1) A new strain of influenza A virus (H1N1) emerged and spread rapidly globally, increasing concern as it disproportionately affected young people. Pregnant women are also at high risk.
2) The antiviral drugs oseltamivir and zanamivir are effective against the new H1N1 strain. Limited data suggests oseltamivir is unlikely to cause major birth defects, while even less is known about zanamivir's safety during pregnancy.
3) Both drugs are considered compatible with breastfeeding as levels transferred to breastmilk would be low. Continued breastfeeding is recommended even if the mother is being treated.
1. The document discusses the differences between seasonal influenza, pandemics, and various flu symptoms such as fever, headache, and cough.
2. It provides details on the 2009 H1N1 outbreak, including where the first cases occurred, how the virus spreads, and recommendations for prevention and treatment.
3. Key advice includes getting vaccinated, practicing good hygiene, seeking medical help if experiencing fever after travel, and avoiding crowds if feeling unwell.
This document provides information about COVID-19 and safety precautions. It discusses the structure of COVID-19, its symptoms, and how it spreads primarily through respiratory droplets. Safety precautions highlighted include social distancing, frequent hand washing, avoiding touching the face, and wearing a mask. The roles of community development and organizations in preventing outbreaks are also summarized.
This document provides information on Ebola virus disease. It begins by describing Ebola virus as a nonsegmented, negative-sense RNA virus of the Filoviridae family. It is divided into five species which differ in virulence for humans. The document then discusses the epidemiology and transmission of Ebola, noting it is transmitted through contact with bodily fluids of infected humans or animals. It provides details on past outbreaks and the current 2014 outbreak. Clinical features including initial flu-like symptoms, rash, gastrointestinal issues, and hemorrhaging are summarized.
The document provides guidelines for administering the Sinopharm COVID-19 vaccine in Pakistan. It outlines that the vaccine is for those 18 years and older and should be stored between 2-8 degrees Celsius. It describes the target populations in three stages and safety of the vaccine. It provides details on administration, potential adverse effects, their management and reporting. It emphasizes the importance of counseling, monitoring recipients for 30 minutes, and handling any emergencies that may arise from vaccination.
The document provides information on potential weaknesses of Covid-19 that may limit its impact and spread, as well as expert advice and tips for healthcare workers on safety. Some key points include that Covid-19 has a low mutation rate, can only spread human to human, does not directly target immune cells, and its evolution is unlikely to make it more deadly over time. Social distancing and isolation are effective strategies. Healthcare workers should focus on hand hygiene, proper mask usage, limiting patient contact, and maintaining distance from others to stay safe.
The document provides information on symptoms of swine flu, emergency warning signs, revised testing guidelines for influenza A(H1N1) that allow testing and home isolation for mild cases, and steps to lessen the spread of flu in the home such as keeping the sick person isolated, frequent hand washing, and cleaning surfaces.
The document discusses the 2009 H1N1 influenza pandemic. It provides details on the virus, symptoms, transmission, management and treatment recommendations, and control measures. As of December 2009, over 9,500 deaths had been reported worldwide from the H1N1 virus. While the overall global mortality rate was approximately 1%, continued virus transmission was observed across many regions. Vaccines and antiviral medications such as oseltamivir were the primary interventions recommended for treatment and prevention.
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases,The World Health Organization has announced that COVID-19 is a pandemic.
Seminar Prepared by :-
Mohammed Musa (M.B.Ch.B)
Azadi Teaching Hospital - Kirkuk
1. The document discusses the differences between seasonal influenza, pandemics, and various flu symptoms such as fever, headache, and cough.
2. It provides details on the 2009 H1N1 outbreak, including where the first cases occurred, how the virus spreads, and recommendations for prevention and treatment.
3. Key advice includes getting vaccinated, practicing good hygiene, seeking medical help if experiencing fever after travel, and avoiding crowds if feeling unwell.
This document provides information about COVID-19 and safety precautions. It discusses the structure of COVID-19, its symptoms, and how it spreads primarily through respiratory droplets. Safety precautions highlighted include social distancing, frequent hand washing, avoiding touching the face, and wearing a mask. The roles of community development and organizations in preventing outbreaks are also summarized.
This document provides information on Ebola virus disease. It begins by describing Ebola virus as a nonsegmented, negative-sense RNA virus of the Filoviridae family. It is divided into five species which differ in virulence for humans. The document then discusses the epidemiology and transmission of Ebola, noting it is transmitted through contact with bodily fluids of infected humans or animals. It provides details on past outbreaks and the current 2014 outbreak. Clinical features including initial flu-like symptoms, rash, gastrointestinal issues, and hemorrhaging are summarized.
The document provides guidelines for administering the Sinopharm COVID-19 vaccine in Pakistan. It outlines that the vaccine is for those 18 years and older and should be stored between 2-8 degrees Celsius. It describes the target populations in three stages and safety of the vaccine. It provides details on administration, potential adverse effects, their management and reporting. It emphasizes the importance of counseling, monitoring recipients for 30 minutes, and handling any emergencies that may arise from vaccination.
The document provides information on potential weaknesses of Covid-19 that may limit its impact and spread, as well as expert advice and tips for healthcare workers on safety. Some key points include that Covid-19 has a low mutation rate, can only spread human to human, does not directly target immune cells, and its evolution is unlikely to make it more deadly over time. Social distancing and isolation are effective strategies. Healthcare workers should focus on hand hygiene, proper mask usage, limiting patient contact, and maintaining distance from others to stay safe.
The document provides information on symptoms of swine flu, emergency warning signs, revised testing guidelines for influenza A(H1N1) that allow testing and home isolation for mild cases, and steps to lessen the spread of flu in the home such as keeping the sick person isolated, frequent hand washing, and cleaning surfaces.
The document discusses the 2009 H1N1 influenza pandemic. It provides details on the virus, symptoms, transmission, management and treatment recommendations, and control measures. As of December 2009, over 9,500 deaths had been reported worldwide from the H1N1 virus. While the overall global mortality rate was approximately 1%, continued virus transmission was observed across many regions. Vaccines and antiviral medications such as oseltamivir were the primary interventions recommended for treatment and prevention.
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases,The World Health Organization has announced that COVID-19 is a pandemic.
Seminar Prepared by :-
Mohammed Musa (M.B.Ch.B)
Azadi Teaching Hospital - Kirkuk
The presentation discusses COVID-19 vaccines. It introduces coronaviruses and how they can cause respiratory illnesses in humans and animals. It then defines COVID-19 vaccines as vaccines aimed at providing immunity against SARS-CoV-2, the virus that causes COVID-19. The main vaccines discussed are Covishield, Sputnik V, Sinopharm, Pfizer-BioNTech, Sinovac, and Moderna. Brief descriptions of each vaccine's origins and technologies are provided.
The document discusses coronaviruses and COVID-19. It notes that coronaviruses can infect humans and cause diseases like the common cold, SARS, and MERS. COVID-19 is caused by a new coronavirus called SARS-CoV-2 that was first detected in Wuhan, China in December 2019 and causes respiratory illness. Symptoms range from mild to severe pneumonia and death. While there is no vaccine yet, prevention focuses on hand washing, social distancing, and isolation of sick individuals.
