient.
Feel free to correct if there is any error.
Refer to other reference books for clarity.
Vaccination of pregnant women and health care workers - Slideset by Professor...WAidid
Professor Lopalco suggests the vaccines to be considered for pregnant women and the ones recommended for health care workers (Influenza, HBV, dTap, MMR-V, meningococcal).
Safety Of the Influenza vaccine In pregnancy Lifecare Centre
Dr. Sharda jain,Life care centre
Safety of Inactivated Influenza Vaccines – WHO –SAGE position paper ,
The study found no evidence of increased RR or HR for
Major birth defects,
spontaneous abortion, or
Small for gestational age infants in pregnant women vaccinated with trivalent or monovalent influenza vaccine .
Influenza in Pregnancy : Recommendations of Treatment & Prevention ,Dr. Shar...Lifecare Centre
MANAGEMENT OF INFLUENZA IN PREGNANCY
Implementation of infection control measures.
Preferably isolation room should be there, if not available then patients can be kept in well-ventilated isolation ward with beds kept one meter apart.
All those entering the room must use high efficiency masks, gowns, goggles, gloves, cap and shoe cover.
Restrict number of visitors.
Provide antiviral prophylaxis to health care personnel
Dispose waste properly by placing it in sealed impermeable bags labeled as biohazard.
The Role of Maternal Immunization in Reducing Infections in InfantsHelen Madamba
A lecture provided for the Immunization for Filipino Women committee of the Philippine Obstetrical and Gynecological Society, Inc (POGS) and the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) to encourage vaccination for pregnant women in the Philippines
COVID-19 and COVID-19 Vaccination in PregnancyHelen Madamba
As an update to the management of COVID-19 in Pregnancy based on the PIDSOG Handbook, we have the POGS Practice Bulletin on COVID19 Vaccination for Pregnant and Breastfeeding Women. Vaccines work!
A lecture orientation to first year medical students, this lecture was lifted from the PIDSOG HANDBOOK: A GUIDANCE FOR CLINICIANS ON THE OBSTETRIC MANAGEMENT OF PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19). APRIL 2020.
This is a lecture for medical students of the Cebu Institute of Medicine as an orientation on the prevalence of HIV infection in the Philippines, the basic knowledge on HIV and the program on prevention of mother to child transmission of HIV.
During the time of COVID-19 use of social media in medicine is as relevant than ever and should be maximized by healthcare professionals as a public health tool for health education and promotion to ensure the impact on healthcare is a positive one.
Use of social media for public health promotionHelen Madamba
A short talk with medical technology students of the Velez College for the seminar on "Cyber Etiquette: A Social Responsibility on Health Promotion for the Society" February 15, 2020 from 1pm to 5pm.
This was a lecture given during the CME activitiy for POGS Region 7 by the Philippine Infectious Disease Society for Obstetrics and Gynecology (PIDSOG) at Casino Espanyol in Cebu City.
As part of the 5th Philippine Healthcare Social Media Summit 2019 #HCSMPH2019 at the Waterfront Hotel in Cebu City, Track B involved choosing platforms for social media depending on one's purpose and based on the target audience.
This is one of the lectures for the POGS Research Forum in Bacolod, mostly based on the chapter on Clinical Practice Guidelines for Ethics Review from the POGS Research Handbook: The Essentials. I hope this can be a guide for residents who are preparing their research proposal for ethical review.
This is a plenary lecture given during the CVCHRD Research and Innovation Conference at CIT-U in Cebu City with the theme "Research innovations for Improved Health and Wellness"
Emerging Issues for Social Workers in dealing with PLHIVsHelen Madamba
This was a talk for ALSWDOPI 2019 at Waterfront Hotel where LGU social workers are challenged to become the government employees who are catalysts of change that the Philippine society needs to address the Philippine HIV epidemic.
These were slides I was not able to use during the lecture I gave for the weekend POGS research workshop because of a mix up in assigned topics. Nevertheless, I think OBGYN residents may find these slides useful in crafting their research proposals.
