RABIES-A fatal but preventable viral disease is explained in detail (with exclusive pictures) in this PowerPoint presentation.
It also includes the "updates on prevention and control strategy" and "Zero by 2030-Rabies Elimination Strategy"
This was presented at seminar hall, Department of Community Medicine, IMS, Banaras Hindu University as a part of PG seminar.
(The video by Lancet included in this may not be played in this slideshare platform...one can access youtube for the same)
Epidemiology is the study and analysis of the patterns, causes, and effects of health, disease & production conditions in defined populations, in terms of space and temporality.
RABIES-A fatal but preventable viral disease is explained in detail (with exclusive pictures) in this PowerPoint presentation.
It also includes the "updates on prevention and control strategy" and "Zero by 2030-Rabies Elimination Strategy"
This was presented at seminar hall, Department of Community Medicine, IMS, Banaras Hindu University as a part of PG seminar.
(The video by Lancet included in this may not be played in this slideshare platform...one can access youtube for the same)
Epidemiology is the study and analysis of the patterns, causes, and effects of health, disease & production conditions in defined populations, in terms of space and temporality.
Presented by Hung Nguyen-Viet and Jakob Zinsstag at a technical workshop of the Food and Agriculture Organization of the United Nations (FAO) regional initiative on One Health, Bangkok, Thailand, 11–13 October 2017.
Epidemiological method to determine utility of a diagnostic testBhoj Raj Singh
The usefulness of diagnostic tests, that is their ability to detect a person with disease or exclude a person without disease, is usually described by terms such as sensitivity, specificity, positive predictive value and negative predictive value (NPV). Many clinicians are frequently unclear about the practical application of these terms (1). The traditional method for teaching these concepts is based on the 2 × 2 table (Table 1). A 2 × 2 table shows results after both a diagnostic test and a definitive test (gold standard) have been performed on a pre-determined population consisting of people with the disease and those without the disease. The definitions of sensitivity, specificity, positive predictive value and NPV as expressed by letters are provided in Table 1. While 2 × 2 tables allow the calculations of sensitivity, specificity and predictive values, many clinicians find it too abstract and it is difficult to apply what it tries to teach into clinical practice as patients do not present as ‘having disease’ and ‘not having disease’. The use of the 2 × 2 table to teach these concepts also frequently creates the erroneous impression that the positive and NPVs calculated from such tables could be generalized to other populations without regard being paid to different disease prevalence. New ways of teaching these concepts have therefore been suggested.
Presented by Habibur Rahman and Vijayalakshmy Kennady (ILRI) at the Strategy Workshop on Foodborne Diseases, National Academy of Agricultural Sciences, New Delhi, India, 21 November 2019
emerging and re-emerging vector borne diseasesAnil kumar
this presentation in about emerging and re-emerging vector borne diseases and their spatial spread with reference to time, surveillance, monitoring and management program and other difficulties and suggestions for program
Epidemiology and epidemiologist are the most important determinants of any disese control programme irrespective of mode of control. It may either through vaccination or just through interventions at different edges of epidemiological triangle. Even before thinking of developing a vaccine one should understand epidemiology of the Disease.
While developing the vaccine one should test it on the principles of Epidemiology.
Vaccination programmes should be formulated by trained epidemiologists.
Presented by Hung Nguyen-Viet and Jakob Zinsstag at a technical workshop of the Food and Agriculture Organization of the United Nations (FAO) regional initiative on One Health, Bangkok, Thailand, 11–13 October 2017.
Epidemiological method to determine utility of a diagnostic testBhoj Raj Singh
The usefulness of diagnostic tests, that is their ability to detect a person with disease or exclude a person without disease, is usually described by terms such as sensitivity, specificity, positive predictive value and negative predictive value (NPV). Many clinicians are frequently unclear about the practical application of these terms (1). The traditional method for teaching these concepts is based on the 2 × 2 table (Table 1). A 2 × 2 table shows results after both a diagnostic test and a definitive test (gold standard) have been performed on a pre-determined population consisting of people with the disease and those without the disease. The definitions of sensitivity, specificity, positive predictive value and NPV as expressed by letters are provided in Table 1. While 2 × 2 tables allow the calculations of sensitivity, specificity and predictive values, many clinicians find it too abstract and it is difficult to apply what it tries to teach into clinical practice as patients do not present as ‘having disease’ and ‘not having disease’. The use of the 2 × 2 table to teach these concepts also frequently creates the erroneous impression that the positive and NPVs calculated from such tables could be generalized to other populations without regard being paid to different disease prevalence. New ways of teaching these concepts have therefore been suggested.