Coronavirus (COVID-19) - Symptoms, Diagnosis and Prevention - Dr Rohit BhaskarDr Rohit Bhaskar, Physio
A coronavirus is a type of virus that can cause respiratory illness in humans and animals. In 2019, a new coronavirus called SARS-CoV-2 emerged in Wuhan, China, and quickly spread around the world. An infection with the new coronavirus causes a respiratory disease called COVID-19.
Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
Bhaskar Health News and Medical Education is dedicated to medical students, physiotherapists, doctors, nurses, paramedics, physician associates, dentists, pharmacists, midwives and other healthcare professionals.
We're committed to being your source for expert health guidance. Bhaskar Health and Medical Education.
Source : https://www.bhaskarhealth.com
Health Shop: https://www.bhaskarhealth.org
@drrohitbhaskar @bhaskarhealth
#DrRohitBhaskar #BhaskarHealth
#Health #Medical #News #Physiotherapy
Emphasis on wellness, education and prevention of covid 19shamil C.B
The document discusses COVID-19 and provides information on the virus, its transmission, symptoms, diagnosis, treatment and prevention. It describes coronaviruses and defines COVID-19. It covers the incidence and spread of COVID-19 globally. Key points include how the virus is transmitted, its incubation period, high-risk groups, common and severe symptoms, diagnostic tests and medical management. The presentation emphasizes the importance of prevention measures like hand washing, social distancing and mask wearing.
This document provides an overview of the 2009 H1N1 influenza pandemic from an Indian perspective. It discusses the challenges faced in recognizing and confirming cases of the disease. It also outlines treatment recommendations, including the use of antiviral drugs like Tamiflu and supportive care. Complications tend to be more severe in younger people, possibly due to a 'cytokine storm' immune response, and include pneumonia and acute respiratory distress syndrome.
The document provides information on several COVID-19 vaccines, including Pfizer, Moderna, Johnson & Johnson, Covaxin, Covishield, Sputnik V, and vaccines from China. It describes the manufacturers, countries of origin, vaccine types, dosing schedules, effectiveness and clinical trial demographics for each vaccine. Overall, the vaccines were shown to effectively prevent COVID-19 illness and reduce severe outcomes, with effectiveness rates ranging from 66.3% to 97% depending on the specific vaccine.
This document provides an overview of COVID-19, including its aetiology, epidemiology, clinical features, diagnosis, management, and prevention. It describes how COVID-19 is caused by a novel coronavirus, SARS-CoV-2, which likely originated in animals. It summarizes the symptoms of COVID-19 and outlines recommendations for preventing and treating both mild and severe cases. The document also discusses differential diagnoses and provides references for further information.
Bacterial diarrhea remains a major global health problem and common reason for patients seeking medical care. While strategies can improve diagnostic ability, such as increasing stool culture yield and new rapid tests, emerging antimicrobial resistance among common bacterial causes has challenged treatment. Recent studies showing favorable results for rifaximin, a nonabsorbed antibiotic, provide a potential solution as resistance grows to traditionally used antibiotics. However, prudent antibiotic use remains important to slow further development of resistance.
describe about SARS-2 virus
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).
A novel coronavirus of zoonotic origin it mean this disease are spsread by animals to humans.
Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans.
The first person infected in Wuhan(hubei) in China on 17 November 2019.
The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020.
COVID-19 is the name given by the WHO. On 11 February 2020. for the disease caused by the novel corona virus SARS-CoV-2.
Travel – associated cases have also been reported in a few other countries.
Outbreaks in health care workers indicate human to human transmission.
In India, first patient found in kerala on 30 January 2020.
Structure of the SARS-CoV-2 spike glycoprotein reveals the architecture of the key player of viral entry into host cells and provides a blue print for vaccine design.
Diagnosis is made based on Clinical features and history of International travel or a close contact with nCOVID POSITIVELY TESTED patients.
The CDC(The Centres for Disease Control and Prevention) recommends collection of three specimen types, lower respiratory, upper respiratory, and serum (Blood) specimens for testing.
Real – time Reverse Transcription –Polymerase Chain Reaction (rRT-PCR) test is used to diagnose nCOVID-19 in respiratory serum samples from clinical specimens.
Find the latest research on a wide range of molecular and serological assays currently available or under development:
Detection of Virus and Its Components (including Molecular Diagnostics ).
Serological (including Neutralization).
People who are at high risk
Elderly – more than 60 years.
People with decreased immunity.
People with co-morbidities such as Diabetes, Hypertension, Kidney disease etc.
Infants.
INTRODUCTION OF COVID-19, ORIGIN OF COVID-19, STRUCTURE OF COVID-19, CAUSES OF CORON VIRUS, SYMPTOMS OF COVID-19, TYPICAL SYMPTOMS OF COVID-19, MODE OF TRANSMISSION, PEOPLE WHI ARE AT HIGHER RISK, WHY COVID-19 IS SAID T BE AS THE PANDEMIC BY WHO?, PREVENTION, WHAT TO DO, WHAT NOT TO DO, MYTHS AND FACTS OF COVID-19 SPREADING, SOME OTHER CONSEQUENCES OF COVID-19, MOST IMPORTANT POINTS OF COVID-19, COVID-19 VACCINES INTRODUCTION, TYPES OF VACCINES , COVAXIN, COVISHIELD, COVID VACCINE REGISTERATION, WHO CAN REGISTER, WHO SHOULDNT TAKE VACCINE SHOTS, STEP BY STEP GUIDE FOR REGISTERATION, COMPARISON BETWEEN COVAXIN AND COVISHIELD,
1. The document discusses SARS-CoV-2, the virus that causes COVID-19. It originated in Wuhan, China and has since caused a global pandemic.
2. The virus is transmitted via respiratory droplets when infected individuals cough or sneeze. It has an incubation period of 2-14 days and a mortality rate of around 2%.
3. Clinical features of COVID-19 range from mild to severe and include fever, cough, breathing difficulties, and fatigue. Diagnosis involves tests like chest CT scans and PCR testing of respiratory samples.
This document provides an overview of COVID-19 for EMS providers, including terminology, the origins and spread of the virus, clinical presentation, screening and risk assessment, treatment considerations, infection control protocols, and recommendations for interacting with the public. Key points covered include how the virus is transmitted, projected disease course, limitations of current testing and treatment options, importance of PPE and prenotification, and dispelling common myths. The goal is to equip EMS with up-to-date facts and best practices for responding safely and effectively during the pandemic.
This document discusses information about COVID-19 including:
- Understanding the basics of COVID-19 and how to establish an operational framework to respond.
- COVID-19 spreads through respiratory droplets and contact with contaminated surfaces. Basic precautions like hand hygiene and cough etiquette can help reduce spread.
- Common symptoms include fever, cough and tiredness while serious symptoms include difficulty breathing. Older people and those with pre-existing conditions are most at risk of severe illness.
Coronavirus Disease (COVID-19) is caused by SARS-CoV-2 virus. It spreads mainly person to person and symptoms range from mild to severe illness which can lead to death. The document discusses COVID-19's structure, symptoms, transmission, diagnosis, treatment and prevention. Key facts provided include that only those sick or caring for the sick need masks; the virus is not human-made; and older individuals and those with pre-existing conditions are more vulnerable to severe illness.
