The unusual occurrence in a community or region of disease, specific health related behaviour (eg. Smoking) or other health related events (eg. Traffic accidents) clearly in excess of “expected occurrence.
The unusual occurrence in a community or region of disease, specific health related behaviour (eg. Smoking) or other health related events (eg. Traffic accidents) clearly in excess of “expected occurrence.
This presentation will help to get an insight into Epidemiological methods and describes details of Descriptive epidemiology. It will be useful to medical researcher as an initial input.
To understand:
The principles of detecting and controlling an
outbreak.
What is needed for outbreak investigation
Steps in disease outbreak investigations.
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
This presentation will help to get an insight into Epidemiological methods and describes details of Descriptive epidemiology. It will be useful to medical researcher as an initial input.
To understand:
The principles of detecting and controlling an
outbreak.
What is needed for outbreak investigation
Steps in disease outbreak investigations.
Outbreak management ppt comprises the definition , history , investigations and the steps of management of outbreak. This was my seminar and UG class tpoic
steps in epidemic investigation
Prepare for field work
Confirm the existence of an outbreak
Verify the diagnosis and determine the etiology of the disease.
Define the population at risk
Develop case definition, start case finding, and collect information on the cases(after choosing study design)
Describe person, place and time (by questionnaire)
Evaluation of ecological factors
Formulate several possible hypothesis hypotheses.
Test hypotheses using analytical study
Refine hypotheses and carry out additional studies
Draw conclusions to explain the causes or determinants of outbreak based on clinical, laboratory, epidemiological & environmental evidence
Report and recommend appropriate control measures to concerned authorities at the local/national, and if appropriate at international levels
Communication of the findings
Follow up of the recommendation to assure implementation of control measures
Surveillance of healthcare-associated infections: understanding and utilizing...Evangelos Kritsotakis
Presented at the EUCIC Basic Module for Infection Prevention and Control, Groningen, May 2022.
This module is organised by the European Committee on Infection Control (EUCIC) is taught face-to-face by top experts from different academic centres in Europe, who cover all major aspects of Infection Prevention and Control in the hospital.
Investigation of an epidemic by taking ebola as an example...Grandhe Sumanth
investigation of an epidemic by taking ebola as an example....................................................................................................................................................................................................................................................................
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
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
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
2. “A sudden rise in the incidence of a disease”
The occurrence in a community or region of cases of
an illness with a frequency clearly in excess of normal
expectancy.
3. Endemic infections in hospital
Usual or expected frequency of infections in the
hospital (background rate)
Epidemic nosocomial infections in hospital
Unusual occurrence of infections clearly in excess of
expected occurrence (background rate)
Isolation of unusual (rare) organism
Isolation of organism with different anti-microbial
susceptibility, or molecular typing
4. Common source epidemics
Single source or point source
Continuous or Multiple exposure
Propagated epidemics
Person to person spread
5. Outbreak in Hospital/ Health facility
Outbreak in Community
Outbreak in community may have origin in a hospital
Outbreak in community may trigger outbreak in hospital
We take almost similar steps to investigate community
and hospital outbreaks
Infection control programme in hospital may not only
prevent outbreak in hospital, but in community also
6. Prevent additional cases in the current outbreak
Prevent future outbreaks
Learn about a new disease
Learn something new about an old disease
Reassure the public
Minimize economic and social disruption
Teach epidemiology
7. Magnitude
Characterization of cases by time, person and place
Risk factors
Source of infection, mode of transmission
Control of outbreak
Prevent recurrence
Document the outbreak – lessons learnt
8. Epidemiologist
Clinician/paediatrician/ neonatologist
Microbiologist
Member of Hospital Infection Control Committee
Staff from affected unit/ward
Others depending on the need
9. Confirm the diagnosis
Confirm the existence of an outbreak
Define at-risk population and characterize the cases by
time, person and place (Case definition; case
ascertainment – identify and count cases; line list of
cases; epidemic curve)
Review of literature about outbreaks/isolates
Formulate hypothesis about genesis of outbreak
(source and route of infection)
Make further investigations to confirm/refute the
hypothesis (case control studies, culture surveys)
Control the outbreak
Prepare and disseminate the report (documentation)
10. Case definition changed
Introduction of new laboratory tests
Frequency of testing of patients changed
Introduction of a new medical or surgical
procedure
New areas or population included under the
surveillance
11. Confirm outbreak
– Confirm diagnoses
– Case definition
– Case line listing started
– Case finding
– Case interviews
– Complete line listing
– Case descriptive epidemiology
– Establish baseline occurrence of cases
– Rule out alternative explanations (chance, bias, ...)
