This document provides information about malaria, including:
1. Malaria is caused by Plasmodium parasites transmitted via mosquito bites and affects millions worldwide, especially in tropical regions.
2. The life cycle of the malaria parasite involves stages in both mosquitos and humans, starting when an infected mosquito bites a person and injecting sporozoites.
3. Symptoms of malaria include fever, chills, and flu-like illness, and can become severe or fatal if untreated, particularly for P. falciparum malaria. Microscopic examination of blood smears remains an important diagnostic method.
this lecture has focus on definition,history of malaria,causative agents,life cycle,mode of transmission,epidemeolog,susceptibility,incubation period ,prevention and control
this lecture has focus on definition,history of malaria,causative agents,life cycle,mode of transmission,epidemeolog,susceptibility,incubation period ,prevention and control
Malaria is a Vector-borne parasitic disease found in 91 countries worldwide. >120 Plasmodium species infect mammals, birds, and reptiles. Only five are known to infect human. Plasmodium falciparum causes majority of deaths due to high levels of parasitemia, sequestration of parasite in critical organs and causing severe anemia
Malaria is a Vector-borne parasitic disease found in 91 countries worldwide. >120 Plasmodium species infect mammals, birds, and reptiles. Only five are known to infect human. Plasmodium falciparum causes majority of deaths due to high levels of parasitemia, sequestration of parasite in critical organs and causing severe anemia
Dengue fever- clinical features,investigations, diagnosis, treatment and prev...DeepakBhosle
This presentation is for medical students and general practitioner It contains detailed account of epidemiology, causation, clinical features, investigations,diagnosis, treatment of dengue fever. contains pictures. useful latest and comprehensive information about Dengue. It also contains dengue case definitions of WHO.It also lists the complications of dengue. It enumerates the warning signs for more severe form of dengue fever. Includes risk factors for dengue shock syndrome and dengue hemorrhagic fever.It includes a list if clinical markers of dengue. Also details about the habits of the dengue vector , aedes aegypti mosquito
30 elementary, middle, and high school students came together to animate their ideas in front of a live audience in a series of short and inspiring talks. The concept of the Nspire Talks is a charity event to give kids the stage and microphone to add their voice to the collective conversation and inspire others. Speeches are no more than five minutes and cover a wide range of topics. All talks answered the question: "What's your vision for ...?"
This year's event benefitted the Michigan Eye Bank and raised awareness of the impact of the Organ Donor Registry.
Learning objectives
At the end of this unit, the students will be able to know about:
Epidemiological aspects of blood, and tissue sporozoan
Life cycle and pathogenesis of each blood, and tissue sporozoan
Necessary laboratory procedures for the detection and identification of blood, and tissue Sporozoa.
This presentation includes definition, epidemiology, etiology, pathophysiology (life cycle), diagnosis, clinical features of uncomplicated & severe malaria and treatment of malaria.
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
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.
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.
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
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.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
3. WWhhaatt iiss MMaallaarriiaa??
• Vector-borne infectious disease caused by
single-celled protozoan parasites of the
genus Plasmodium.
• Transmit by bite from an infective female
Anopheles mosquito.
• Widespread in tropical and subtropical
regions.
• Probably one of the oldest diseases
known to mankind that has had profound
impact on our history.
4. Alternative names:
oQuartan malaria
oFalciparum malaria
oBlackwater fever
oTertian malaria
At risk for malaria:
4400%% ooff tthhee wwoorrlldd’’ss ppooppuullaattiioonn
Female Anopheles are:
Anthropophilic : from humans
Zoophilic : from animals
Endophagic : prefer to bite indoors
Exophagic : prefer outdoor biting
5. WWhhaatt ccaauusseess MMaallaarriiaa??
• Malaria is caused by an infection by one of four single celled
Plasmodia species, they are: falciparum, vivax, malariae, and
ovale.
The most dangerous of the four is P.falciparum
• In the human body, the parasites multiply in the liver, and
then infect red blood cells.