As a speech during the Public Health Forum 2018, this is a collection of inspirational post from my facebook newsfeed. Talking about how to be a clinical specialist involved in public health, the emphasis is in finding your passion, something you would be willing to do even if you were not paid for it.
This focuses on the Consensus Recommendations on the Prevention and Management of Surgical Site Infections in the Philippine Setting by Saguil, Bermudez, Antonio and Cochon, PJSS 2017.
Public Health Forum - Social Media in Medicine: Etiquettes for the Modern DoctorHelen Madamba
This lecture introduces reasons why healthcare providers should be on social media and the limits of what we should and shouldn't post on social media, remembering that people are on the other end of the public health conversation.
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
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
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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
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
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
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!
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
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
2. THIS LECTURE IS LIFTED FROM
THE PHILIPPINE OBSTETRICAL
AND GYNECOLOGICAL SOCIETY
(POGS)
CLINICAL PRACTICE GUIDELINES
ON IMMUNIZATION FOR
FILIPINO WOMEN
(NOVEMBER 2011)
@helenvmadamba
3. General Considerations for
Vaccination
• Never administer vaccines in the
buttock.
• Confirm completion of childhood (or
more recent) primary vaccine series
for measles, mumps, rubella (MMR)
and tetanus-diptheria (Td) before
initiating adult recommended
vaccine schedules.
@helenvmadamba
4. General Considerations for
Vaccination
• Maintain vaccine administration
record in patient’s chart, including
date, site and route of
administration, manufacturer and
lot number of vaccine.
@helenvmadamba
5. General Considerations for
Vaccination
• Knowing the route of vaccine
administration, needle size, and
vaccine storage and handling are
critical components of a quality,
office-based vaccine program.
@helenvmadamba
6. General Considerations for
Vaccination
• Simultaneous use of any vaccines is
not contraindicated.
• Antibiotic therapy or breastfeeding
are not contraindications to
vaccination. Likewise, the presence
of a pregnant woman or
immunosuppressed person in the
household is not a reason to withold
an indicated vaccine to a family
member.
@helenvmadamba
7. General Contraindications to
Vaccination
• Severe allergy to vaccine
components.
• Pregnancy (or if planning pregnancy
within four weeks) for live
attenuated vaccines.
• Severe immune attenuation (for live
attenuated vaccines only) –
consultation with infectious disease
specialist is advised.
@helenvmadamba
8. General Contraindications to
Vaccination
• Moderate or severe acute illness.
• If a live attenuated vaccine is given
simultaneously with another
vaccine, a four week separation
interval should be used between
vaccinations.
@helenvmadamba
10. Target Population - HPV
• The bivalent HPV vaccination and
the quadrivalent HPV vaccination
can protect women aged 15-25
years and 16-45 years respectively,
from persistent HPV infection and
≥cervical intraepithelial neoplasia
(CIN) 2+.
Level 1, Grade A
@helenvmadamba
11. Target Population - HPV
• The bivalent HPV vaccine can be
given to patients age 10-14 years
and 26-55 years while the
quadrivalent HPV vaccine can be
given to patients age 9-45.
Level 1, Grade A
@helenvmadamba
12. Target Population - HPV
• The bivalent HPV vaccination and
quadrivalent HPV vaccination can
protect women aged 15 to 25 years
and 9-45 years respectively, from
developing vulvar intraepithelial
neoplasia (VIN) and vaginal
intraepithelial neoplasia (VAIN).
Level 1, Grade A
@helenvmadamba
13. Target Population - HPV
• The quadrivalent HPV vaccination
can protect women aged 16 to 45
years from developing anogenital
warts.
Level 1, Grade A
@helenvmadamba
14. Target Population - HPV
• The bivalent HPV vaccine can protect
women aged 15-25 years from ≥CIN
2+ associated with combined
nonvaccine oncogenic HPV types
(HPV 33, 45).