- Swine flu, also known as H1N1, is caused by the influenza A H1N1 virus and causes respiratory illness. It was first detected in Mexico in 2009 and caused a global pandemic.
- In India, it has caused periodic outbreaks since 2009, killing over 1000 people annually. The worst affected states have been Gujarat and Rajasthan.
- The virus is transmitted through respiratory droplets from coughing and sneezing of infected individuals. It has an incubation period of 1-4 days. Symptoms include fever, cough, sore throat and body aches. Complications can include pneumonia.
Everything you need to know about Corona Virus.Tanveer Padder
• This is one of the most comprehensive & fact based resources for Corona virus
• This Presentation covers everything Including the symptoms, diagnosis, testing ,treatment options and prevention of Corona virus.
• This Presentation will definitely help you to prevent yourself from getting the corona virus.
• This is complete guide and must have resource for everybody.
Here is the you tube Video of this presentation
https://www.youtube.com/watch?v=4ABj7xqMYS4
https://youtu.be/ZogtL23P3Pg
This document provides guidance for cytopathology laboratories handling samples from patients with suspected or confirmed COVID-19. It outlines precautions to take during procedures like fine needle aspiration, sample processing, disposal, and spill management. Proper personal protective equipment and disinfection protocols are emphasized. Reporting and staff training procedures are adapted to minimize risk of virus transmission.
This document discusses Covid-19 in children. It notes that while fewer Covid cases have been diagnosed in children, most pediatric cases are mild. Hospitalization rates are significantly lower in children. The pathophysiology and risk factors for children are also discussed. Common symptoms in children are cough and fever. Diagnostic methods, treatment options, and prevention strategies are summarized.
Waheed Shouman was informed on December 31, 2019 of 44 cases of pneumonia in Wuhan, China with no known cause. Most patients reported a link to a seafood market. By January 1, 2020 person-to-person spread was occurring, including among healthcare workers. As of March 5, 2020 there were over 82 countries affected globally.
Coronaviruses & COVID 19 - Its Morphology, Role, Mechanism of Action, and Tre...Haider Ali Malik
This document discusses COVID-19 and coronaviruses. It defines COVID-19 as a novel coronavirus first identified in Wuhan, China in late 2019. Coronaviruses are a large family of viruses that can cause illnesses ranging from the common cold to more severe diseases like MERS and SARS. The document then provides details on the structure, replication, and transmission of coronaviruses, symptoms of COVID-19, the ongoing global pandemic, and the discovery and identification of SARS-CoV-2 under electron microscopy.
Maternal immunization is an important strategy to protect both mothers and newborns from infectious diseases. The document discusses various vaccines recommended during pregnancy including influenza, tetanus, diphtheria, pertussis (Tdap), respiratory syncytial virus (RSV), and COVID-19 vaccines. It provides evidence that maternal immunization reduces morbidity and mortality in mothers and newborns by providing passive immunity through antibody transfer across the placenta. The timing and efficacy of different vaccines in reducing infections, hospitalizations, and complications in mothers and newborns is reviewed. Caution is advised for some vaccines that are contraindicated during pregnancy.
The presentation discusses COVID-19 vaccines. It introduces coronaviruses and how they can cause respiratory illnesses in humans and animals. It then defines COVID-19 vaccines as vaccines aimed at providing immunity against SARS-CoV-2, the virus that causes COVID-19. The main vaccines discussed are Covishield, Sputnik V, Sinopharm, Pfizer-BioNTech, Sinovac, and Moderna. Brief descriptions of each vaccine's origins and technologies are provided.
The document discusses coronaviruses and COVID-19. It notes that coronaviruses can infect humans and cause diseases like the common cold, SARS, and MERS. COVID-19 is caused by a new coronavirus called SARS-CoV-2 that was first detected in Wuhan, China in December 2019 and causes respiratory illness. Symptoms range from mild to severe pneumonia and death. While there is no vaccine yet, prevention focuses on hand washing, social distancing, and isolation of sick individuals.
Coronavirus (COVID-19) - Symptoms, Diagnosis and Prevention - Dr Rohit BhaskarDr Rohit Bhaskar, Physio
A coronavirus is a type of virus that can cause respiratory illness in humans and animals. In 2019, a new coronavirus called SARS-CoV-2 emerged in Wuhan, China, and quickly spread around the world. An infection with the new coronavirus causes a respiratory disease called COVID-19.
Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
Bhaskar Health News and Medical Education is dedicated to medical students, physiotherapists, doctors, nurses, paramedics, physician associates, dentists, pharmacists, midwives and other healthcare professionals.
We're committed to being your source for expert health guidance. Bhaskar Health and Medical Education.
Source : https://www.bhaskarhealth.com
Health Shop: https://www.bhaskarhealth.org
@drrohitbhaskar @bhaskarhealth
#DrRohitBhaskar #BhaskarHealth
#Health #Medical #News #Physiotherapy
Emphasis on wellness, education and prevention of covid 19shamil C.B
The document discusses COVID-19 and provides information on the virus, its transmission, symptoms, diagnosis, treatment and prevention. It describes coronaviruses and defines COVID-19. It covers the incidence and spread of COVID-19 globally. Key points include how the virus is transmitted, its incubation period, high-risk groups, common and severe symptoms, diagnostic tests and medical management. The presentation emphasizes the importance of prevention measures like hand washing, social distancing and mask wearing.
This document provides an overview of the 2009 H1N1 influenza pandemic from an Indian perspective. It discusses the challenges faced in recognizing and confirming cases of the disease. It also outlines treatment recommendations, including the use of antiviral drugs like Tamiflu and supportive care. Complications tend to be more severe in younger people, possibly due to a 'cytokine storm' immune response, and include pneumonia and acute respiratory distress syndrome.
The document provides information on several COVID-19 vaccines, including Pfizer, Moderna, Johnson & Johnson, Covaxin, Covishield, Sputnik V, and vaccines from China. It describes the manufacturers, countries of origin, vaccine types, dosing schedules, effectiveness and clinical trial demographics for each vaccine. Overall, the vaccines were shown to effectively prevent COVID-19 illness and reduce severe outcomes, with effectiveness rates ranging from 66.3% to 97% depending on the specific vaccine.
This document provides an overview of COVID-19, including its aetiology, epidemiology, clinical features, diagnosis, management, and prevention. It describes how COVID-19 is caused by a novel coronavirus, SARS-CoV-2, which likely originated in animals. It summarizes the symptoms of COVID-19 and outlines recommendations for preventing and treating both mild and severe cases. The document also discusses differential diagnoses and provides references for further information.
Bacterial diarrhea remains a major global health problem and common reason for patients seeking medical care. While strategies can improve diagnostic ability, such as increasing stool culture yield and new rapid tests, emerging antimicrobial resistance among common bacterial causes has challenged treatment. Recent studies showing favorable results for rifaximin, a nonabsorbed antibiotic, provide a potential solution as resistance grows to traditionally used antibiotics. However, prudent antibiotic use remains important to slow further development of resistance.
describe about SARS-2 virus
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).