Presented by Habibur Rahman and Vijayalakshmy Kennady (ILRI) at the Strategy Workshop on Foodborne Diseases, National Academy of Agricultural Sciences, New Delhi, India, 21 November 2019
emerging and re-emerging vector borne diseasesAnil kumar
this presentation in about emerging and re-emerging vector borne diseases and their spatial spread with reference to time, surveillance, monitoring and management program and other difficulties and suggestions for program
Epidemiology and epidemiologist are the most important determinants of any disese control programme irrespective of mode of control. It may either through vaccination or just through interventions at different edges of epidemiological triangle. Even before thinking of developing a vaccine one should understand epidemiology of the Disease.
While developing the vaccine one should test it on the principles of Epidemiology.
Vaccination programmes should be formulated by trained epidemiologists.
Peste des-ruminants-is-a-rinderpest.doc pdfGudyne Wafubwa
Peste des petits ruminant virus (PPRV) is a disease mostly affecting goats and sheep. Since its first discovery, it has caused massive economic loss to most small pastoralists in Africa and other developing countries. It is the integral role of all stakeholders to join hands so as to eradicate the disease.
This presentation shown basically clear concept of vaccination or herd immunity. Now-a-days, this topic is more important for biological students. Hope, this powerpoint presentation helps all of them.
State two factors that have contributed to the development of emergi.pdfeyevisioncare1
State two factors that have contributed to the development of emerging infectious diseases.
For either Rabies or Anthrax, provide the following information:
1.Causative agent (e.g., viral, bacterial, parasitic)
2.Symptoms (at least two)
3.Geographic distribution
4.Host factors
5.Responsible vector
6.Potential human hazards
7.A method of control
Solution
1. The causative agent of rabies is virus called Rabies virus (RV) or Lyssavirus which is a
negative stranded ribonucleic acid virus belonging to rhabdovirus family.
The causative agent of Anthrax is a bacillus bacterium called Bacillus anthracis which is a large
Gram positive rod shaped aerobic belonging to Rhabdoviridae family.
2. The symptoms of Rabies are initially similar to flu which includes fever, muscle weakness and
tingling. Other symptoms include insomnia, anxiety, excess salivation, hydrophobia, problems in
swallowing etc.
The symptoms of Anthrax are different depending upon the route of infection. The symptoms of
cutaneous anthrax are raised itchy bump like insect bite alongwith swelling in the lymph glands
and sore. The symptoms of gastrointestinal anthrax include nausea,vomiting, headache. loss of
appetite, severe bloody diarrhoea, swollen neck etc. The symptoms of pulmonary anthrax include
flu like symptoms with shortness of breath, coughing up blood, nausea etc.The symptoms of
injection anthrax include redness and swelling of the area of infection, shock,meningitis,
multiple organ failure etc.
3. Rabies is present in mammals in most parts of the world. Per year Most of the estimated 55
000 human rabies deaths occur in Africa and Asia.
Sporadic cases of Anthrax occur in animals worldwide. However there are occasional outbreaks
in Africa, central and southern Asia.
4. Like many rhabdoviruses, Rabies virus has an extremely wide host range. Many mammalian
species in the wild has been found infecting , while in the laboratory it has been found that birds
can be infected, as well as cell cultures from mammals, birds, reptiles and insects.
Anthrax is spread from infectious animal products by contact with the spores of the bacteria.
Contact is by breathing, eating, or through an area of broken skin. It does not typically spread
directly between people.
5. There are three vectors for rabies:
c. Tissue transplants (such as corneas) from infected humans.
In its infectious form, anthrax is a spore that usually populates the soil but which, in rare cases,
can become airborne and inhaled. With cutaneous anthrax, the bacteria infects the host through
direct penetration of the host skin.
It depends on the death of its host for propagation which is different from many pathogenic
organisms. Once the host is dead, its body starts decaying and the bacteria in the bloodstream are
exposed to oxygen. These bacteria turn into spores which populate the surrounding soil.. The
spores can be eaten up by herbivores or from cutaneous infection.
Anthrax does not appear to be transmissable from person to per.
