Opportunistic infections are infections that occur more frequently and are more severe in people with weakened immune systems such as those with HIV/AIDS. These infections include fungal, bacterial, viral, and parasitic infections that typically do not seriously affect those with healthy immune systems. Common opportunistic infections in HIV/AIDS patients include Pneumocystis pneumonia, tuberculosis, candidiasis, toxoplasmosis, cryptococcus, and cytomegalovirus. Antiretroviral therapy has significantly reduced the rates of opportunistic infections by suppressing HIV and allowing immune recovery. HIV/AIDS remains a major global public health challenge.
The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS).
The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS).
A short class presentation I gave in college detailing some opportunistic pathogens which attempt infection in HIV along with commonly used drugs for treatment.
References available in slides.
Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur "silently" before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.
How common is chlamydia?Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2010, 1,307,893 chlamydial infections were reported to CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. Also, testing is not often done if patients are treated for their symptoms. An estimated 2.8 million infections occur annually in the U.S. Women are frequently re-infected if their sex partners are not treated.
A short class presentation I gave in college detailing some opportunistic pathogens which attempt infection in HIV along with commonly used drugs for treatment.
References available in slides.
Chlamydia is a common sexually transmitted disease (STD) caused by the bacterium, Chlamydia trachomatis, which can damage a woman's reproductive organs. Even though symptoms of chlamydia are usually mild or absent, serious complications that cause irreversible damage, including infertility, can occur "silently" before a woman ever recognizes a problem. Chlamydia also can cause discharge from the penis of an infected man.
How common is chlamydia?Chlamydia is the most frequently reported bacterial sexually transmitted disease in the United States. In 2010, 1,307,893 chlamydial infections were reported to CDC from 50 states and the District of Columbia. Under-reporting is substantial because most people with chlamydia are not aware of their infections and do not seek testing. Also, testing is not often done if patients are treated for their symptoms. An estimated 2.8 million infections occur annually in the U.S. Women are frequently re-infected if their sex partners are not treated.
AIDS stands for: Acquired Immune Deficiency Syndrome
AIDS is a medical condition. A person is diagnosed with AIDS when their immune system is too weak to fight off infections.
Since AIDS was first identified in the early 1980s, an unprecedented number of people have been affected by the global AIDS epidemic. Today, there are an estimated 33.3 million people living with HIV and AIDS worldwide.
http://www.pediatricdentists.blogspot.com
Adenoviruses, papillomaviruses, parvoviruses and polymovirusesNCRIMS, Meerut
Adenoviruses, papillomaviruses, parvoviruses and polymoviruses are Double stranded DNA Viruses except parvoviruses. Adenoviruses are non enveloped icosahedral symmetry.
For the students studying Medical Microbiology like MSC BSC MBBS DENTAL BPTH Nursing DMLT Pharmacy etc and also for those who are preparing for exams such as NEET
Tuberculosis is a chronic, wasting, communicable disease, which made a huge comeback with the HIV pandemic, making it an opportunistic infection, and and an AID-defining infection. This presentation explores the different types of tuberculosis in terms of their locations (pulmonary and extra-pulmonary) as well as in terms of their drug susceptibility. It also addresses the approach to the management of each one of these.
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
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.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Background
Patients are susceptible to
bacterial, fungal, parasitic and
viral infections
HIV, Cancer chemotherapy,
bone marrow transplantation,
immune deficiency disorder or
blood disorders .
2
2
3. Definition
• An infection by a microorganism when
the body's immune system is impaired
and unable to fight off infection, as in
AIDS, Infants, neutropenia, and
congenital
4. AIDS (Aquired Immune Deficiency
Syndrome)
AIDS (Aquired Immune Deficiency
Syndrome) is the final stage and
natural progression of HIV (Human
Immunodeficiency Virus.)
These infections usually occur
when the CD4 cells drop below 200
cells/ul, i.e. immunocompromised
state.
It is estimated that as many as 40
million people worldwide suffer
from AIDS
6. OI (CDC GUIDELINE 2011)
• Fungal • VIRUS
• Candidiasis of bronchi, • Cytomegalovirus disease
trachea, esophagus, or lungs (particularly CMV retinitis)
oral thrush, vaginitis • Herpes simplex 1,2 : chronic
• Coccidioidomycosis ulcer(s) (greater than 1
month's duration); or
• Cryptococcosis(Meningitis) bronchitis, pneumonitis, or
• Histoplasmosis esophagitis
• Pneumocystis carinii • Herpes zoster
pneumonia • Human papilloma virus
• Aspergillosis • Hepatitis B
• Penicilliosis(P. marneffi) • HHV-6 and HHV-7 Disease
• Varicella-Zoster Virus Disease
• Human Herpesvirus-8 Disease
• Molluscum contagiosum
7. OI (CDC GUIDELINE 2011)
• PARASITES • BACTERIA
• Mycobacterium avium complex
• Isosporiasis, chronic • Tuberculosis
intestinal (greater than 1 • Pneumonia -recurrent
month's duration) • Progressive multifocal
leukoencephalopathy
• Toxoplasmosis of brain • Salmonella septicemia- recurrent
• Cryptosporidiosis, chronic • Neurosyphilis Syphilis
• Bartonellosis
intestinal (greater than 1
month's duration) • OTHERS
• Leishmaniasis • Wasting syndrome due to HIV
• Invasive cervical cancer
• Chagas Disease • Kaposi's sarcoma
• Malaria • Lymphoma, multiple forms
• Encephalopathy, HIV-related
• Isosporiasis
8. Respiratory Infections
• Bacterial pneumonias (LRTI)
can be very serious &
recurrent
• As Cell Mediated Immunity
depletes, opportunistic
infections such as
Pneumocystis , severe
fungal and viral pneumonias
may occur.