A novel coronavirus of zoonotic origin it mean this disease are spsread by animals to humans.
Coronavirus disease (COVID-19) is a new strain that was discovered in 2019 and has not been previously identified in humans.
The first person infected in Wuhan(hubei) in China on 17 November 2019.
The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020.
COVID-19 is the name given by the WHO. On 11 February 2020. for the disease caused by the novel corona virus SARS-CoV-2.
Travel – associated cases have also been reported in a few other countries.
Outbreaks in health care workers indicate human to human transmission.
In India, first patient found in kerala on 30 January 2020.
Structure of the SARS-CoV-2 spike glycoprotein reveals the architecture of the key player of viral entry into host cells and provides a blue print for vaccine design.
Diagnosis is made based on Clinical features and history of International travel or a close contact with nCOVID POSITIVELY TESTED patients.
The CDC(The Centres for Disease Control and Prevention) recommends collection of three specimen types, lower respiratory, upper respiratory, and serum (Blood) specimens for testing.
Real – time Reverse Transcription –Polymerase Chain Reaction (rRT-PCR) test is used to diagnose nCOVID-19 in respiratory serum samples from clinical specimens.
Find the latest research on a wide range of molecular and serological assays currently available or under development:
Detection of Virus and Its Components (including Molecular Diagnostics ).
Serological (including Neutralization).
People who are at high risk
Elderly – more than 60 years.
People with decreased immunity.
People with co-morbidities such as Diabetes, Hypertension, Kidney disease etc.
Infants.
INTRODUCTION OF COVID-19, ORIGIN OF COVID-19, STRUCTURE OF COVID-19, CAUSES OF CORON VIRUS, SYMPTOMS OF COVID-19, TYPICAL SYMPTOMS OF COVID-19, MODE OF TRANSMISSION, PEOPLE WHI ARE AT HIGHER RISK, WHY COVID-19 IS SAID T BE AS THE PANDEMIC BY WHO?, PREVENTION, WHAT TO DO, WHAT NOT TO DO, MYTHS AND FACTS OF COVID-19 SPREADING, SOME OTHER CONSEQUENCES OF COVID-19, MOST IMPORTANT POINTS OF COVID-19, COVID-19 VACCINES INTRODUCTION, TYPES OF VACCINES , COVAXIN, COVISHIELD, COVID VACCINE REGISTERATION, WHO CAN REGISTER, WHO SHOULDNT TAKE VACCINE SHOTS, STEP BY STEP GUIDE FOR REGISTERATION, COMPARISON BETWEEN COVAXIN AND COVISHIELD,
1. The document discusses SARS-CoV-2, the virus that causes COVID-19. It originated in Wuhan, China and has since caused a global pandemic.
2. The virus is transmitted via respiratory droplets when infected individuals cough or sneeze. It has an incubation period of 2-14 days and a mortality rate of around 2%.
3. Clinical features of COVID-19 range from mild to severe and include fever, cough, breathing difficulties, and fatigue. Diagnosis involves tests like chest CT scans and PCR testing of respiratory samples.
This document provides an overview of COVID-19 for EMS providers, including terminology, the origins and spread of the virus, clinical presentation, screening and risk assessment, treatment considerations, infection control protocols, and recommendations for interacting with the public. Key points covered include how the virus is transmitted, projected disease course, limitations of current testing and treatment options, importance of PPE and prenotification, and dispelling common myths. The goal is to equip EMS with up-to-date facts and best practices for responding safely and effectively during the pandemic.
This document discusses information about COVID-19 including:
- Understanding the basics of COVID-19 and how to establish an operational framework to respond.
- COVID-19 spreads through respiratory droplets and contact with contaminated surfaces. Basic precautions like hand hygiene and cough etiquette can help reduce spread.
- Common symptoms include fever, cough and tiredness while serious symptoms include difficulty breathing. Older people and those with pre-existing conditions are most at risk of severe illness.
Coronavirus Disease (COVID-19) is caused by SARS-CoV-2 virus. It spreads mainly person to person and symptoms range from mild to severe illness which can lead to death. The document discusses COVID-19's structure, symptoms, transmission, diagnosis, treatment and prevention. Key facts provided include that only those sick or caring for the sick need masks; the virus is not human-made; and older individuals and those with pre-existing conditions are more vulnerable to severe illness.
- Swine flu, also known as H1N1, is caused by the influenza A H1N1 virus and causes respiratory illness. It was first detected in Mexico in 2009 and caused a global pandemic.
- In India, it has caused periodic outbreaks since 2009, killing over 1000 people annually. The worst affected states have been Gujarat and Rajasthan.
- The virus is transmitted through respiratory droplets from coughing and sneezing of infected individuals. It has an incubation period of 1-4 days. Symptoms include fever, cough, sore throat and body aches. Complications can include pneumonia.
Everything you need to know about Corona Virus.Tanveer Padder
• This is one of the most comprehensive & fact based resources for Corona virus
• This Presentation covers everything Including the symptoms, diagnosis, testing ,treatment options and prevention of Corona virus.
• This Presentation will definitely help you to prevent yourself from getting the corona virus.
• This is complete guide and must have resource for everybody.
Here is the you tube Video of this presentation
https://www.youtube.com/watch?v=4ABj7xqMYS4
https://youtu.be/ZogtL23P3Pg
This document provides guidance for cytopathology laboratories handling samples from patients with suspected or confirmed COVID-19. It outlines precautions to take during procedures like fine needle aspiration, sample processing, disposal, and spill management. Proper personal protective equipment and disinfection protocols are emphasized. Reporting and staff training procedures are adapted to minimize risk of virus transmission.
This document discusses Covid-19 in children. It notes that while fewer Covid cases have been diagnosed in children, most pediatric cases are mild. Hospitalization rates are significantly lower in children. The pathophysiology and risk factors for children are also discussed. Common symptoms in children are cough and fever. Diagnostic methods, treatment options, and prevention strategies are summarized.
Waheed Shouman was informed on December 31, 2019 of 44 cases of pneumonia in Wuhan, China with no known cause. Most patients reported a link to a seafood market. By January 1, 2020 person-to-person spread was occurring, including among healthcare workers. As of March 5, 2020 there were over 82 countries affected globally.
Coronaviruses & COVID 19 - Its Morphology, Role, Mechanism of Action, and Tre...Haider Ali Malik
This document discusses COVID-19 and coronaviruses. It defines COVID-19 as a novel coronavirus first identified in Wuhan, China in late 2019. Coronaviruses are a large family of viruses that can cause illnesses ranging from the common cold to more severe diseases like MERS and SARS. The document then provides details on the structure, replication, and transmission of coronaviruses, symptoms of COVID-19, the ongoing global pandemic, and the discovery and identification of SARS-CoV-2 under electron microscopy.
Maternal immunization is an important strategy to protect both mothers and newborns from infectious diseases. The document discusses various vaccines recommended during pregnancy including influenza, tetanus, diphtheria, pertussis (Tdap), respiratory syncytial virus (RSV), and COVID-19 vaccines. It provides evidence that maternal immunization reduces morbidity and mortality in mothers and newborns by providing passive immunity through antibody transfer across the placenta. The timing and efficacy of different vaccines in reducing infections, hospitalizations, and complications in mothers and newborns is reviewed. Caution is advised for some vaccines that are contraindicated during pregnancy.