Level 1, Grade A
@helenvmadamba
15. Target Population - HPV
• HPV vaccination can be given in
women with the following special
situations: abnormal Papanicolau
(Pap) smear, history of genital warts,
breastfeeding and
immunocompromised.
• Papsmear and HPV infection status is
not a prerequisite for HPV
vaccination.
GPP
@helenvmadamba
16. Dose Regimen - HPV
• The bivalent HPV vaccine is injected
intramuscularly at 0, 1, 6 months,
while the quadrivalent HPV vaccine
is injected intramuscularly at 0, 2, 6
months.
• The bivalent and quadrivalent HPV
vaccines are not interchangeable to
complete the 3 doses.
Level I, Grade A
@helenvmadamba
17. Dose Regimen - HPV
• The quadrivalent HPV vaccine can be
given concomitantly with diphtheria,
tetanus, pertussis, and poliomyelitis
vaccine in healthy adolescents 11 to
17 years of age.
Level I, Grade A
@helenvmadamba
18. Dose Regimen - HPV
• The bivalent HPV vaccine can be
given concomitantly with diphtheria-
tetanus-acellular pertussis (tdap),
inactivated polio vaccine (IPV),
hepatitis A inactivated vaccine
(HepA) and Hepatitis B inactivated
vaccine (HepB).
GPP
@helenvmadamba
19. Contraindications - HPV
• HPV vaccines cannot be given to
pregnant women.
• HPV vaccines can be given to women
with minor illnesses.
• Women who receive HPV vaccination
should be observed for syncope in the
clinic for 15 minutes.
• HPV vaccination should not be given to
patients with a history of adverse
reactions to any vaccine component.
GPP
@helenvmadamba
22. Target Population - Varicella
• Persons aged >13 years
• School-aged children, college
students, and students in other post-
secondary educational institutions
• Other healthy adults
Level I, Grade A
@helenvmadamba
23. Postpartum Vaccination -
Varicella
• Women who do not have evidence
of varicella immunity should receive
the first dose of vaccine before
discharge from the health-care
facility. The second dose should be
administered 4-8 weeks later.
• Women should be counseled to
avoid conception 1 month after each
dose of varicella vaccine.
Level I, Grade A
@helenvmadamba
24. Dose Regimen - Varicella
• Eligible recipients should receive two
0.5 mL doses of single-antigen
varicella vaccine administered
subcutaneously, 4-8 weeks apart. If
>8 weeks elapsed after the first
dose, the second dose may be
administered without restarting the
schedule.
Level I, Grade A
@helenvmadamba
25. Contraindications - Varicella
• Persons with history of anaphylactic
reaction to any component of the
vaccine, to neomycin
• Persons with malignant condition
• Family history of congenital or
hereditary immunodeficiency
Level I, Grade A
@helenvmadamba
26. Contraindications - Varicella
• Persons receiving high-dose systemic
immunosuppressive therapy
• Pregnant women
Level I, Grade A
@helenvmadamba
27. Precautions - Varicella
• Vaccination of persons who have
acute severe illness, including
untreated, active tuberculosis,
should be postponed until recovery.
• Varicella vaccines should not be
administered for the same intervals
as measles vaccine, after
administration of blood, plasma or
immunoglobulin.
Level I, Grade A
@helenvmadamba
28. Available Preparation -
Varicella
Vaccine Formulation
Varicella Virus Vaccine,
live-attenuated, freeze-
dried with separate
diluent, to be
reconstituted right
before administration
0.5 mL
@helenvmadamba
30. Target Population - MMR
• All non-pregnant women of
childbearing age must be offered
measles, mumps and rubella (MMR)
vaccination.
Level I, Grade A
@helenvmadamba
31. Target Population - MMR
• Upon completion or termination of
pregnancy, women who do not have
serologic evidence of rubella
immunity or documentation of
rubella vaccination should be
vaccinated with MMR before
discharge from the hospital or
birthing center.
Level I, Grade A
@helenvmadamba
32. Target Population - MMR
• Routine prenatal serologic testing
for rubella on all pregnant women
who lack acceptable evidence of
rubella immunity should be done.