10. Pneumocystis jiroveci
Most common one with Lung
infection, other organs like liver,
spleen,bonemarrow can also
infect.
Chest radiograph
Classically bilateral, diffuse
interstitial shadowing
Can be relatively normal even with
severe respiratory distress
Induced sputum and
Bronchoalveolar lavage
Can give definitive diagnosis
11. Mycobacterium tuberculosis
• 85,000 new cases of tuberculosis in
United States in 2009 (6% among
children <15 years of age)
• Number of these that were HIV
infected is uncertain
• Incidence of TB in HIV-infected
100 times higher than in
uninfected
• Extrapulmonary and miliary TB
more common
• Congenital TB has been reported
• Drug-resistant TB can be
transmitted
12. Diagnosis of Pulmonary TB
• Sputum examination
– Negative Sputum does not
exclude TB!
– Sputum negative PTB more
common in HIV+
– Only 50% sensitive
• Chest radiograph
– No “typical” TB X-ray
– TB can create almost any
abnormality, or even none
13. Diagnosis of Extrapulmonary TB
• Often very difficult
– CXR often normal and sputum if available is
negative
• If lymph nodes enlarged - aspirate
• If meningism present - lumbar puncture
• If septic arthritis or abscess - aspirate
– Always request ZN Stains on samples
14. A Patient with HIV Wasting Syndrome
This can be clinically indistinguishable
from advanced TB
16. Gastrointestinal Infections
Causes:
Direct HIV infection
Bacterial/viral/protozoal/parasitic
infection
Presentations
• Watery/loose Diarrhoea,+/-
malabsorption due to villous
atrophy
• loss of appetite, nausea &
vomiting, progressive weight loss
N.B. bloody stool indicates
shigellosis/amoebic dysentry
18. Neurological Infections
Cryptococcal Meningitis
• Most frequent systemic
fungal infection in HIV
infected persons
• Symptoms: headache,
neck stiffness, cranial
.B.
nerve palsies,+/- coma;
fever is rare
• Prognosis is poor with :Raised skin lesions resulting
from dissemination of the yeast
no treatment. in an imunocompromised patient
19. Syphilis
• Treponema pallidum
• Neurosyphilis
• Rate of congenital syphilis 50
times greater among infants
born to HIV-infected mothers
• All infants born to mothers
with reactive nontreponemal
and treponemal test should be
evaluated with a quantitative
nontreponemal test, e.g., slide
test, rapid plasma reagin (RPR)
22. Oral Hairy leukoplakia
• Common in HIV immunosuppressed
• Characterised by fine linear, warty growths
on edge of tongue.
• Can be mistaken for candidiasis
• Caused by Epstein Barr virus/?HPV
• No specific treatment; good oral hygeine
23. Oral Herpes
Causative organism:
Herpes simplex virus
Infection:
superficial painful ulcers;
Site:
mouth , around lips and
nose
Treatment:
5 days acyclovir 200mg
24. Skin Conditions
• Herpes Zoster
• Reactivation of previous
varicella (chicken pox)
• Very common
• Can occur early in HIV disease
• Multi-dermatomal, recurrent
Causes acute, severe pain
• Risk of debilitating post
herpetic neuralgia (PHN more
common in older aptient)
• Disfiguring keloid formation
• Diagnosis clinical
25. HIV and Genital Herpes
• More extensive disease
• Frequent recurrences
• Chronicity
• Associated high genital
viral load
• Important cofactor for
transmission of HIV
• Treatment of fist episode
as standard however
higher doses may be
required for longer periods
especially in chronic cases
27. Giant granulomatous leishmanial ulceration
Visceral leishmaniasis
Has become more
Prevalent
Unusual presentations
Often occur
e.g.
Leishmania species
Normally causing only
Cutaneous disease,
Can present with
Visceral Leishmaniasis
28. HIV Related Malignancies
• Kaposi’s sarcoma
• Primary CNS lymphoma
• Carcinoma of the cervix
• Other lymphomas
30. The Role of ARVs in Opportunistic
Infections
• Antiretroviral therapy(ARV)
• ARVs improve the immune status, and therefore, enhance
how the host fights disease – keeping it free from
infections that might otherwise have taken the
opportunity to occur.
• Widespread use of Highly Active Anti Retroviral Therapy
(HAART) has been associated with considerable
– Reduction in mortality
– Reduction in morbidity
– Reduction in social isolation
31. HIV/AIDS is one of the greatest
worldwide public health
challenges of the modern age,
and as future health care
workers, it is of the utmost
importance that we maintain
awareness and continuing
knowledge of this
heartbreaking and deadly
scourge.