Generate preliminary causal hypotheses
12. Standard set of criteria for deciding if a person should
be classified as suffering from the disease under
investigation.
Clinical criteria, restrictions of time, place, person
characteristics
Specific inclusion and exclusion criteria
Simple, practical, objective
Suspect, probable, confirmed
Case definition may be more sensitive initially
Case definition should be more specific when
sufficient information is available
13. Identification No.
Age
Sex
Date of admission
Cause of admission
Intervention/surgery/procedure done, device used, if any
Date of undertaking intervention/surgery/procedure
Place where intervention/surgery/procedure undertaken
Date of onset of outbreak associated clinical features
Outbreak associated clinical features
Lab investigations
Result of lab investigations
Diagnosis (Nosocomial infection)
Outcome: Still ill, recovered, died, other (specify)
Other relevant variables
Comments
15. • Who is at risk of becoming ill?
• What is the disease causing the
outbreak?
• What is the source and the vehicle?
• What is the mode of transmission?
Compare hypotheses with facts
16. Systematically review known causal factors
(Transmission mechanisms and dynamics)
Prioritize likely causes to guide control
measures (Step 3)
Generate testable hypotheses to conduct analytic study
(Step 4) if cause remains unknown or control measure
not working
19. Implement control measures
May occur at any time
during the outbreak!!
Control the source of infection
Interrupt transmission
Modify host response
Prevent recurrence
20. Control measures related to source of infection
Identify and remove the source of infection
Isolation of cases
Quarantine of healthy contacts of infectious disease
Interrupt transmission
Protect susceptible host
Immunization
Chemoprophylaxis
Non specific measures
Surveillance programme for detection/control of
infections
Risk communication (IEC)
Research
21. Prepare study protocol
1. Primary question(s)
2. Significance
3. Design
4. Subjects
5. Variables
6. Statistical issues
● Conduct study
● Analyze data
● Interpret findings
24. Detect outbreaks
Detect public health threats
Detect infectious cases (case finding)
Monitor trends in a target population
Monitor exposed individuals for symptoms
Monitor treated individuals for complications
Direct public health interventions
Evaluate public health interventions
Generate hypotheses for further evaluation
25. Communicate preliminary assessments and
recommendations (letter, memo)
Prepare interim/final reports
Prepare manuscript (optional)
Risk communication strategy (what to say)
Media communication strategy (how to say it)
26. Every outbreak in the
hospitals is an opportunity to
improve infection control
programme. Lessons learnt
should be used to prevent
future outbreaks
27. Assign a spokesperson who has the authority,
is knowledgeable and respected by community,
health professionals and media
Give clear, accurate and timely information. Avoid
technical terms, if possible. Update information
regularly.
Forward 3 positive points against one negative
point.
Do not allow media to control the entire
dialogue
Be frank about your efforts and the challenges
28. Chronology of events - How was the outbreak suspected?
Methodology adopted for investigation
Outbreak investigation Team
Case definition
Case ascertainment
Lab investigations
Epidemiological observations
Characterization of cases/deaths by time, person and place
Results of laboratory investigations
Analysis and interpretation of data collected and compiled
Further investigations undertaken
Conclusion about source and route of infection
Interventions made/recommended
Dissemination of report including executive summary to all
stakeholders
29. Viral hepatitis B outbreaks occurred in hospitals in 1980s
and 90s
In 1997, NICD investigated 3 community outbreaks of viral
hepatitis B
Mehasana district in Gujarat
Sirsa district in Haryana
Sri Ganganagar in Rajasthan
Inadequately sterilized needles and syringes resulted in
these outbreaks
Inadequate sterilization still causes many infectious
diseases outbreaks in hospitals
Source: WHO 1998; 76:93-98; Epidemiol Infect 2000;125:367-375
30. ESI Hospital Colony, Madurai had an explosive outbreak of
chikungunya in September 2009
Chikungunya cases were admitted to the ESI Hospital
There was heavy breeding of Aedes mosquitoes in the
campus
Infection was transmitted to other cases and hospital staff
9 of 11 doctors and 34 of 37 nurses who worked in the
hospital or stayed in the campus were affected during the
outbreak
Most of other residents of the hospital colony were also
affected
Hospital transmission of dengue and chikungunya has been
observed in other cities also in the past
31. A patient admitted in a hospital probably started
the outbreak
Infection spread to other patients, visitors and
health acre workers
66 probable cases, 45 died
Many including health care workers got infection
in the hospital
No exposure of cases to animals
Human to human transmission of Nipah/ Hendra
virus was suspected
Source: IJMR 2006;123: 553-560