Rotavirus RV is a disease that is extremely spreadable in children whose age ranges between 3'5 years. Rotavirus vaccination RVV is an effective method for combating the diarrhoea disease as rotavirus is the leading cause of diarrhoea worldwide. For fulfilling the aim of reducing the burden of RV caused in children under 5 years for diarrhoea mortality. World Health Organization WHO recommends introducing RVVs worldwide. Globally three RVVs are licensed for local use two monovalent vaccines Rotarix, and Rotavac and a pentavalent vaccine RotaTeq. Safety and efficacy of these vaccines have been proved, however, they require cold chain storage at or below 2oto 8oC before use. In this article, a detailed profile of Rotarix vaccine is being emphasized. Rotavirus Vaccines are in high demand for introduction by many low income countries, but limitations such as price, poor supply and insufficient cold chain capacity at distant delivery points, have restricted their introduction. A. A Bhosale | Dr. V. U Barge "Illustrative Review on Rotavirus Vaccines" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-1 , December 2019, URL: https://www.ijtsrd.com/papers/ijtsrd29552.pdfPaper URL: https://www.ijtsrd.com/biological-science/biotechnology/29552/illustrative-review-on-rotavirus-vaccines/a-a-bhosale
Issues in Veterinary Disease Diagnosis.pptxBhoj Raj Singh
Diagnosis of a disease or a problem is the first step towards solution/ treatment/ control/ prevention.
Diagnosis is successfully. important to determine Prevalence (True prevalence, apparent prevalence) and Incidence of the disease to estimate the disease burden so that prevention and control measures can be planned and implemented.
However, in few years with the invasion of pharmaco-politics in disease control the term got vitiated.
Epidemiological Approaches for Evaluation of diagnostic tests.pptxBhoj Raj Singh
Diagnosis of a disease or a problem is the first step towards solution/ treatment. Clinical Diagnosis or Provisional Diagnosis is the first step in diagnosis and is done after a physical examination of the patient by a clinician. Clinical diagnosis may or may not be true and to reach Final diagnosis Laboratory Investigations using gross and microscopic pathological observations and determining the disease indicators are required. The diagnostic tests may be Non-dichotomous Diagnostic Tests (when continuous values are given by the test in a range starting from sub-normal to above-normal range) and Dichotomous Diagnostic Tests (when results are given either plus or minus, disease or no-disease). To make non- Dichotomous diagnostic test a Dichotomous one you need to establish the cut-off values based on reference values or Gold Standard test readings or with the use of Receiver operator characteristic (ROC) curves, Precision-Recall Curves, Likelihood Ratios, etc., and finally establishing statistical agreement (using Kappa values, Level of Agreement, χ2 Statistics) between the true diagnosis and laboratory diagnosis. Thereafter, the Accuracy, Precision, Bias, Sensitivity, Specificity, Positive Predictive value, and Negative Predictive value, of a diagnostic test are established for use in clinical practice. Diagnostic tests are also used to determine Prevalence (True prevalence, apparent prevalence) and Incidence of the disease to estimate the disease burden so that control measures can be implemented. There are several Phases in the development and use of a diagnostic assay starting from conceptualization of the diagnostic test, development and evaluation to determine flaws in diagnostic test use and Interpretation influencers. This presentation mainly deals with the epidemiological evaluation procedures for diagnostic tests.
Types of Trials in Medicine, vaccine efficacy or effectiveness trials and rel...Bhoj Raj Singh
The importance of learning about medicines’ and vaccines’ efficacy or effectiveness trials is not only necessary to those who are developing, producing or marketing these pharmaceutical products but to the users also because: The Emergency approval of Covid-19 vaccines and many other medicines in last few years has created so much fuss to understand the reality. The lesson learnt from Covid-19 vaccine(s) by vaccine production, marketing, vaccination and finally the revenue earned by vaccine developers and producers, and political gain by politicians, is proving deleterious to the society as several vaccine(s), useless or scarcely proven safe and useful, are going to infest and some have already infested the market (the health industry). So reading this presentation may be useful to you so that you may question the authorities if any is engaged in bluffing you. The presentation talks briefly about Prevention trials, Screening trials, Treatment trials, Feasibility studies, Pilot studies, Phases in clinical trial, Multi-arm multi-stage (MAMS) trials, Global Clinical Trials, Vaccine efficacy, Vaccine safety, Emergency Use Authorization (EUA), Serious Adverse Events (SAE), SEA rules, The Vaccine Adverse Event Reporting System (VAERS), Vaccine Safety Datalink (VSD), The Advisory Committee on Immunization Practices (ACIP), Clinical Immunization Safety Assessment (CISA), CDSCO Rules Governing Clinical Trials, Schedule Y, The Ethics Committee, Empowered Committee on Animal Health, Tracking Vaccine Quality, Pre-clinical and Clinical data, Proof of Concept, Biological License Application (BLA) and Clinical hold.