This document discusses evidence for drug safety and efficacy in pregnancy. It notes that while prospective safety data from clinical trials is preferable, registries provide some reassurance in the absence of such data. Large prospective treatment trials in pregnancy are also absent. The document then examines infection risk and specific infections in pregnancy like urinary tract infections. It discusses how physiologic changes in pregnancy affect drug pharmacokinetics and considerations for drug selection and treatment of conditions like nausea/vomiting, hypertension, and migraines in pregnancy.
Safety of Mebendazole Use During Lactationmothersafe
This case series study evaluated the safety of mebendazole use in 45 lactating women and their infants. Mebendazole was administered using single or repeated doses and was well tolerated by both the mothers and infants, with no adverse effects observed in infants. Mild GI irritability occurred in two treated mothers. This study provides the first evidence that mebendazole is safe for use in breastfeeding.
Tuberculosis in prenancy by dr alka mukherjee dr apurva mukherjee nagpur ms i...alka mukherjee
Prevention of Tuberculosis
The BCG vaccine has been incorporated into the National immunization policy of many countries, especially the high burden countries, thereby conferring active immunity from childhood. Nonimmune women travelling to tuberculosis endemic countries should also be vaccinated. It must, however, be noted that the vaccine is contraindicated in pregnancy [72].
The prevention, however, goes beyond this as it is essentially a disease of poverty. Improved living condition is, therefore, encouraged with good ventilation, while overcrowding should be avoided. Improvement in nutritional status is another important aspect of the prevention.
Pregnant women living with HIV are at higher risk for TB, which can adversely influence maternal and perinatal outcomes [73]. As much as 1.1 million people were diagnosed with the co-infection in 2009 alone [2]. Primary prevention of HIV/AIDS is, therefore, another major step in the prevention of tuberculosis in pregnancy. Screening of all pregnant women living with HIV for active tuberculosis is recommended even in the absence of overt clinical signs of the disease.
Isoniazid preventive therapy (IPT) is another innovation of the World Health Organisation that is aimed at reducing the infection in HIV positive pregnant women based on evidence and experience and it has been concluded that pregnancy should not be a contraindication to receiving IPT. However, patient's individualisation and rational clinical judgement is required for decisions such as the best time to provide IPT to pregnant women
This document discusses pharmacotherapy for pediatric HIV infection. It covers antiretroviral therapy (ART) used during pregnancy and delivery to prevent mother-to-child transmission of HIV. ART regimens aim to achieve high drug levels in the fetus to prevent transmission. Short-term neonatal ART prophylaxis is also used. While ART has significantly reduced pediatric HIV infections, challenges remain due to limited access in developing countries, where most new pediatric HIV cases occur. Ongoing research monitors potential long-term effects of in utero ART exposure on children.
This document summarizes a study on bacterial contamination found in powdered infant formula. The key points are:
- Testing found that over 50% of powdered formula samples from 35 countries were contaminated with Enterobacteria bacteria.
- Several outbreaks of illness in neonatal intensive care units were linked to formula contaminated with Salmonella or Enterobacter sakazakii bacteria before the formula was opened.
- In response, some formula brands recalled batches and health authorities issued safety warnings, but more needs to be done to inform consumers directly of the risks and encourage stricter manufacturing practices.
This study examined maternal and fetal outcomes in term premature rupture of membranes (PROM) using medical records from a hospital in Ethiopia between 2011-2013. The study found that 22.2% of women experienced unfavorable maternal outcomes like puerperal sepsis. 33.5% of neonates experienced unfavorable outcomes like stillbirth. Factors associated with unfavorable outcomes included residing in a rural area, duration of PROM over 12 hours, latency over 24 hours, and birth weight under 2500g. The study aims to identify factors that can help reduce complications from term PROM and improve outcomes.
Professor Soo Downe presenting at the Doctoral Midwifery Research Society Alcohol & Medication in Pregnancy Conferene about 'Which horse for which courses? The EBM Problem in studies of pharmacological substances in maternity care'.
Oral surgery during pregnancy
Dr. Ahmed M. Adawy
Professor Emeritus, Dep. Oral & Maxillofacial Surg.
Former Dean, Faculty of Dental Medicine
Al-Azhar University
Pregnancy, also known as gestation, is the time during which a fetus develops inside a woman's uterus. Pregnancy is typically divided into three trimesters. The common belief has been that, if an oral surgery procedure is recommended, but it’s not an emergency, the second trimester is the ideal time. Pregnancy however, is not a disease and pregnant woman should not be treated differently than the general population. In short, it could be concluded that:
• Dental care is safe and essential during pregnancy
• Pregnancy is not a reason to defer routine dental care or treatment
• Diagnostic measures, including needed dental x-rays, can be undertaken safely
• Emergency care should be provided at any time during pregnancy
This document summarizes key findings from several studies on exposures during pregnancy and lactation. The studies found:
- Teratogen information services receive thousands of calls annually regarding exposures to medications, infections, herbs and other substances during pregnancy and breastfeeding. The majority of calls concern analgesics, cold medications, herbs and dietary supplements.
- Most calls are made by exposed individuals themselves, highlighting a need for more education during prenatal care about risks of nonprescription drugs and vaccines.
- While some drugs used to treat autoimmune diseases like methotrexate and leflunomide can cause harm if taken during early pregnancy, others like sulfasalazine, azathioprine and antimalarials are
This randomized controlled trial tested the effects of antibiotics (erythromycin and co-amoxiclav) on neonatal outcomes in women with preterm prelabor rupture of membranes (pPROM). 4826 women with pPROM were assigned to receive erythromycin, co-amoxiclav, both antibiotics, or placebo for 10 days or until delivery. Erythromycin was associated with reductions in the composite outcome of neonatal death, chronic lung disease or major brain abnormality compared to placebo, as well as prolongation of pregnancy and reductions in other neonatal complications. Co-amoxiclav provided no benefits and was associated with an increased risk of necrotizing enterocolitis. Eryth
This randomized controlled trial tested the effects of antibiotics (erythromycin and co-amoxiclav) on neonatal outcomes in women with preterm prelabor rupture of membranes (pPROM). 4826 women with pPROM were assigned to receive erythromycin, co-amoxiclav, both antibiotics, or placebo for 10 days or until delivery. Erythromycin was associated with reductions in the composite outcome of neonatal death, chronic lung disease or major brain abnormality compared to placebo, as well as prolongation of pregnancy and reductions in other neonatal complications. Co-amoxiclav was associated with prolongation of pregnancy but also an increased risk of necrotizing enterocolitis and did
Current Point of View in Preterm Labor Management in AlbaniaRustem Celami
The document discusses a study conducted in Albania on the use of maintenance tocolysis therapy to prevent preterm labor. The study included 325 pregnant women between 28-32 weeks gestation hospitalized for preterm labor. Women received tocolysis therapy for over one month. Those between 28-30 weeks gestation saw more prolonged pregnancies compared to the 30-32 weeks group. The study concluded that maintenance tocolysis therapy can considerably benefit women diagnosed with preterm labor and help prolong their singleton pregnancies when medical intervention is not urgently needed. However, more research is still required.