• Transmission of Malaria do not occur <160C and >330C.
• Malaria is fourth leading cause of death
• In Pakistan majorly infectious species of plasmodium are:
P. vivax 70% P. falciparum 30%
6.
7. Species IInnffeeccttiinngg HHuummaannss
Five Species known to infect Man
Plasmodium vivax – Benign Tertian,
Tertian Malaria(Grassi and Feletti)
P.ovale - Ovale tertian Malaria(Stephens)
P.malariae – Quartan malaria (Laveran)
P.falciparum – Falciparum malaria or
Malignant Tertian malaria(Welch)
P. knowlesi (Sinton and Muller)
8. Species IInnffeeccttiinngg HHuummaannss
Plasmodium falciparum
Malignant tertian (Cerebral)
Plasmodium vivax
Tertian
Plasmodium ovale
Tertian
Plasmodium malariae
Common & Severe
Quartan Rare & Mild
9. AN AANNCCIIEENNTT DDIISSEEAASSEE ––
TThhee HHiissttoorryy OOff MMaallaarriiaa
Malaria parasites have been with us since the
dawn of time. They probably originated in
Africa (along with mankind), and fossils of
mosquitoes up to 30 million years old, show
that the malaria vector, the malaria mosquito,
was present well before the earliest history.
10. EEvveennttss oonn MMaallaarriiaa
Charles Louis
Alphose Lavern
discovered
malarial parasite
in wet mount
1880 1898 1948 1955 1970 1976
Roland Ross - Life
cycle of parasite
transmission,
wins Nobel Prize
in 1902
WHO starts world
wide malaria
eradication
programme using
DDT
Trager and Jensen
did in vitro
cultivation of
parasite
Site of
Exoerythrocytic
development in
Liver by Shortt
and Garnham
Mosquitos
develop
resistance to DDT
Programme fails
14. Period of Pre eerryytthhrrooccyyttiicc ccyyccllee
• P.vivax 8 days
• P.falciparum – 6 days
• P.malariae - 13 – 16 days,
• P.ovale 9 days
AAffffiinniittyy ooff PPaarraassiittee ttoo EErryytthhrrooccyytteess
• P.vivax Young red blood cells
• P.malariae Old red blood cells
• P.ovale Young red blood cells
• P.falciparum Infects all age groups
15. o Pregnant women have increased susceptibility to P.
falciparum malaria; in malaria-endemic countries, P.
falciparum contributes to 8-14% of low birth weight, which
in turn decreases the chance of a baby’s survival.
o Malarial parasite found mostly in warmer climates, malaria
breeds where there is an abundance of humidity and rain.
o Biologic characteristics and behavioral traits can influence
an individual's risk of developing malaria and, on a larger
scale, the intensity of transmission in a population.
o An experienced laboratory technician or pathologist can
distinguish between P. falciparum, P. vivax, P.
malariae and P. ovale based on the appearance of the
parasites and infected blood cells. Under the microscope, P.
knowlesi can resemble either P. falciparum or P. malariae.
Increasingly reference diagnostic tools like PCR
are employed to confirm malaria infection and to determine
definitively which species are involved.
16.
17. o Patient’s Performa:
Name – Mr. X
Age – 26 yrs
Gender – Male
Date of admission – 06/10/12
Date of discharge – 10/10/12
Chief complaints
Chills, intermittent fever, vomiting, back pain, fatigue, head ache
X 3days.
History of present illness
Back pain ,headache
Personal History
Non-alcoholic, Non-smoker
How we relate these sign & ssyymmppttoommss wwiitthh MMaallaarriiaa aanndd
wwhhaatt ssoorrtt ooff llaabb ddiiaaggnnoossiiss wwee ccaann ddoo,, ttoo ccoonnffiirrmm tthhee
ddiiaaggnnoossiiss ooff ppaattiieenntt??