Detection and Characterization of Pathotypes, Serotypes, Biotypes, Phenotypes...Bhoj Raj Singh
This presentation of my lecture, to Epidemiology students, briefs about different methods for differentiating or finding similarities among isolates of pathogens required establishing causal associations in epidemiological disease diagnosis.
Epidemiology of antigenic, genetic and biological diversity amongst pathogens...Bhoj Raj Singh
This presentation briefly describes the Antigenic, genetic and biological diversity amongst pathogens, and their origin and emergence. It also discusses with their association with different forms associated with a disease/ outbreak. The presentation also enlists diversity in strains causing some common diseases of livestock in India.
Differentiation of field isolates (wild) from vaccine strains (Marker, DIVA &...Bhoj Raj Singh
Nowadays vaccination is often reported as the cause of disease outbreaks. To ward off this misconception (vaccines are made to save the masses not to risk their lives)or to understand vaccination failures, it is necessary to understand the difference between a field strain causing the disease and a vaccine strain having attenuated virulence. This presentation talks about DIVA and DISA vaccines too.
Lumpy skin disease (LSD) Globally and in India.pptxBhoj Raj Singh
LSD has emerged as a dairy industry devastating disease in India in the last four years. First noticed in Orrisa and is now present all over India. Recurring outbreaks are now noticed in Rajasthan, Uttarakhand and other states indicating that the disease is becoming endemic in India.
Molecular determinants of pathogenicity and virulence among pathogens.pptxBhoj Raj Singh
The presentation discusses the pathogenicity and virulence of pathogens, their determinants and their interaction with the host. It talks briefly about pathogenicity, virulence, adhesions, invasions, toxins, disease, pathogenesis, pathogenicity islands (PAIs), intracellular, extracellular, bacteria, virus, fungi, prion, metazoan worms, protozoa, tuberculosis, E. coli, Salmonella, Yersinia, Mycobacterium, cytotoxins, enterotoxins, exotoxins, neurotoxins, endotoxins, in-silico, in-Vitro, in-vivo, immunohistology, haemagglutinins, spike proteins, integrins, and phagolysosomes.
Molecular epidemiology and Disease causation.pptxBhoj Raj Singh
This short presentation describes molecular epidemiology, differentiate it from genetic epidemiology, and also deals with ascertaining the cause of disease.
My research proposals, to porotect holy cow, rejected by the ICAR-IVRI in the...Bhoj Raj Singh
The presentation relates to my three research proposals, aimed at Protection of Holy cow, rejected at ICAR-ICAR-Indian Veterinary Research Institute, Izatnagar-243 122, India, in last five years
Clinical evaluation of newly advocated therapies for brucellosis in cattle and buffaloes. Duration: September 2019 to August 2021
A cross-sectional survey of Holy Cow Infectious Problems in Gaushalas (Gaushalas are protective shelters for stray cows in India). Duration: September 2022-August 2024
Explorative study on Epidemiological determinants associated with a drastic reduction in Milk Production of Dairy Animals with reference to communicable diseases. Duration: September 2022-August 2024
Animal Disease Control and Antimicrobial Resistance-A Message to Veterinary S...Bhoj Raj Singh
This presentation is for
• Introspection by all authorities before criticizing Veterinarians for an increase in AMR & to Doyens of Veterinary Science sitting mum when Vets are criticized!
• To realize that DAHD and State Animal/ Livestock Departments are:
– Fake data masters!
A realization to Doyens of Veterinary Science that they are:
– Spineless when their voice is the most needed!
– Don’t understand epidemiology to the least and make minimal attempts to improve Epidemiological understanding in veterinarians!
– The real negative thinkers!
– Suffering from an inferiority complex!
– Real killers of the holy cow!
– Interested to develop the best vet doctors but creating butchers!
– Real anti-nationals!
They talk of one health without understanding it!
– Much more!!!
Causes of Disease and Preserving Health in Different systems of Medicine.pptxBhoj Raj Singh
This presentation deals with concepts of disease causation and methods used for the alleviation of those causes to ensure health. It has briefed the causes of diseases according to Ayurvedic medicine, Unani medicine, Siddham medicine, Naturopathy, Homeopathy, Chinese medicine, Touch therapy- Reiki, Mantra therapy, and Allopathy. It also summarizes the treatments and practices in different systems of medicine. DOI: 10.13140/RG.2.2.30883.22569
AMR challenges in human from animal foods- Facts and Myths.pptxBhoj Raj Singh
This presentation talks about ÄMR: A public health threat, a “silent pandemic”.