Respiratory Disorders In Pregnancy 26092023.pptxNiranjan Chavan
This document discusses respiratory disorders that can occur during pregnancy. It begins by outlining the normal physiological changes to respiration that occur during pregnancy, including increased oxygen demand and changes in lung volume. It then examines specific pulmonary diseases like asthma, tuberculosis, influenza, and COVID-19 that can impact pregnant women. For each condition, it describes associated risks, symptoms, diagnosis, effects on pregnancy, and recommended treatment approaches. The goal is to understand how these respiratory disorders present during pregnancy and should be managed while considering the health and safety of both the mother and fetus.
This study analyzed data from over 15,000 infants in the UK Millennium Cohort Study to examine the relationship between breastfeeding and hospitalization for diarrhea and respiratory infections in the first 8 months of life. The results showed that exclusive breastfeeding, compared to no breastfeeding, was associated with a lower risk of hospitalization for both diarrhea and respiratory infections after adjusting for various confounding factors. Partial breastfeeding also showed a protective effect, but it was weaker than exclusive breastfeeding. The protective effects of breastfeeding decreased after breastfeeding cessation. The study suggests that increased rates of exclusive and prolonged breastfeeding could significantly reduce hospitalizations in the UK.
Drugs, pregnancy, and lactation: ondansetron--troubling data.unequaledkismet13
This document summarizes recent studies on the safety of the drug ondansetron (Zofran) during pregnancy. It notes that while early data found no increased risk of birth defects, more recent studies have found possible associations between first trimester exposure and congenital heart defects or oral clefts. The document also discusses risks of serotonin syndrome and cardiac arrhythmias for pregnant women taking ondansetron. Given these potential risks, it recommends caution in using ondansetron during pregnancy.
A prospective observational study was conducted in the Neonatal Unit of Indraprastha Apollo Hospital over a period of 10 months. A total of 86 high-risk newborns were included to study the mortality and morbidity patterns. Majority of these (68%) were outborn male babies: 65% were pre-term and 36% were low birth weight. Overall survival was 77.2% and was better in inborn babies. Survival was directly proportional to gestation and birth weight. Systemic infection was associated with higher mortality and morbidity. Klebsiella was the commonest organism cultured followed by Candida. Hyaline membrane disease was the commonest respiratory morbidity. Sixty-seven percent required ventilatory support, and mortality was directly proportional to the duration of ventilation. Only 6% of the survivors had neurodevelopmental delay at 6 months and one baby had hearing impairment requiring cochlear implant. They continue to be on long-term follow-up.
A prospective observational study was conducted in the Neonatal Unit of Indraprastha Apollo Hospital over a period of 10 months. A total of 86 high risk newborns were included to study the mortality and morbidity pattern. Majority of these (68%) were outborn male babies. Sixty five percent were preterm and 36% low birth weight. Overall survival was 77.2% and was better in inborn babies. Survival was directly proportional to gestation and birth weight. Systemic infection was associated with higher mortality and morbidity. Klebsiella was the commonest organism cultured followed by Candida. Hyaline membrane disease was the commonest Respiratory morbidity. Sixty Seven pecent required ventilatory support and mortality was directly proportional to the duration of ventilation. Only six percent of the survivors had Neurodevelopmental delay at 6 months and 1 baby had hearing impairment requiring Cochlear implant. They continue to be on long term follow up.
This document discusses preventing preterm labour. It begins by providing statistics on the incidence of preterm birth in various locations. It then discusses the magnitude of the problem, highlighting the high costs of preterm birth. Several studies on outcomes of extremely preterm infants are summarized. The document is then organized into sections on primary, secondary, and tertiary prevention of preterm labour. Key points are made about various risk factors and diagnostic tools, as well as treatments such as progesterone, cerclage and antibiotics.
Similar to Safety of neuraminidase inhibitors in pregnant and breastfeeding women tanaka cmaj_2009 (20)
Este documento presenta una introducción a la metodología científica en la que se definen conceptos clave como conocimiento, ciencia y método científico. Explica que existen dos tipos de conocimiento: el conocimiento vulgar y el conocimiento científico. Luego describe las características del conocimiento científico como verificable, objetivo, sistemático, explicativo y predictivo. Finalmente, introduce conceptos relacionados con la investigación científica como variables e hipótesis.
Este documento presenta una introducción a la investigación cualitativa escrita por Uwe Flick. El libro ofrece una guía detallada de los métodos cualitativos, incluyendo teorías, diseño de investigación, recolección y análisis de datos verbales y visuales, y validación de los hallazgos. El autor también discute temas actuales como el uso de computadoras y la integración de métodos cualitativos y cuantitativos. El libro provee una visión general completa de la investigación cualitativa.
Este documento presenta una introducción a la metodología de la investigación educativa. Explica que la investigación educativa surgió a finales del siglo XIX y ahora es fundamental para el avance del conocimiento en educación. También describe las principales fases del proceso de investigación y analiza el supuesto dilema entre los enfoques cuantitativos y cualitativos, concluyendo que ambos pueden ser compatibles y ampliar las opciones metodológicas del investigador.
Metodología de la investigación manual para el desarrollo de personal de saludRuth Vargas Gonzales
Este documento presenta la segunda edición del manual "Metodología de la investigación". El manual fue desarrollado para estudiantes y personal de salud con el objetivo de enseñar los fundamentos y procesos de la investigación. La introducción describe el propósito y alcance del manual, mientras que las siguientes unidades cubren temas como la base filosófica de la investigación, los pasos del proceso de investigación, la formulación de problemas y objetivos, y el marco teórico y conceptual. El manual concluye con dos ejemplos completos de investigaciones para facilit
La dactilología es la representación manual de las letras del alfabeto utilizada para comunicarse con personas sordas cuando no existe un signo para una palabra. Se realiza con la mano dominante a la altura de la barbilla y se complementa con la articulación oral. Algunas palabras en lengua de signos española tienen su origen en la dactilología de las letras iniciales de palabras en castellano. El documento proporciona ejercicios para practicar la dactilología con letras, palabras y frases.
Este documento analiza el problema de la mortalidad materna en Perú a través de estadísticas, casos emblemáticos y factores contribuyentes. Discute cómo la falta de acceso a servicios de salud de calidad, pobreza, desigualdad de género y otros factores sociales contribuyen a altas tasas de mortalidad materna. También examina deficiencias en la capacidad de resolución del sistema de salud y propone medidas para mejorar el acceso a la atención obstétrica de emergencia en zonas remotas.
Directiva manejo de its sintomaticas en gentantes y mujeres lactantesRuth Vargas Gonzales
Este documento establece un sistema de atención para el manejo de casos de infecciones de transmisión sexual sintomáticas en gestantes y mujeres durante la lactancia a través de diagnóstico y tratamiento oportunos siguiendo esquemas de manejo sindrómico, información a pacientes, captación de contactos y provisión de condones. Define síndromes como úlcera genital, flujo vaginal y dolor abdominal bajo, e incluye protocolos de tratamiento para cada síndrome.