18. Some important ffaaccttoorrss rreeggaarrddiinngg
ssyymmppttoommss……
TThhee ttiimmee ffrroomm tthhee iinniittiiaall mmaallaarriiaa iinnffeeccttiioonn uunnttiill ssyymmppttoommss
aappppeeaarr
20. Appearance of Common Symtoms..
The common first symptoms – fever, headache, chills and vomiting – usually
appear 10 to 15 days after a person is infected. If not treated promptly with
effective medicines, malaria can cause severe illness and is often fatal.
CClliinniiccaall eevveennttss
The symptoms often associated with malaria are due to bursting red blood cells
and clogged capillaries of major organs. Infection occurs when an infected
anopheles mosquito feeds on an individual releasing sporozites into the blood
stream. Mosquitos can carry more than one species and thus can infect peoples
with more than one species.
PPeerriiooddiicciittyy CClluueess
Periodicity can be clue in Diagnosis and species relation:
¤Malaria tertiana: 48h between fevers (P. vivax and ovale)
¤Malaria quartana: 72h between fevers (P. malariae)
¤Malaria tropica: Irregular high fever (P. falciparum)
28. 1. Blood Smear
• Malaria parasite
identified by examining
under the microscope a
drop of the patient's
blood, spread out blood
smear on a microscope
slide
Blood smear stained
with Giemsa’s stain
Microscopic
demonstration still the
Gold standard in
Diagnosis Blood Smear Stained
With Giensa Stain
29. Collection ooff BBlloooodd SSmmeeaarrss
4.
Slide must always be
grasped by its edges.
5.
Touch the drop of
blood to the slide
from below.
1.
The second or third
finger is usually
selected and
cleaned.
2.
Puncture at the side
of the ball of the
finger.
3.
Gently squeeze
toward the puncture
site.
30. Preparing thick aanndd tthhiinn ffiillmmss
1.
Touch one drop of
blood to a clean
slide.
2.
Spread the first
drop to make a 1
cm circle.
3.
Touch a fresh drop
of blood to the edge
of another slide.
4.
Carry the drop of blood
to the first slide and hold
at 45 degree angle.
5.
Pull the drop of blood
across the first slide in
one motion.
6.
Wait for both to
dry before fixing
and staining.
31. 2. Fluorescent Microscopy
• Modification of light microscopy
• Fluorescent dyes detect RNA and DNA that is contained in parasites
• Requires Fluorescent microscope
• Nuclei of malaria parasites fluoresce bright green and cytoplasm red.
• Staining itself is cheap
• Sensitivities around 90%
32. 3. Quantitative Buffy Coat
• Rapid and precise
method in Diagnosis
• Useful for screening
large numbers of sample
• Requires centrifuge,
special stains
33. AAnnttiiggeenn DDeetteeccttiioonn
• Immunochromatographic test (RDTs)
• Various test kits are available to detect
antigens derived from malaria parasites.
• Provide results in 2-15 minutes.
• These Rapid Diagnostic Tests (RDTs) offer a
useful alternative to microscopy in situations
where reliable microscopic diagnosis is not
available.
• RDTs Test Formats;
• Plastic Cassette
• Card
• Dipstick
• Hybrid Cassette Dipstick
35. MMoolleeccuullaarr DDiiaaggnnoossiiss
• Polymerase chain reaction (PCR)
• Molecular technique to identify
parasite genetic material
Lane S: Molecular base pair
standard (50-bp ladder). Black
arrows :size of standard bands.
Lane 1: P. vivax (size: 120 bp).
Lane 2: P. malariae (size: 144 bp).
Lane 3: P. falciparum (size: 205 bp).
Lane 4: P. ovale (size: 800 bp).
36. SSeerroollooggyy
• Serology detects antibodies against
malaria parasites
• Using either indirect
immunofluorescence (IFA) or enzyme-linked
immunosorbent assay (ELISA).
OOtthheerr LLaabboorraattoorryy FFiinnddiinnggss……..
¤Normocytic anemia of variable severity.