Infections caused by Antimicrobial-drug-resistant (AMR) pathogens caused >1.27 million deaths worldwide in 2019 (low level or no surveillance) and increasing year after year which may be > million in coming decades. Covid-19 caused ~6.8 million deaths in >3 years but now the pandemic is ending but the AMR pandemic has no timeline for its ending. Many deaths are also attributed to AMR pathogens.
More antibiotic use (irrespective of the sector) = More AMR.
This presentation also talks about ways and means to mitigate the AMR pandemic. 1. Stopping the blame game. All are equally responsible for the emergence of AMR, the share of developed and educated communities is much more than poor and un-educated communities.
2. Working together: On-Line Real-Time AST Data Sharing Platform for different diagnostic and research laboratories doing AST routinely.
3. Implementing not only antibiotic veterinary and medical stewardship but antimicrobial production and distribution stewardship too.
4. Educating for Environmental health not only human, plant, and animal health.
5. AMR's solution is not in searching for alternatives to antibiotics but in establishing environmental harmony.
6. More emphasis on AMR epidemiology than on AMR microbiology and pharmacology.
7. Development of understanding that bacteria and other microbes are more essential for life on earth than the human race. Microbes can live without humans, but humans can’t without microbes.
Global-Health is of prime importance than economic growth/ greediness.
Herbal antimicrobials are considered as an important alternative to antibiotic and probable tools to mitigate emerging antimicrobial-drug-resistance (AMR). However, it is difficult to accept that microbes may not adapt to herbal antimicrobials as rapidly as to antibiotics. This is now well documented that herbal antimicrobial resistance is also common among common pathogenic microbes and genes are now known to encode herbal drug-resistance too. This lecture gives description how resistance to conventional antimicrobials impacts susceptibility of microbes for herbal antimicrobials. Lecture Scheduled on 21st February 2023, In: Antimicrobial Resistance (AMR) in Foodborne pathogens” sponsored under the ICAR-NAHEP-CAAST project by the MAFSU, Mumbai Veterinary College, at the Division of Veterinary Public Health, ICAR-IVRI from 20th February to 25th February, 2023.
Epidemiological characterisation of Burkholderia cepacia complex (Bcc) from c...Bhoj Raj Singh
The presentation is extracted from the thesis talking about
1. The presence of Bcc organisms in the clinical infections of animals.
2. Ultrasound gels as a potential source of pathogens, especially Bcc.
3. Multidrug resistance in BCCs.
4. Lack of regulatory guidelines in Indian Pharmacopeia as existing in USP.
There are hundreds of diseases of livestock and pet animals that can be printed through properly used quality vaccines. This presentation summarises different types of vaccines used by veterinarians to control/ prevent diseases. The presentation enlists the vaccine-preventable diseases of pets and livestock, and also the different vaccines used.
Major flaws in Animal Disease Control Leading to Partial Success or Failure.pptxBhoj Raj Singh
This presentation summarises major problems of Animal Disease Control Programs ongoing in India. India is a hyperendemic country for many animal diseases and zoonotic diseases. Every year billions of rupees are spent on disease control, surveillance, monitoring, and vaccination against vaccine-preventable diseases. However, due to the failure of most animal disease control programs for one or other reasons India directly losses about 20 and 25 thousand crores annually due to endemicity of FMD & brucellosis, respectively. The presentation identifies problems at different levels of different ongoing disease control programs in India. The non-availability of authentic disease data and flaws in vaccine quality control are the biggest problems.
Animal Disease Control Programs in India.pptBhoj Raj Singh
India is a hyperendemic country for many animal diseases and zoonotic diseases. Every year billions of rupees are spent on disease control, surveillance, monitoring, and vaccination against vaccine-preventable diseases. However, due to the failure of most animal disease control programs for one or other reasons India directly losses about 20 and 25 thousand crores annually due to endemicity of FMD & brucellosis, respectively. The presentation describes the pros and cons of different ongoing disease control programs going on in India.
Control and Eradication of Animal diseases.pptxBhoj Raj Singh
The presentation details different methods and terminologies used in disease management. It briefs about different types of disease control programs run at global, regional, and national levels. It also tells about the success and failure of different disease control programs. The presentation also briefed about methods of disease control.