Este documento presenta una propuesta de Norma Técnica de Salud para la atención integral de salud materna en Perú. Su objetivo general es lograr un manejo estandarizado y de calidad de la atención materna basado en derechos humanos e interculturalidad. Establece normas y procedimientos para la atención prenatal, parto, puerperio y emergencias obstétricas en todos los establecimientos de salud del país.
Este documento presenta un análisis comparativo de siete planes de beneficios de salud en América Latina, con el objetivo de sistematizar las experiencias y lecciones aprendidas. Los planes analizados incluyen: las Garantías Explícitas de Salud de Chile, el Plan Obligatorio de Salud de Colombia, el Plan Integral de Atención a la Salud de Uruguay, el Catálogo Universal de Servicios Esenciales de Salud y el Fondo de Protección de Gastos Catastróficos de México, el Plan Esencial
Este resumen describe los principales resultados de una encuesta de satisfacción de usuarios del sistema de aseguramiento universal de salud en Perú. Los usuarios de clínicas privadas reportaron los mayores niveles de satisfacción, mientras que los de establecimientos públicos reportaron los menores niveles. Los usuarios de EsSalud esperaron más tiempo para citas y atención. Los de establecimientos públicos esperaron más tiempo para ser atendidos. En general, los usuarios de Ayacucho y Catacaos reportaron mayores niveles de satisfacción
Este documento presenta instrucciones para el registro y codificación de las actividades de la Estrategia Sanitaria Nacional de Salud Sexual y Reproductiva - Atención Planificación Familiar. Explica cómo registrar la orientación/consejería en planificación familiar, anticoncepción quirúrgica voluntaria, prescripción de métodos anticonceptivos para usuarias nuevas, y repetición de prescripciones. Proporciona ejemplos detallados de cómo completar correctamente cada sección del registro para estas actividades.
Este documento presenta las actividades más frecuentes de la Estrategia Sanitaria Nacional de Salud Sexual y Reproductiva para la atención materno perinatal. Incluye códigos diagnósticos y actividades relacionadas con el embarazo, parto y puerperio, así como instrucciones para el registro y codificación de dichas atenciones. Además, define la atención prenatal como la vigilancia y evaluación integral de la gestante y el feto por parte del profesional de salud para lograr un nacimiento sano sin riesgos para la
Este documento proporciona instrucciones para el registro y codificación de actividades relacionadas a la prevención y control del cáncer en la consulta externa. Explica cómo registrar diagnósticos, consejería para prevención de cáncer, toma de Papanicolaou, y consulta médica especializada en mama. Proporciona detalles sobre los códigos y campos a utilizar para cada procedimiento o actividad de salud.
El documento presenta un manual de registro y codificación de la atención en consulta externa y actividades preventivo-promocionales de la Estrategia Sanitaria Nacional de Prevención y Control de Infecciones de Transmisión Sexual VIH/SIDA en Perú. Incluye instrucciones para el registro de diferentes actividades como detección, tratamiento y consejería de infecciones de transmisión sexual, VIH y hepatitis, así como códigos CIE-10 correspondientes.
La ley peruana de seguridad y salud en el trabajo establece que los trabajadores del sector público deben participar en la implementación de sistemas de gestión de seguridad y salud ocupacional. Estos sistemas requieren la identificación de peligros, evaluación de riesgos, capacitación de trabajadores, investigación de accidentes e incidentes, y protección contra represalias por parte de los empleadores. La participación de los trabajadores es fundamental para crear condiciones de trabajo seguras y sin riesgos.
El documento presenta información sobre la ergonomía y los riesgos disergonómicos en el trabajo. Define la ergonomía como la adaptación del puesto de trabajo al hombre para minimizar el estrés y la fatiga. Explica que los riesgos disergonómicos son probabilidades de sufrir accidentes o enfermedades relacionadas con factores como la manipulación de cargas, posturas y movimientos repetitivos. Finalmente, ofrece recomendaciones ergonómicas para mejorar los puestos de trabajo en oficinas, incluyendo ajustes de
El documento describe los factores de riesgo psicosocial en el trabajo, incluyendo factores individuales, extra-laborales e intra-laborales. Explica que estos factores afectan la salud y el rendimiento de los trabajadores a través de mecanismos psicofisiológicos. También describe los objetivos de evaluar estos factores, las medidas preventivas para eliminarlos, y el marco legal relevante según la ley peruana.
Este documento presenta el Reglamento de Ensayos Clínicos del Perú, el cual integra tres decretos supremos relacionados a la regulación de ensayos clínicos en el país. El reglamento establece las normas y procedimientos para realizar ensayos clínicos de manera ética y protegiendo a los sujetos de investigación. Incluye secciones sobre el consentimiento informado, roles y responsabilidades de los participantes en los ensayos, requisitos de aprobación, y monitoreo y reporte de resultados. El objetivo general es regular la
El documento propone un modelo de organización y funciones para oficinas o unidades regionales de investigación en salud. Describe la situación actual de la investigación en el Perú y la necesidad de promoverla a nivel regional. Presenta una propuesta de conformación de dichas oficinas, incluyendo sus objetivos, ubicación en la estructura organizativa regional, y conformación de comités de investigación. También establece requerimientos mínimos en infraestructura, equipamiento y documentación.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
2. Practice
CMAJ • JULY 7, 2009 • 181(1-2)56
women. Of the 13 women for whom sufficient data were
available, 3 were admitted to hospital; 1 of these patients died
of respiratory complications. This patient was started on os-
eltamivir therapy 1 week after acute respiratory distress de-
veloped.6
At present, the groups at high risk of influenza-
related complications from the novel H1N1 influenza are the
same as those for seasonal influenza. These groups include,
but are not limited to, pregnant women and children aged
5 years or less.8
Lactation
Whether influenza viruses are passed into human milk is not
known; however, respiratory droplets are likely to be the
main mode of viral transmission. Because of the anti-infective
benefits of human milk for infants, continuation of breast-
feeding is recommended even if the mother is receiving treat-
ment for novel H1N1 influenza infection.3–5
Pharmacotherapy
The Centers for Disease Control and Prevention recommen-
dation8
during the current pandemic is that drug treatment and
chemoprophylaxis be considered, along with other public
health measures, for patients at high risk of complications, in-
cluding pregnant women and infants. Recent meta-analyses
have suggested that oseltamivir and zanamivir may be mod-
estly effective in alleviating symptoms of seasonal influenza
in otherwise healthy adults16
and children.17
Routine use of
these drugs is discouraged for patients at low-risk of compli-
cations from seasonal influenza, although these neu-
raminidase inhibitors are capable of reducing within-
household spread of the disease, nasal viral load and lower
respiratory tract complications.16
Data about the effectiveness
of these drugs in high-risk populations, specifically during the
current pandemic, are limited.