Level I, Grade A
@helenvmadamba
33. Dose Regimen - MMR
• 0.5 mL, administered
subcutaneously, 1-2 doses
• Second dose of MMR vaccine,
administered 4 weeks after the first
dose is recommended for adults
Level I, Grade A
@helenvmadamba
34. Contraindications - MMR
• Severe allergic reaction after a
previous dose of the vaccine
• Pregnancy
• Severely immunocompromised
patients
@helenvmadamba
35. Precautions - MMR
• Women administered the MMR
vaccine should be advised not to get
pregnant during the next 4 weeks
post-vaccination
• Recent (≤11 months) receipt of
antibody-containing blood product
@helenvmadamba
36. Precautions - MMR
• History of thrombocytopenia or
thrombocytopenic purpura
• Need for tuberculin skin testing
• Moderate or severe acute illness
with or without fever
@helenvmadamba
37. Available Preparation - MMR
Vaccine Formulation
Measles, Mumps,
Rubella Virus Vaccine,
live-attenuated
0.5 mL
@helenvmadamba
39. Target Population - TDaP
• Pregnant women with no previous
tetanus immunization or unknown
tetanus immunization history
should receive three doses of Td
vaccine to be given on month apart,
starting the second trimester. The
third dose can be given postpartum
as Tdap.
Level I, Grade A
@helenvmadamba
40. TDaP
• Pregnant women whose last Td/Tdap
vaccination was more than ten years
ago should receive Td booster in the
second or third trimester of
pregnancy.
Level I, Grade A
@helenvmadamba
41. Dose Regimen of TDaP
• The primary tetanus immunization
series consists of 3 Td injections
given intramuscularly. The first two
doses are given one month apart,
and the third dose is given 6-12
months after the second dose. The
third dose may be given as Tdap.
• Tdap dose is 0.5 mL administered
IM, preferably into the deltoid
muscle.
Level I, Grade A
@helenvmadamba
42. Contraindication - TDaP
• Severe allergic reaction (e.g.
anaphylaxis) after a previous dose or
to a vaccine component.
@helenvmadamba
43. Precaution - TDaP
• History of arthus-type
hypersensitivity reactions following
a previous dose of TT-containing
vaccine – defer vaccination until at
least 10 years have lapsed since the
last TT-containing vaccine.
@helenvmadamba
44. Adverse Events - TDaP
• Pain
• Redness or swelling
• Fever
• Headache or tiredness
@helenvmadamba
47. Target Population –
Influenza Virus
• All pregnant and breastfeeding
women should receive the
inactivated flu vaccine
• Individuals belonging to the
following risk groups
– All children aged 6 months to 18 years
– All persons aged ≥ 50 years
– Other persons at risk for medical complications
from influenza
– All healthcare professionals
@helenvmadamba
48. Dosing Regimen –
Influenza Virus
• Infants, children and adolescents
aged 6 months to 18 years
• Women ≥ 19 years: given
intramuscularly, every year, as soon
as the newest/current WHO-
recommended vaccine strains
become available.
Level III, GPP
@helenvmadamba
49. Contraindications –
Influenza Virus
• Severe allergic reactions (e.g.
anaphylaxis) after a previous dose or
to a vaccine component, including
egg protein
@helenvmadamba
50. Precautions –
Influenza Virus
• Guillaine Barre Syndrome within 6
weeks of previous dose of influenza
vaccine
• Moderate or severe acute illness
with or without fever.
@helenvmadamba
51. Available Preparations –
Influenza Virus
Vaccine Formulation
Inactivated Split-
Influenza Virus
Vaccine
0.5 mL prefilled
syringe
Inactivated
Influenza Virus
Vaccine
0.25 mL and 0.5
mL prefilled
syringe
@helenvmadamba
53. Target Population -
Pneumococcal Bacteria
• High risk patient who have not
received prior immunization or
whose prior vaccination status is
unknown.