The presentation summarises important methods and protocols of Clinical Microbiology. It may be useful to learners of Clinical microbiology at the undergraduate label. The presentation describes the procedures for collecting clinical samples, transport, and testing. It also describes the different methods of antimicrobial susceptibility testing and standards.
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
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. R0 VALUE & HERD IMMUNITY
(HERD EFFECT/ COMMUNITY IMMUNITY/
POPULATION IMMUNITY/ SOCIAL
IMMUNITY)
DR. BHOJ R SINGH, PRINCIPAL SCIENTIST (VM)
HEAD DIVISION OF EPIDEMIOLOGY
INDIAN VETERINARY RESEARCH INSTITUTE, IZATNAGAR-243122, BAREILLY, UP, INDIA.
TELEFAX +91-581-2302188
THE PROPORTION OF IMMUNE INDIVIDUALS IN A POPULATION
ABOVE WHICH A DISEASE MAY NO LONGER PERSIST IS THE
HERD IMMUNITY THRESHOLD.
2. R0 VALUES
The average number of secondary cases arising from an
average primary case in an entirely susceptible population.
The basic reproduction number (basic reproductive rate, basic
reproductive ratio R0) of a contagious disease is the number of
cases than a case of the disease generates (on an average) over
the course of its infectious period in a susceptible population.
3. FACTORS DETERMINING THE R0
R0 will vary from agent to agent depending on the
infectiousness of the agent.
R0 may also vary from population to population
depending on population density.
Course of infectiousness of the disease. Incubation
period, latent periods and period of infectiousness).
Mode of transmission and contagiousness.
4. FACTORS AFFECTING R0
It can be explained by the epidemiological triad
Host Factor: Mixed Population, different age group of
animals, difference in nutritional status, inbred
population, parasitic load and mobility of host.
Environment Factor: Seasonal Variation e.g., FMD
(autumn and spring) and Malaria (hot and humid
climate).
Agent Factor: The agent may not spread at the same
rate in all the countries. Genetic changes in the host
factors like Genetic drift and genetic shift. Evolution of
new antigenic variant strains.
5. COURSE OF SOME INFECTIOUS
DISEASES IN DAYS
Infectious disease Incubation period Latent period Infectious period
Measles 8-13 6-9 6-7
Mumps 12-26 12-18 4-8
Pertussis 6-10 21-23 7-10
Rubella 14-21 7-14 11-12
Diphtheria 2-5 14-21 2-5
Chickenpox 13-17 8-12 10-11
Hepatitis B 30-80 13-17 19-22
Poliomyelitis 7-12 1-3 14-20
Influenza 1-3 1-3 1-3
Smallpox 10-15 8-11 2-3
Scarlet fever 2-3 1-2 14-21
6. Infectious disease Host R0
Measles Humans (UK) 12-18
Pertussis (whooping cough) Humans (UK) 12-18
Chickenpox (varicella) Humans (UK) 10-12 (16-18 in India)
Rubella Humans (UK) 5-7
Smallpox Humans 3.5-7
Feline immunodeficiency virus
(FIV) Domestic Cats 1.1-1.5
Rabies Dogs (Kenya) 2.44
Phocine distemper Seals 2-3
Tuberculosis Cattle 2.6
Influenza (Pandemic) Humans 2-4
Foot-and-mouth disease Livestock farms (UK) 3.5-4.5
Mumps Humans 4-12
Poliomyelitis (polio) Humans 5
HIV/AIDS Hetro 2-5
HIV Male homosexuals UK 4
HIV Female prostitutes in Kenya 11
Malaria Humans ≈ 100
SARS Human 2-5
IBR Cattle (UK) 7
TB Cattle 2.6
R0 of Some Diseases
8. CALCULATION OF R0
R0= β/ γ
γ= 1/ average infectious period
β= Transmission rate (Number contacts by infective case in
defined time, contact rate)
If susceptible fraction of a population is >1/R0 then only
disease can progress. We can get is by vaccination, preventive
therapy or control measures.
When initial fraction of susceptible population is less than γ/β
or 1/R0 then infection can not progress and dies out, it is
called the threshold fraction.
R0 is also defined as inverse of relative removal rate (the
already got infected during the period).
1- 1/R0 is also defined as fraction of the population to be
vaccinated for getting herd immunity.
9. HOW TO REDUCE R0 VALUE?
R0 can be reduced through intervention at any point in the
transmission cycle by the following methods:
Reducing or eliminating the shedding of the agent by the
infected host. e.g., by antibiotics and segregation and
quarantine.