Oseltamivir
Oseltamivir is a prodrug that is hydrolyzed by the liver to
its active metabolite, oseltamivir carboxylate, with an elim-
ination half-life of about 6–10 hours.18
The therapeutic oral
dosage for influenza, including novel H1N1 influenza, for
adults is 75 mg taken twice daily for 5 days, starting within
48 hours of the initial symptoms to capture the early phase
of viral replication. For chemoprophylaxis, the recom-
mended dosage is 75 mg taken once daily for 10 days after
exposure.8
Therapeutic and prophylactic dosing schedules
for children are similar (about 2 mg/kg twice a day for
5 days for treatment, and 2 mg/kg once a day for 10 days
for prophylaxis).8
Pregnancy
A study using an ex vivo human placenta model showed that
oseltamivir was extensively metabolized by the placenta.19
Transplacental transfer of the metabolite was incomplete with
minimal accumulation on the fetal side.19
In postmarketing
surveillance, 61 pregnant women who were exposed to os-
eltamivir with unknown timing were reported by the manu-
facturer.20
Among these pregnancies, there were 10 abortions,
including 6 therapeutic terminations, and 1 case each of tri-
somy 21 and anencephaly.20
These findings are consistent
with data from 2 Japanese teratogen information services
(Toranomon Hospital,21
and Japan Drug Information Institute
in Pregnancy, National Center for Child Health and Develop-
ment, Tokyo, Japan), which prospectively followed 90 preg-
nant women who took therapeutic doses of oseltamivir
(75 mg twice a day for up to 5 days) during the first trimester
(Table 1). In these 90 cases, there was 1 malformation
(1.1%), which is within the incidence of major malformations
in general population (1%–3%).
Lactation
Wentges-van Holthe and colleagues22
reported the case of a
lactating woman who received oseltamivir (75 mg twice daily
for 5 days). The maximum milk concentrations of oseltamivir
and its active metabolite were 38.2 ng/mL and 39.5 ng/mL
(equivalent to 43.4 ng/mL of oseltamivir), respectively. The
authors estimated that the infant would have been exposed to
milk containing a maximum of 81.6 ng/mL oseltamivir–
Table 1: Outcomes of pregnancies in Japan after therapeutic exposure to oseltamivir in the first trimester
Characteristic
Toranomon Hospital21
n = 65
Japan Drug Information Institute
in Pregnancy
n = 25
Time of exposure, gestational wk, range 1–12 2–10
No. of spontaneous abortions 1 2
No. of therapeutic abortions 0 1
Gestational age at birth, wk, range 35–41* 35–42
No. of preterm births 2* 2
Birth weight, g, range 2090–3810* 2418–3480
No. of infants with a low birth weight 3* 4
No. of infants with a major malformation 1† 0
*n = 42 (women exposed between gestational week 4 and 7 who had a live birth).
†Ventricular septal defect.
3. Practice
CMAJ • JULY 7, 2009 • 181(1-2) 57
equivalents, which corresponds to 0.012 mg/kg per day.22
This is much smaller than the pediatric doses (2–4 mg/kg
per day).
Zanamivir
Zanamivir is administered by inhalation with a dry powder
inhaler. The bioavailability of the drug is 10%–20% by in-
halation, compared with 2% by oral administration. About
90% of the absorbed dose is excreted unchanged in the urine.
The elimination half-life in serum of zanamivir is between 2.5
and 5.1 hours.23
The therapeutic dose is 10 mg inhaled twice
daily for 5 days starting within 48 hours of the initial symp-
toms. For chemoprophylaxis, the dose is once daily for 10
days after exposure.7,8
The recommended doses for children
are the same.8
Because zanamivir therapy requires the patient
to voluntarily inhale through the device, oseltamivir may be
preferred over zanamivir for young children.
Pregnancy
Three pregnant women were accidentally exposed to
zanamivir during clinical trials.24
Among these women,
1 pregnancy was spontaneously miscarried, 1 pregnancy was
terminated, and 1 woman delivered a healthy baby.24
The
Japan Drug Information Institute in Pregnancy has informa-
tion about 1 woman who took zanamivir at 4 weeks of gesta-
tion and delivered a healthy baby at term.
Lactation
A peak concentration of zanamivir in the serum after a 10 mg
oral-inhalation dose ranges from 34 to 96 ng/mL.23
Assuming
a maternal serum concentration of 100 ng/mL, a milk-to-
plasma ratio of 1.0 and an intake of milk of 150 mL/kg per
day, the maximum amount of zanamivir that a 5 kg infant
would ingest would be about 0.075 mg/day, which is much
lower than the recommended prophylactic dosage for children
of 10 mg/day inhalation.
Vaccine
The seasonal influenza vaccine does not appear to provide
protection against novel H1N1 influenza.25
Currently no vac-
cine for novel H1N1 influenza exists. However, vaccination
for seasonal influenza should continue because of higher mor-
bidity among pregnant women and possible concurrent epi-
demics with novel H1N1 influenza.26
Once developed, it is
unlikely that an inactivated vaccine against novel H1N1 in-
fluenza would be contraindicated for pregnant and lactating
women, similar to regular influenza vaccines.27,28
Discussion
Pregnant women, especially those in the late stages of preg-
nancy, are at high risk of complications from influenza, in-
cluding novel H1N1 influenza. Although the data are limited,
this should be considered during the current novel H1N1 in-
fluenza pandemic.
If treatment or chemoprophylaxis is required for pregnant
women during the current pandemic, oseltamivir appears to
be the drug of choice because there are more data on its safety
in pregnancy. The data suggest that oseltamivir is not a major
teratogen for humans. Zanamivir may also be used, but there
are less data available about its safety for pregnant women.
Both oseltamivir and zanamivir are considered to be com-
patible with breastfeeding. Continuation of breastfeeding by a
woman taking these medications is unlikely to lead to sub-
stantial drug exposure by the infant. Adjustment of dose be-
cause of breastfeeding is not necessary. If mother–infant con-
tact is clinically allowed, breastfeeding during oseltamivir or
zanamivir treatment is acceptable. If an infant being breastfed
by the mother receiving oseltamivir or zanamivir needs direct
treatment or chemoprophylaxis, the recommended dose of os-
eltamivir or zanamivir for infants should be given. Therapy
should start within 48 hours of the initial symptoms.
Prospective data collection with robust follow-up should
continue for both oseltmivir and zanamivir.
REFERENCES
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2009. Available: www.who.int/mediacentre/news/statements/2009/h1n1
_20090429/en/index.html (accessed 2009 May 27).
2. Centers for Disease Control and Prevention. Update: novel influenza A (H1N1) virus
infections — worldwide, May 6, 2009. MMWR Morb Mortal Wkly Rep 2009;58:453-8.
3. Centers for Disease Control and Prevention. Pregnant women and novel influenza
A (H1N1) considerations for clinicians. Atlanta (GA): The Centers; 2009. Avail-
able: www.cdc.gov/h1n1flu/clinician_pregnant.htm (accessed 2009 May 27).
4. Centers for Disease Control and Prevention. What pregnant women should know
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Acknowledgements: Dr. Tanaka is supported by Nobel Pharma Scholarship,
TFB Scholarship, Scholarship for Researchers through the Japanese Society
of Clinical Pharmacology and Therapeutics, and The Research and Training
Competition (RESTRACOMP) through the Hospital for Sick Children Re-
search Institute.
Dr. Garcia-Bournissen has received funding from the Clinician Scientist
Training Program. This program is funded by the Ontario Student Opportu-
nity Trust Fund and the Hospital for Sick Children Foundation Student
Scholarship Program.
Dr. