This document provides guidelines for post-exposure prophylaxis (PEP) for HIV in India. It defines occupational and non-occupational exposure, and PEP as the comprehensive management to minimize HIV infection risk after a potential exposure. For occupational exposures, PEP includes first aid, counselling, risk assessment, testing the source if consented, and providing a 4-week course of antiretroviral drugs if risk is assessed as high, with follow-up. Body fluids posing risk include blood, semen, and vaginal secretions. The first PEP dose should be given within 2 hours of exposure. Exposed individuals receive counselling, baseline HIV testing, and a 4-week course of antiretrovirals if
Are you injured by used needle ? You may be at risk of getting blood born pathogen like HIV, Hepatitis B and Hepatitis C. Good news is that still you have chance of protect yourself from potential HIV and Hepatis B infection by using post exposure prophylaxis.
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
Are you injured by used needle ? You may be at risk of getting blood born pathogen like HIV, Hepatitis B and Hepatitis C. Good news is that still you have chance of protect yourself from potential HIV and Hepatis B infection by using post exposure prophylaxis.
a double-stranded DNA virus : human herpesvirus-3 subfamily Alphaherpersvirinae
only one serotype is known
humans are the only reservoir
VZV enters the host through the nasopharyngeal mucosa, and almost invariably produces clinical disease in susceptible individuals
Following varicella, the virus persists in sensory nerve ganglia, from where it may later be reactivated to cause herpes zoster (Shingles)
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
Rabies is a viral disease that causes acute encephalitis
(inflammation of the brain) in warm blooded animals. Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
Scrub typhus, also known as bush typhus, is a disease caused by a bacteria called ORIENTIA TSUTSUGAMUSHI.
Scrub typhus is spread to people through bites of infected chiggers (larval mites).
Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia. Anyone living in or travelling to areas where scrub typhus is found could get infected
Scrub typhus is not transmitted directly from person to person; it is only transmitted by the bites of vectors
Chiggers are abundant in locales with high relative humidity (60%–85%), low temperature (20°C–30°C), low incidence of sunlight, and a dense substrate-vegetative canopy.
Occupational risk is higher in farmers (aged 50–69 years), females.
Dengue virus rarely causes death. However, the infection can progress into a more serious condition known as severe dengue or dengue hemorrhagic fever. Symptoms of dengue hemorrhagic fever include: bleeding under the skin. frequent vomiting.
Rabies is a viral disease that causes acute encephalitis
(inflammation of the brain) in warm blooded animals. Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus
The lecture gives concise review about the main four groups of viruses causing hemorrhagic fever i.e. Flavivirues, Filoviruses, Arenaviruses and Bunyaviruses.
Needle stick injury (NSI) has a serious risk of transmission of various blood...lokendraicn
Needle stick injury (NSI) has a serious risk of transmission of various blood borne pathogens amongst healthcare personnel and more so in anaesthesiologists.
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
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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!
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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.
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.
2. INTRODUCTION
• Post exposure management protocols form an important
element of work place safety
• These guidelines describe the risks of infection, the
preventive measures and the steps to be followed after
accidental occupational exposure
• Health Care Personnel is defined as any persons, paid or
unpaid; working in healthcare settings who are potentially
exposed to infectious materials
3. INTRODUCTION
• Exposure is defined as:
A percutaneous injury
Contact with the mucous membranes of the eye or mouth
Contact with non-intact skin (when the exposed skin is chapped
skin or afflicted with dermatitis)
Contact with intact skin when the duration of contact is prolonged
with blood or other potentially infectious body fluids
4. INTRODUCTION
• Occupational exposure refers to exposure to potential
blood-borne infections (HIV, HBV and HCV) that occurs
during performance of job duties
• Non-occupational exposure refers to exposure to potential
blood-borne infections (HIV, HBV, HCV) outside of the work
place setting like unsafe sex, sexual assault
5. INTRODUCTION
• Post exposure prophylaxis (PEP) refers to the comprehensive
management instituted to minimize the risk of infection following
potential exposure to blood-borne pathogens (HIV, HBV, HCV)
• This includes first aid, counselling, risk assessment, relevant
laboratory investigations based on informed consent of the source
and exposed person, depending on the risk assessment, the
provision of short term (4 weeks) of antiretroviral drugs, with follow
up and support including maintaining confidentially
6. INTRODUCTION
• Needle Stick Injury is a broad term that includes injuries caused
by needles or other sharp objects (e.g. glass vials, surgical blades,
forceps) that accidentally puncture the skin
• Exposed Person is the person who is potentially at risk of
acquiring HIV infection due to exposure to blood or potentially
infectious body fluids in his on her occupation
• Source Person is the person who is (either identified or not
identified) the possible source of contamination through blood or
potentially infectious body fluids
7. INTRODUCTION
NACP PEP guidelines provide PEP
services for all occupational exposures
and victims of sexual assault but not
for those following unsafe sexual
behaviour or having other high-risk
exposure
8. RISK OF EXPOSURE
• BODY FLUIDS CONSIDERED AT RISK
Blood
Semen
Vaginal secretions
Cerebrospinal fluid
Synovial, pleural, peritoneal, pericardial fluid
Amniotic fluid
Other body fluids contaminated with visible blood
9. RISK OF EXPOSURE
• BODY FLUIDS CONSIDERED NOT AT RISK
Tears
Sweat
Urine & faeces
Saliva
Sputum
Vomitus
Exposure to these body fluids
are considered 'not at risk,'
unless these fluids contain
visible blood
10. RISK OF EXPOSURE
For human bites, clinical evaluation must include the
possibility that both the person bitten and the person who
inflicted the bite were exposed to blood- borne pathogens.