– All persons >50 years of age,
particularly those living in institutions
– Persons with certain underlying chronic
medical conditions
@helenvmadamba
54. Target Population -
Pneumococcal Bacteria
• Immunocompromised persons ≥ 2
years of age
• Any adult 19 through 49 years of age
who is a smoker and has asthma
(Grade B)
@helenvmadamba
55. Target Population -
Pneumococcal Bacteria
• Revaccination with pneumococcal
polysaccharide vaccine (PPSV) is
recommended, at least 5 years after the
first dose particularly with the ff
populations: Grade A
– 50 to 64 years old
– 65 years and older who had a prior
dose with a lapse of at least 5 years
– People age 2 to 49 years with
immunocompromised condition Grade B
@helenvmadamba
56. Target Population -
Pneumococcal Bacteria
• Pneumococcal vaccination should be
recommended to pregnant and
breastfeeding women who are at
high risk for invasive pneumococcal
disease.
@helenvmadamba
57. Target Population -
Pneumococcal Bacteria
• The vaccine should preferably be
administered during the 2nd or 3rd
trimester of pregnancy as a general
safety precaution. Women at high
risk should be offered vaccination
before becoming pregnant.
@helenvmadamba
58. Dose Regimen –
Pneumococcal Bacteria
• Candidates for vaccination should
receive single 0.5 mL dose,
intramuscular (IM) or subcutaneous
(SQ) injection.
@helenvmadamba
59. Contraindication/ Precautions
– Pneumococcal Bacteria
• Hypersensitivity to any component
of the vaccine. Epinephrine
injection (1:1000) must be available
immediately in case of anaphylaxis
• Severely compromised
cardiovascular and/or pulmonary
function (since a systemic reaction
incurs significant risks)
@helenvmadamba
61. Adverse Reactions –
Pneumococcal Bacteria
• About 30-50% or patients who
received the PPSV had mild side
effect such as local erythema.
• Serious allergic reaction with the
PPSV is uncommon.
• Among children who received the
PCV, 10-20% developed local
erythema, tenderness or swelling
and 11% had low grade fever.
@helenvmadamba
62. Available Preparation –
Pneumococcal Bacteria
Vaccine Formulation
Pneumococcal 23-
valent polysaccharide
vaccine, PPSV23
0.5 mL prefilled
syringe
@helenvmadamba
64. Target Population - Hepatitis A
• Women, 18 years old and above,
who have close contact with persons
with hepatitis A, must be vaccinated.
• Women travelling to or working in
countries with high or intermediate
prevalence of hepatitis A should be
vaccinated.
Level I, Grade A
@helenvmadamba
65. Target Population - Hepatitis A
• Women who use street drugs are
candidates for vaccination.
• Women with chronic liver disease
(including hepatitis B and C) should
receive hepatitis A vaccination.
Level I, Grade A
@helenvmadamba
66. Target Population - Hepatitis A
• Women previously treated with
clotting factor concentrates should
avail of hepatitis A vaccination.
• Women with occupational risk
including laboratory staff should be
vaccinated.
Level I, Grade A
@helenvmadamba
67. Post-exposure Prophylaxis -
Hepatitis A
• For susceptible healthy women up
to age 40 years, single-antigen
hepatitis A vaccine should be
administered as soon as possible
after exposure.
• Beyond 40 years, immune globulin
(Ig) is preferred. Vaccine can be
used if Ig cannot be obtained.
Level I, Grade A
@helenvmadamba
68. Dose Regimen - Hepatitis A
• Hepatitis A vaccine should be
administered by intramuscular route
for 2 doses, 6-12 months apart, for
lasting protection.
@helenvmadamba
69. Contraindications/Precautions
/Adverse Events - Hepatitis A
• Severe or life-threatening allergic
reaction to a previous dose of
hepatitis A vaccine is an absolute
contraindication.
• Severe or life-threatening allergic
reaction to any vaccine component
contraindicates the administration
of hepatitis A vaccine.