Reducing the duration of environmental survival of the agent.
e.g., sunlight, fumigation, aeration etc.
Reducing or eliminating vehicle contamination and fomite
transmission.
Controlling the Vector Population for biological transmission.
Reducing the exposure of susceptible host. e.g., density
reduction, provision of protective gears as masks, goggles,
aprons, gloves, gumboots etc.
Increasing the resistance of susceptible host by vaccination,
passive immunization etc.
10. IMPORTANCE OF RO
For an infectious disease with average infectious
period 1/γ and transmission rate β, Ro = β/γ:
For a closed population, an infectious disease can only
invade if there is a threshold fraction of susceptible
individuals greater than 1/Ro .
If R0 is 2.5 then 1/R0 is 0.4, i.e., for control of the
disease less than 0.4 fraction of the population be
susceptible or more than 60% be non-susceptible or
immune.
Vaccination policy: if proportion of susceptible
individuals is reduced to below 1/Ro the disease can be
eradicated.
11. LIMITATIONS
When calculated from mathematical models, particularly using
ordinary differential equations, R0 is, in fact, simply a
threshold, not the average number of secondary infections.
There are many methods used to derive such a threshold from a
mathematical model, but many of them often give an
hypothetical value sometimes far away from the the true value
of R0. This is particularly problematic if there are intermediate
vectors between hosts, such as malaria.
Methods include the survival function, rearranging the
largest value from the Jacobian matrix, the next-generation
method, calculations from the intrinsic growth rate, existence of
the endemic equilibrium, the number of susceptibles at the
endemic equilibrium, the average age of infection and the final
size equation.
Few of these methods agree with one another, even when
starting with the same system of differential equations. Even
fewer actually calculate the average number of secondary
infections. Since R0 is rarely observed in the field and is usually
calculated via a mathematical model, this severely limits its
usefulness
12. HERD IMMUNITY
The term herd immunity was first used in 1923.
It was an integral part During the Small Pox eradication in the
1960s and 1970s.
The practice of Ring Vaccination, of which herd immunity is
integral to, began as a way to immunize every person in a
"ring" around an infected individual to prevent outbreaks from
spreading.
Vaccination controversies and opposing of vaccination are
mainly due to failed herd immunity, either it was not be
established or disappeared in certain communities, allowing
preventable diseases to persist in or return to these
communities.
Topley, W. W. C.; Wilson, G. S. (May 1923). "The Spread of Bacterial Infection. The Problem of Herd-
Immunity". The Journal of Hygiene (London). 21 (3): 243–
249. PMC 2167341 . PMID 20474777. doi:10.1017/s0022172400031478.
Strassburg, M. A. (1982). "The global eradication of smallpox". American journal of infection control. 10 (2): 53–
9. PMID 7044193. doi:10.1016/0196-6553(82)90003-7.
13. DEFINITION OF HERD IMMUNITY
As per John TJ, Samuel R. European Journal of Epidemiology
2000;16, Herd Immunity can be defined as follows:
1. The resistance of a group for attack by a disease because of the
immunity of a large proportion of the members and the
consequent lessening of the likelihood of an affected individual
coming into contact with a susceptible individual.
2. The prevalence of immunity in a population above which it
becomes difficult for the organism to circulate and reach new
susceptible is called herd immunity.
3. It is well known that not everyone in a population needs to be
immunised to eliminate disease.
14. HERD IMMUNITY
The indirect protection from infection of
susceptible livestock in a herd, and the
protection of the herd as a whole, which is
brought about by the presence of immune
individuals.
The number of individuals in a population
(herd) who are (relatively) immune to
infection with an infectious agent may
depend on the proportion who have
previously been infected with the agent
and the proportion who have been
vaccinated with an efficacious vaccine.
15.
16. A measure of the level of population-immunity or herd-
immunity is the proportion who are thus immune from further
infection.
For many infections, the level of herd immunity may have an
effect on the transmission of the infection within the population
and, in particular, may affect the risk of an uninfected becoming
infected.
For such infections, increasing the level of herd immunity will
decrease the risk of an uninfected person becoming infected.
If the herd effect reduces the risk of infection among the
uninfected sufficiently then the infection may no longer be
sustainable within the population and the infection may be
eliminated.
This concept is important in disease elimination or eradication
programmes. It means, for example, that elimination can be
achieved without necessarily vaccinating the entire population.