¤Liver function tests may be abnormal
¤Presence of protein and casts in the Urine of
children with P.malariae is suggestive of Quartan
nephrosis.
¤In severe Falciparum malaria with renal damage
may cause oliguria and appearance of casts, protein,
and red cells in the Urine
38. AANNTTIIMMAALLAARRIIAALL DDRRUUGGSS
• Antimalarial drugs are used for the treatment and prevention of
malaria infection.
• Most antimalarial drugs target the erythrocytic stage of malaria
infection, which is the phase of infection that causes symptomatic
illness.
• Treatment of the acute blood stage infection is necessary for
malaria caused by all malaria species.
• For infection due to Plasmodium ovale or P. vivax, terminal
prophylaxis is required with a drug active against hypnozoites
(which can remain dormant in the liver for months -- and
occasionally years -- after the initial infection.
40. QQUUIINNOOLLIINNEE DDEERRIIVVAATTIIVVEESS
• Include chloroquine, amodiaquine, quinine,
quinidine, mefloquine, primaquine,
lumefantrine and halofantrine.
• These drugs have activity against the
erythrocytic stage of infection; primaquine also
kills intrahepatic forms and gametocytes.
• The drugs act by accumulating in the parasite
food vacuole and forming a complex with heme
that prevents crystallization in the plasmodium
food vacuole.
• Heme polymerase activity is inhibited, resulting
in accumulation of cytotoxic free heme.
41. 4-aminoquinolines
• CChhlloorrooqquuiinnee:: has activity against the blood stages of
Plasmodium ovale, P. malariae, and susceptible strains of
P. vivax and P. falciparum.
• MMeecchhaanniissmm OOff AAccttiioonn :: Binds to and inhibits DNA and
RNA polymerase; interferes with metabolism and
hemoglobin utilization.
• Chloroquine concentrates within parasite acid vesicles
and raises internal pH resulting in inhibition of parasite
growth.
42. DDOOSSIINNGG:: AADDUULLTTSS
• Malaria, suppression or prophylaxis: Oral: 500 mg/week on the same day each
week; begin 1-2 weeks prior to exposure; continue for 4-6 weeks after leaving
endemic area; if suppressive therapy is not begun prior to exposure, double the
initial loading dose to 1 g and administer in 2 divided doses 6 hours apart,
followed by the usual dosage regimen.
• Malaria, acute attack: Oral: 1 g on day 1, followed by 500 mg 6 hours later,
followed by 500 mg on days 2 and 3.
• SSiiddee EEffffeeccttss
• Chloroquine is only administered orally; intravenous infusion is associated with
significant toxicity.
• Side effects of chloroquine include headaches, dizziness, abdominal discomfort,
vomiting, and diarrhea.
43. 4-methanolquinolines
• QQuuiinniinnee && QQuuiinniiddiinnee:: Quinine is a derivative from the
bark of the South American Cinchona tree and exists in
oral and parenteral forms and is the most commonly
used parenteral antimalarial drug.
• Quinidine is a stereoisomer of quinine available in
parenteral formulation and is very effective for
treatment of severe malaria.
• MMeecchhaanniissmm ooff AAccttiioonn:: Depresses oxygen uptake and
carbohydrate metabolism; intercalates into DNA,
disrupting the parasite's replication and transcription
44. • DDoossiinngg--AAdduulltt ::
Treatment of chloroquine-resistant
malaria:
648 mg every 8 hours for 7
days with tetracycline,
doxycycline, or clindamycin.
• DDoossiinngg--AAdduulltt ::
Dosage expressed in terms of
the salt: 267 mg of
quinidine gluconate = 275
mg of quinidine
polygalacturonate = 200 mg
of quinidine sulfate.
UUSSEE::
Quinidine gluconate (I.V.
formulation) and quinidine
sulfate: Treatment of
malaria (Plasmodium
46. • MMeeffllooqquuiinnee:: is an orally administered medication used in
the prevention and treatment of malaria.
• MMeecchhaanniissmm OOff AAccttiioonn :: The exact mechanism of action is
uncertain. However, it is proposed to share a similar
mechanism of action with chloroquine, which is
inhibition of heme polymerase.
• UUssee::Treatment of acute malarial infections and
prevention of malaria.
47. DDoossiinngg::
• AADDUULLTTSS:: Malaria treatment (mild-to-moderate infection): Oral: 5 tablets as a
single dose. If clinical improvement is not seen within 48-72 hours, an
alternative therapy should be used for retreatment.
• Malaria prophylaxis: Oral: 1 tablet (250 mg) weekly starting 1 week before
arrival in endemic area, continuing weekly during travel and for 4 weeks after
leaving endemic area
• PPEEDDIIAATTRRIICC:: Malaria treatment: Oral: 20-25 mg/kg in 2 divided doses, taken 6-8
hours apart (maximum: 1250 mg).
• If clinical improvement is not seen within 48-72 hours, an alternative therapy
should be used for retreatment.
• Malaria prophylaxis: Oral: 5 mg/kg/once weekly (maximum dose: 250 mg)
starting 1 week before arrival in endemic area, continuing weekly during travel
and for 4 weeks after leaving endemic area.
49. 8-aminoquinolines
• PPrriimmaaqquuiinnee:: is the only 8-aminoquinoline in clinical use.
• Largely used to prevent relapse of P. ovale and P. vivax
malaria by eliminating dormant hypnozoites, and it also
has activity against the pre-erythrocytic stage and
gametocytes of P. falciparum.
• MMeecchhaanniissmm OOff AAccttiioonn :: Eliminates the primary tissue
exoerythrocytic forms of P. falciparum; disrupts
mitochondria and binds to DNA.
50. DDoossiinngg::
ADULTS
The CDC recommends screening for G6PD deficiency prior to
initiating treatment with primaquine. (15 mg)
• It can cause hemolytic anemia in those with glucose-6-phosphate
dehydrogenase (G6PD) deficiency. Therefore, patients should
receive primaquine only if G6PD deficiency has been excluded.
53. AANNTTII--FFOOLLAATTEESS
• Antifolates include sulfonamides,
pyrimethamine, proguanil and dapsone.
• These drugs act synergistically to target
enzymes involved in folate synthesis, a pathway
required for parasite DNA synthesis.
54. SSuullffaaddooxxiinnee aanndd ppyyrriimmeetthhaammiinnee
•MMeecchhaanniissmm OOff AAccttiioonn :: Sulfadoxine interferes with
bacterial folic acid synthesis and growth via competitive
inhibition of para-aminiobenzoic acid; pyrimethamine
inhibits microbial dihydrofolate reductase, resulting in
inhibition of tetrahydrofolic acid synthesis
•UUssee:: Treatment of Plasmodium falciparum malaria in
patients in whom chloroquine resistance is suspected.
55. • DDoossee::
• AAdduullttss -- Treatment of acute malaria attacks: Oral: A single dose of
the following number of Fansidar® tablets is used in sequence with
quinine or alone: 3 tablets
• MMaallaarriiaa pprroopphhyyllaaxxiiss:: A single dose should be carried for self-treatment
in the event of febrile illness when medical attention is
not immediately available: Oral: 3 tablets
• AAddvveerrssee EEffffeeccttss::
• Mild adverse effects include gastrointestinal upset and headache.
Mild bone marrow suppression may occur, and sulfadoxine can
precipitate hemolysis in patients with G6PD deficiency.
57. AANNTTII--MMIICCRROOBBIIAALLSS
• Tetracycline, doxycycline, and clindamycin
target prokaryotic protein synthesis.
• In malaria parasites, these drugs appear to
target the apicoplast, an organelle derived from
prokaryotic ancestors.
• They have relatively slow antimalarial activity
because they exert their toxic effects in the
subsequent cycle of cell division.
• They are typically paired with fast-acting
antimalarials (usually quinine).