@helenvmadamba
70. Contraindications/Precautions
/Adverse Events - Hepatitis A
• Moderate or severe ilnnes at the
time of vaccination may defer the
scheduled administration.
• Safety of the hepatitis A vaccine for
pregnant women has not been
determined.
@helenvmadamba
71. Contraindications/Precautions
/Adverse Events - Hepatitis A
• The most commonly reported
adverse reaction following hepatitis
A vaccination is local reaction at the
site of injection.
@helenvmadamba
72. Available Preparations -
Hepatitis A
Vaccine Formulation
Inactivated hepatitis A
vaccine
1 ml/vial
Combined inactivated
hepatitis A and B
vaccine
1 mL prefilled
syringe
@helenvmadamba
74. Target Population - Hepatitis B
• Women 18 years old and above who
belong to the high risk groups:
– Healthcare and public safety and security
workers who may have exposure to blood
in the workplace
– Persons in training for allied health
professions
– Hemodialysis patients and those receiving
blood and blood products including
transplant candidates
Level I, Grade A
@helenvmadamba
75. Target Population - Hepatitis B
• Women 18 years old and above who
belong to the high risk groups:
– Patients in early course of chronic liver
diseases
– Sexually transmitted disease (STD)
clinic clients
– Multiple sexual partners or prior STD
– Inmates of correctional facilities
Level I, Grade A
@helenvmadamba
76. Target Population - Hepatitis B
• Women 18 years old and above who
belong to the high risk groups:
– Clients and staff of institutions for
development disability
– Travelers to high endemicity areas
– Overseas foreign workers
– Injection drug users
– Household contacts and sexual
partners of hepatitis B virus carriers
Level I, Grade A
@helenvmadamba
77. Target Population - Hepatitis B
• Hepatitis B vaccine may be
administered to a pregnant woman
who is otherwise eligible for it.
• All HBsAg-negative pregnant women
seeking STD treatment who have not
been previously vaccinated should
receive hepatitis B vaccination.
Level III, Grade B
@helenvmadamba
78. Dose Regimen - Hepatitis B
• Hepatitis B vaccine is administered
intramuscularly in 3 doses at 0, 1, 6-
12 months.
• The accelerated schedule should be
given in 4 doses at 0, 1, 2, 12
months.
• The rapid schedule should be given
in 4 doses at 0, 7, 21 days and 12
months.
@helenvmadamba
79. Contraindications/Precautions/
Adverse Events - Hepatitis B
• A severe allergic reaction to vaccine
component or to a prior dose of
hepatitis B vaccine is a
contraindication to further doses of
the vaccine.
• Persons with moderate or severe
acute illness should not be
vaccinated until their condition
improves.
@helenvmadamba
82. Levels of Evidence
Level Definition
I Evidence obtained from at least one properly
randomized controlled trial
II-1 Evidence obtained from well-designed controlled
trials without randomization
II-2 Evidence obtained from well-designed cohort or
case control analytic studies, preferably from more
than one center or research group
II-3 Evidence obtained from multiple time series with
or without the intervention
III Opinions of respected authorities, based on clinical
experience, descriptive studies and case reports or
reports of expert committes
@helenvmadamba
83. Grades of Recommendation
Grade Definition
A There is good evidence to support the recommendation of
the practice in immunization for Filipino women.
B There is fair evidence to support the recommendation of the
practice in immunization for Filipino women.
C There is insufficient evidence to recommend for or against
the inclusion of the practice in immunization for Filipino
women.
D There is fair evidence to support the recommendation that
the practice be excluded in immunization for Filipino women.
E There is good evidence to support the recommendation that
the practice be excluded in immunization for Filipino women.
GPP A good practice point (GPP) is a recommendation for best
practice based on the experience of the Technical Working
Group.
@helenvmadamba
84. #HealthXPH tweetchat
Healthcare Conversations on Twitter
Saturdays 9:00 p.m. to 10:00 p.m.
@helenvmadamba
https://www.facebook.com/helenvmadamba
http://helenvmadamba.blogspot.com
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