17. TYPES OF HERD IMMUNITY
Innate (Inherent) Herd Immunity: It is
genetically determined physiological changes with respect to
antibody production or other defence mechanism in a herd. It
does not depend on the previous exposure of herd with
infection or it may arise in a herd through prolonged exposure
to an infection or natural selection.
18. Some population of domestic fowl
have innate resistance to pullorum
disease due to an inherited difference
in lymphocyte numbers immediately
after hatching.(Robert & Card,1926)
Inheritance of resistance to influenza
virus in mice is probably due to a
single dominant autosomal allele.
(Lindermann, 1964)
Cameroon et al have shown that
resistance to brucellosis in swine may
be genetically determined.
19. Acquired Herd Immunity: It is a type of herd
immunity where a sufficient number of its members have
actually been exposed naturally or artificially to infectious
agents during their lifespan.
This kind of exposure may be made very early in life.
Polio in paralytic form are rare in countries with poor hygiene
and sanitation where exposure to the virus occurs in early part
of life but in countries where the hygiene is better and exposure
is delayed till school age then paralytic manifestations are
higher.
20.
21.
22.
23.
24.
25.
26.
27. ADVANTAGES OF HERD IMMUNITY
Potential for infection elimination.
Reduced risk of infection for those refusing vaccination (“free
riders”).
Vaccination against sexually transmitted diseases (STIs)
targeted at one sex result in significant declines in sexual
disease in both sexes.
Reduced risk of infection for those for whom vaccination is
contraindicated (e.g., immune-suppressed) or who cannot be
vaccinated e.g., cancer patients, too young animals and
pregnant animals.
Prioritization of vaccination towards target groups or High
Risk groups in the community may lead to protection of the
whole community e.g. prioritization of vaccinating children
against pneumococcus and rotavirus, school-age children for
seasonal flu immunization reduces of the disease burden in
the whole community.
28. Limitations
Herd immunity generally applies only to diseases that are contagious. It
does not apply to diseases such as tetanus, botulism food borne infections
and intoxications.
Raise the average age of infection among those who are infected.
Particular problem for those infections where the severity of infection
increases with age (e.g. polio, rubella, varicella, measles, hepatitis A).
It is not a permanent attribute, depending on the duration of the immunity
conferred after vaccination the structure of herd for susceptible versus
immune rapidly changes.
Herd immunity might be associated with emergence of variants of
pathogens more dangerous than the existent due to Evolution Pressure on
the pathogen or Selection Pressure on the antigen variant.
Herd immunity may lead to antigenic variation among pathogens at much
faster rate than it would have been in the absence of herd immunity.
Leading to Serotype Replacement.
Herd immunity not work for many of the infectious diseases like Tetanus,
Botulism, and similar toxico-infections.
29. BACTERIAL DISEASES OF LIVESTOCK
Sl.
No
Name of the
Disease
Host Range Type of Vaccine
Used
Duration of
Immunity
1 Haemorrhagic
Septicemia
Cattle, Sheep & Goat,
Pig
Inactivated alum
adjuvant vaccine
6 months
2 Black Quarter Cattle, Sheep & Goat Inactivated alum
adjuvant vaccine
6 months
3 Anthrax Cattle, Sheep & Goat Sterne-avirulent spore
vaccine
1 year
4 Brucellosis Cattle, Sheep & Goat Live freeze dried
vaccine
Life Long
5 Enterotoxemia Sheep Inactivated alum
adjuvant vaccine
6 months
6 Leptospirosis Canine Killed Mixed Vaccine 1 year
30. DISEASE ELIMINATION & HERD
IMMUNITY
If the herd effect reduces the risk of infection among the
uninfected sufficiently then the infection may no longer be
sustainable within the population and the infection may be
eliminated.
The “effective reproduction number” (R) has to be reduced
below 1.
If a proportion (P) of the population are immune then R = (1- P)
R0
So, to get R down to about 1, P must be more than 1-1/ R0.
Thus if R0 = 5 then vaccine coverage will have to be in excess of
80%.
31. QUIZ
What are the factors affecting reproduction ratio (R0
) of a disease?
Give R0 values for important animal diseases.
How is associated with herd immunity?
Give herd immunity values required for prevention
of FMD, HS, BQ, Enterotoxemia, Goat Pox, Sheep
Pox, PPR, Brucellosis, Classical swine fever.
What are different types of herd immunity in
animals?
An useful link
https://www.historyofvaccines.org/content/herd-
immunity-0