The National Leprosy Eradication Program in India has achieved major milestones since its inception in 1955. Through strategies like introducing multi-drug therapy in 1983 and nationwide campaigns, prevalence rates have declined from over 20 per 10,000 people in the early 1990s to less than 1 per 10,000 in 2005, allowing India to achieve the goal of eliminating leprosy at the national level. Ongoing challenges include preventing disability through early detection, reducing stigma, ensuring treatment adherence, and sustaining control efforts. International support from organizations like WHO and NGOs continues to aid India's leprosy elimination efforts through technical guidance and resource provision.
National Leprosy Eradication Programme (NLEP) as on 08/12/2018Tapeshwar Kumar
Health Policy by Government of India under Ministry of Health & Family Welfare(Ministry of Health).
Better. Clarity on Google Drive Link:
https://drive.google.com/drive/folders/1L59zjagV1U4rzkEWe4eV7fW09Y6ZDA_M?usp=sharing
https://goo.gl/jAtCfv
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National Leprosy Eradication Programme (NLEP) as on 08/12/2018Tapeshwar Kumar
Health Policy by Government of India under Ministry of Health & Family Welfare(Ministry of Health).
Better. Clarity on Google Drive Link:
https://drive.google.com/drive/folders/1L59zjagV1U4rzkEWe4eV7fW09Y6ZDA_M?usp=sharing
https://goo.gl/jAtCfv
You can remove footnote (TapeshwarAIIMS_3210/2015) by choosing the Header & Footnote option & deselecting it.
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
National Leprosy Eradication Programme
Date of creation- Feb 2019
Authors - Dr. Madhushree Acharya, Junior Resident, Community Medicine and Family Medicine, AIIMS Bhubaneswar; Dr. Durgesh Prasad Sahoo, Senior Resident, Community Medicine and Family Medicine, AIIMS Bhubaneswar
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
National Leprosy Eradication Programme
Date of creation- Feb 2019
Authors - Dr. Madhushree Acharya, Junior Resident, Community Medicine and Family Medicine, AIIMS Bhubaneswar; Dr. Durgesh Prasad Sahoo, Senior Resident, Community Medicine and Family Medicine, AIIMS Bhubaneswar
National Leprosy Eradication Programme (NLEP)Kavya .
Chronic infectious disease caused by Mycobacterium leprae.
It usually affects the skin and peripheral nerves
Long incubation period generally 5-7 years.
Classified as paucibacillary or multibacillary
permanent disability
Timely diagnosis and treatment of cases
After the successful NSP 2017-2025,Goi is lauching NSP 2017-2025 for elimination of TB on 24th march( World TB day ) 2017. Module is on MOHFW site but i have try to keep it brief,hope its ll be useful specially for academic and administrative purposes.
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!
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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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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.
4. • Centrally sponsored Health Scheme MoH&FW Govt. of India
• Headed by the Deputy Director of Health Services (Leprosy )
under the DGHS
• Supported as Partners by the WHO, ILEP and few NGO’s
6. Early 20 th Century
• 1941: Promine a sulfone
drug used for treatment
• 1950s: Dapsone,
pioneered by Dr. R. G.
Cohrane at Carville
• 1983: MDT introduced
by WHO
7. MILESTONES in NLEP in India
1955 Govt. of India launched National Leprosy Control
Programme
1970s Definite cure through MDT was identified
1981 WHO study group recommended use of MDT
1983 Govt. of India launched NLEP and introduced MDT
1991 WHO declaration to eliminate leprosy global
level by 2000.
1993 - 2000 – World Bank supported NLEP – I
The prevalence rate <<< 24/10,000 (1992) to 3.7/10,000 (2001)
8. 2001 - 2004 – World Bank supported NLEP – II
2005 Elimination of Leprosy at National Level (Dec.2005)
2005 NRHM covers NLEP
2006 Focused leprosy elimination plan (FLEP)
2007 Situational activity plan(SAP)
2007 Block leprosy awareness campaign (BLAC)
WHO provided MDT drugs free of cost worth Rs. 48.00 cr.