• Doxycycline has a longer half life than
tetracycline so is used more commonly.
58. • AAddvveerrssee eeffffeeccttss are common with the
tetracyclines
• Gastrointestinal discomfort and candidiasis are
the most frequent complaints.
• Doxycycline therapy also poses a risk of
esophageal ulceration.
60. AARRTTEEMMIISSIINNIINN
DDEERRIIVVAATTIIVVEESS
• The artemisinins are derived from the leaves of
the Chinese sweet wormwood plant, Artemisia
annua.
• They have been used in China for the treatment
of malaria for over 2000 years and came to
attention outside of China in the 1970s and
1980s.
61. • MMeecchhaanniissmm ooff AAccttiioonn:: Artemisinins act by binding iron,
breaking down peroxide bridges leading to the generation of free
radicals that damage parasite proteins.
• They act rapidly, killing blood stages of all Plasmodium species and
reducing the parasite biomass.
• Artemisinins have the fastest parasite clearance times of any
antimalarial.
• Artemisinins are active against gametocytes, the parasite form
that is infectious to mosquitoes.
• Intravenous artesunate is used for the treatment of severe
malaria.
62. • DDoossiinngg:: If used alone (via the parenteral, rectal or oral
route), artesunate must be administered for 5-7 days.
• Artemisinins are generally well tolerated.
• Type 1 hypersensitivity to the artemisinin compounds
has been reported.
• AAddvveerrssee EEffffeeccttss of orally-administered artemisinins
demonstrated transient neurological
abnormalities( nystagmus and disturbances in balance)
64. WWhhaatt iiss DDeenngguuee FFeevveerr??
a debilitating viral disease of the tropics,
transmitted by mosquitoes, and causing
sudden fever and acute pains in the joints.
ALTERNATIVE NAMES
Hemorrhagic dengue
Dengue shock syndrome
Philippine hemorrhagic
Thai hemorrhagic fever
Singapore hemorrhagic fever
65. OOrriiggiinn
The origin is still debatable.
Scientist proposed it originated from Asian
Forests.
Early outbreaks recorded:
• 992 in Chinese Encyclopedia
• 1635 in French West Indies
• 1699 in Panama.
66. 11777711
• Dr. Jose Sabater
• Disease called “Break-
Bone Fever”
• Treated using small
quantities of Rum.
67. 11778800
• Dr. Benjamin Rush
• Disease called “Bilious
Remitting Fever”
68. 11880011
• People started calling it “Dengue”
• Dengue is Spanish word for “Fastidious”
• Some believe that name came from Swahili Phrase
“Ka Dinga Pepo”
(Disease caused by an evil spirit)
69. 11995533
• First Epidemic of Severe
Dengue.
• Disease spread in South
East Asia during the next
20 years.
72. Main vector
Aedes Aegypti mosquito
Having white band and
scale patterns on its legs
Having white band and
scale patterns on its legs
and thorax.
and thorax.
73.
74. DDOO YYOOUU KKNNOOWW????????
The mosquito is attracted by the body odors, carbon
dioxide and heat emitted from the animal or humans.
Aedes are day-biters, most active during dawn and dusk.
77. Diagnosis of dengue
• Travel history and symptom profile
• Detection of antibodies against the
virus
• Complete blood count
• Liver function test etc.
82. This is what yyoouu ccaann ddoo ttoo hheellpp……..
83.
84. Preventive measure for traveler
• No vaccine or drugs are available for the prevention of
dengue
• Preventive measure should be taken to avoid the bite of
the mosquito
– Well screen accommodations or air conditioning
– Use of insecticide indoors
– Apply insect repellent to skin and clothing. The most effective
are the ones with DEET
– Empty , clean or cover any standing water that can be a
mosquito-breeding site
85. Final word of advice for travellers
• The times of higher risk of being bitten by the
female mosquito is 2 to 3 hours after daybreak
and 3 to 4 hours before nightfall
• The mosquito can feed indoors as well as
outdoors