Transmission of HIV infection after human bites has been
rarely reported
13. WORK PRACTICES AND RISK OF
EXPOSURE
• How to protect oneself from needle stick/sharps injuries
Strict compliance to universal work precautions
Avoid the use of injections where safe and effective
alternatives are available e.g. oral, drugs
Avoid recapping needles
15. WORK PRACTICES AND RISK OF
EXPOSURE
• Plan for safe handling and disposal of needles after use
• Promptly dispose of used needles in appropriate sharps
disposal containers
16. WORK PRACTICES AND RISK OF
EXPOSURE
• Report all needle stick and sharps- related injuries promptly
to ensure that you
Receive appropriate follow-up care
Participate in training related to infection prevention
Use devices with safety features provided by the institute
Record and monitor injuries with an injury register
17. MANAGEMENT OF THE EXPOSED PERSON
A. MANAGEMENT OF EXPOSURE SITE FIRST AID
1. Skin pierced by a needle-stick or sharp instrument
19. MANAGEMENT OF THE EXPOSED PERSON
2. Splash of blood or body fluids to unbroken skin
20. MANAGEMENT OF THE EXPOSED PERSON
3. Splash of blood or body fluids - eye
21. MANAGEMENT OF THE EXPOSED PERSON
4. Splash of blood or body fluids - mouth
22. MANAGEMENT OF THE EXPOSED PERSON
B. ESTABLISH ELIGIBILITY FOR PEP
• A designated person/ trained doctor must assess the risk of
HIV and HBV transmission following an AEB
• Two main factors determine the risk of infection
1. The nature of exposure
2. The status of the source patient
24. MANAGEMENT OF THE EXPOSED PERSON
2. The source of exposure
• A baseline rapid HIV testing of the source of the exposed
should be done before starting PEP
• Informed consent should be obtained before testing of the source
25. MANAGEMENT OF THE EXPOSED PERSON
C. COUNSELLING FOR PEP
• Exposed persons should receive appropriate information
about what PEP is and the risk and benefits of PEP
• He/ she should be counselled on safe sexual practices till
both baseline and 3 months HIV test are found to be negative
• Psychological support
• Documentation on record is essential
26. MANAGEMENT OF THE EXPOSED PERSON
D. ASSESSING NEED FOR AND PRESCRIBING PEP
29. MANAGEMENT OF THE EXPOSED PERSON
The first dose of PEP should be administered
ideally within 2 hours (but certainly within the first
72 hours) of exposure and the risk evaluated as
soon as possible
In cases of sexual assault, PEP should be given
to the exposed person as a part of the overall
package of post sexual assault care
30. MANAGEMENT OF THE EXPOSED PERSON
Lopinavir (200 mg) + Ritonavir (50 mg)
2 Tab Immediately within 2 hours of accidental
exposure, either at day time or at night time
Next day two-tab BD, continue for 4 weeks
Tenofovir 300 mg + Lamivudine 300 mg
1 tab Immediately within 2 hours of accidental
exposure, either at day time or at night time
Next day one tab once OD, continue for 4 weeks
31. MANAGEMENT OF THE EXPOSED PERSON
Tenofovir 300 mg + Lamivudine 300 mg + Efavirenz 600 mg
1 Tab OD may be given for 4 weeks
32. MANAGEMENT OF THE EXPOSED PERSON
• Expert opinion may be obtained for the following
situations
a. Delay in reporting exposure (> 72 hours)
b. Unknown source : use of PEP to be decided on case-to-
case basis after considering the severity of exposure and
the epidemiologic likelihood of HIV transmission
c. Known / suspected pregnancy : do not delay PEP
33. MANAGEMENT OF THE EXPOSED PERSON
d. Breastfeeding issues in the exposed person: do not delay PEP
initiation
e. Source patient is on ART or possibly has HIV drug resistance
f. Major toxicity of PEP regimen: minor side effects may be
managed symptomatically
g. Refer/ consult if in doubt or complicated cases (e.g. major
psychological problem)
34. MANAGEMENT OF THE EXPOSED PERSON
E. LABORATORY EVALUATION
• The exposed individual should be assessed for pre-existing HIV
infection at the time of their potential exposure to HIV
• Exposed individuals who are known or discovered to be HIV
positive should not receive PEP
• They should be offered counselling and information on the
prevention of transmission and referred for clinical and laboratory
assessment for subsequent linkage to comprehensive HIV
35. MANAGEMENT OF THE EXPOSED PERSON
HIV, HBV and HCV testing of exposed staff within
6 days of an AEB is recommended
HIV RNA testing by PCR during PEP has a very poor
positive predictive value and should be strongly
discouraged
Pregnancy testing should also be available
40. PEP FOR HBV
• All health staff should be vaccinated against Hepatitis B
• The vaccination for Hepatitis B consists of 3 doses- initial (zero)
dose, 2nd at 1 month and 3rd dose at 6 months
• Sero-conversion after completing the full course is 99%
41. PEP FOR HBV
National Guidelines for Infection Prevention and Control in Healthcare Facilities