< 1/10,000
9. Special efforts for leprosy case detection
& prompt MDT
• SAPEL – Special Action Project for Elimination of Leprosy (2001-04)
• LEC – Leprosy Elimination Campaign
For early case detection
Mainly in difficult and inaccessible rural/tribal areas & slums
10. • MLEC – Modified Leprosy Elimination Campaign
• Five such nation wide campaigns
• Carried out during 1997-98 to 2003-05
• Helped in bringing out 9.9 lakh new cases under treatment in
a short span of time
11. • As a result of the hard work the country achieved the goal of
elimination of leprosy to less than 1 case per 10,000
population December, 2005
• As on 31st December 2005, Prevalence Rate recorded in the
country was 0.95/10,000 population
14. Staff attached to District Leprosy Organization
• Deputy Director of Medical Services (Leprosy)
• Medical Officer- Deputy Director (Leprosy)
• Health Educator
• Non Medical Supervisor
• Physio Technicians
• Health Inspectors
• Lab technician
15. Clinico-epidemiological factors leading to Multi Case
Family (MCF) in the surveyed village in village
Salaunikhurd in Balodabazar district of Chhattisgarh
1. Delay in detection
2. The patient related (patient hoped that it will be cured on its own)
3. Health system delay can be attributed to the lack of interest and
involvement of ASHA of the village
4. Nature of disease spectrum: De-Novo MB spectrum of cases
16.
17. Stigma
• Felt stigma (Guilt or self-blame related to the stigmatized )
• Enacted stigma (e.g. divorce, denying someone access to public
transport)
• Institutional stigma (e.g. separate clinic arrangements for
people affected by leprosy, buildings without elevators,
sidewalks without ramps)
19. Three pronged strategy for early case detection
I. Leprosy Case Detection Campaign (LCDC) specific for high
endemic districts
II. Focussed Leprosy Campaign (FLC) in hot spots of non LCDC
districts
III. Special plan for case detection in hard to reach areas
20. Other major innovations introduced were
• Sparsh Leprosy Awareness Campaign
• Post Exposure Prophylaxis (PEP) specific to LCDC districts
• Grade II disability case investigation
• Launch of Nikushth online reporting system with Patient
tracking mechanism
• ASHA based Surveillance for Leprosy Suspects (ABSULS) for
enhanced early case reporting in routine.
21. Mycobacterium Indicus Pranii (MIP)
• An exclusive vaccine for leprosy, developed in India
• The protective efficacy of MIP was
• 68.6% at the end of 1st year,
• 59% at the end of 2nd year
• 39.3% at the end of third follow up survey.
• The effect of vaccine is 7-8 years.
22. • MIP Vaccine in new PB patients and patients already taking
treatment should be 2 doses, 6 months apart.
• In new MB cases, the dosage schedule of MIP Vaccine should
be 3 doses, 0, 6 and 12 months after initiation of therapy.
• The dosage of MIP will be same in all age groups.
• Booster will be given at the time of follow up after 4-5 years.
23. SPARSH- Monthly activity schedule
Sep 2018- October 2019
• Leprosy Case Detection Campaign (LCDC): LCDC to be
conducted twice in 251 districts identified on the basis of
Grade II disability (G2D) rate >3%.
24. Focussed Leprosy Campaign (FLC)
• Routine FLC in non LCDC districts against each grade II
disability case detected within 15 days of detection
• Clearance of back log of FLCs, if any
25. Self-care kits distribution
• Identification and line listing of the PAL needing self-care kits
(assessment through review of last 5 years Patient’s cards of
Persons Affected by Leprosy (PAL) having grade I & II disability
(over Hands and Feet)
26. MCR footwear distribution
• Identification and line listing of the PAL requiring MCR footwear
• Distribution of MCR footwear through existing system and work
on Health & Wellness centre involvement for distribution of same
27. Re-constructive Surgeries
• An incentive of Rs 8000/- will be paid to all patients affected by
leprosy undergoing RCS.
• Processing of proposal for inclusion of RCS under tertiary care
provisions of Ayushman Bharat, Pradhan Mantri Jan Arogya
Yojana (PMJAY)
30. SET scheme
(Survey, education and treatment)
• Disability prevention and ulcer care
• IEC
• Referral for RCS
• Research
• Rehabilitation
31. Strategies
a) Decentralization of NLEP to States & Districts
b) Early detection and complete treatment of new leprosy cases
c) Carrying out house hold contact survey (MB, child cases)
d) Involvement of ASHAs in the detection & complete treatment
e) Intensified IEC using Local and Mass Media approaches
f) Disability Prevention & Medical Rehabilitation (DPMR)
g) Monitoring & Evaluation
– Regular - Monthly Reports
– Special Efforts - Independent Evaluation
- Leprosy Elimination Monitoring (LEM)
D
34. National sample
survey
• By national JALMA institute Agra
• Started in 2010.
• House to house survey to access burden of active leprosy
cases, leprosy persons with grade 1 & 2 disability and
magnitude of stigma and discrimination in society.
35. Involvement
of ASHAs
• Incentives provided for ASHAs for bringing out cases from their
villages
• Rs 250 for confirmed diagnosis of cases
• On completion of treatment within specified time Rs 400 for PB
& Rs 600 for MB.
36. Involvement of NGOs
• Help reduce burden of leprosy
• Serve in remote, inaccessible, uncovered, urban slums,
industrial/labour populations and other marginalised
population groups
37. Information
education
communication
• IEC help reduction of stigma & discrimination against leprosy
affected persons.
• Carried out through mass media, out door media, rural media &
advocatory meetings.
• More focus on inter personal communication.
38.
39.
40. • Intensive survey (100% slum population
covered)
• Skin camps: 5 per zone
• School survey: 1str to 8th std children
screened, 9th to 12th std - IEC
41. Disability prevention and
medical rehabilitation
• Inform patients (specially MB) about common s/s of reactions
• Ask them to come to centre (as soon as possible)
• Start treatment for reaction
• Inform them how to protect insensitive hands/ feet eyes
• Involve family members
• Patients provided with dressing materials, supportive medicines &
MCR footwear
• Correction of disability through reconstructive surgery
42. Training
• Training to Medical officers, health workers, lab technicians,
ASHAs conducted every year
• Training of state & district Leprosy officers organized at
Schieffline institute of health research & leprosy centre
Vellore, TN and RLTRI Raipur
43. Monitoring & Supervision
• By analysis of monthly progress reports
• Through field visits by supervisory officers
• Programme review meetings held at central, State & District
levels.
44. • PRIMARY INDICATOR:
- Annual New Case Detection Rate (ANCDR)
- Treatment Completion Rate (cohort analysis)
• INDICATORS FOR CASE DETECTION:
- Proportion of new cases with Gr II disability
- Proportion of child cases(<15yrs) among new cases
- Proportion of MB cases among new cases
- Proportion of Female cases among new cases
• INDICATORS FOR QUALITY OF SERVICE:
- Proportion of new cases correctly diagnosed.
- Proportion of defaulters.
- Number of relapses during a year.
- Proportion of cases with new disabilities.
Monitoring & evaluation
45. Budget and international support
• Since 2005, the program is being conducted with Govt. of
India funds with technical support from WHO & International
federation of anti leprosy association(ILEP)
46. Anti Leprosy Activities in India
• Leprosy Mission - founded in 1874 in H.P.
• Hind Kush Nivaran Sangh
• Gandhiji Memorial Leprosy Foundation, Sevagram, Wardha
• The German Leprosy Relief Association
• Damien Foundation
• The Danish Save the Child Fund
• JALMA- taken over by ICMR in 1975 (Japanese leprosy mission for Asia)
• National Leprosy Organisation- 1965
47.
48. Lessons learned from NLEP
1. Strong Political commitment
2. Special programme for important health problems offer
the advantages of attracting both resources and
community support
3. Providing community wide services, reaching the most
unreachable
4. Intensified supervision and Monitoring
49. 5. Quality control through quality of service indicators.
6. Involvement of NGO’s to support the program.
50. Drawbacks
• Social Stigma
– Even in the present time people with leprosy have to leave their
villages or socially isolated.
• Leprosy Legislation
– Certain legislation still exists that construct leprosy as highly
contagious disease.
– Eg: Hindu Marriage Act 1955
– Leprosy patients cannot contest a civic election or hold a
municipal office.
51. • Resistant to leprosy drug:
– Resistance to MDT could be a problem.
– New alternative regimen is lacking presently
• Transmission of infection:
– elimination campaign is actually a control strategy.
– It may come to the same level as it was before if control
measures are relaxed.
52. 6) Elimination criteria:
– Duration of infection, treatment duration, mortality rate
would be affecting prevalence rate
53. Challenges in “going the last mile”
– The level of international attention and political
commitment is declining
– Knowledge about diagnosis and treatment is decreasing in
many countries.
– While leprosy cases have decreased significantly from 1984
to 2004 (see figure 1), a stagnation has occurred from 2005
onwards.
56. 3 Pillars
a) Strengthen Govt ownership, Coordination and partnership
b) Stop leprosy and its complications
c) Stop discriminating and promote inclusion
57. 3 Targets
a) Zero grade 2 disability among children diagnosed with leprosy
b) The reduction of new leprosy cases with G2D to < 1 case per
million population
c) Early detection and complete treatment with MDT remains
the fundamental principle of leprosy control
58. References
• http://www.who.int/lep/en/ 09/05/2019, 14.00hrs
• http://www.who.int/mediacentre/factsheets/fs101/en/
08/05/2019, 16.30 hrs
• Text book of public health and community medicine. 1st ed. Pune
(India). Dept. of Community Medicine AFMC; 2009
• J Kishore. National Health Programs of India. 10th ed. Century
Publication. New Delhi. 2012
• Park.K. Text Book of Preventive and Social Medicine.25td ed.
Jabalpur: M/S. Banarasidas Bhonot Publishers;2013.P.60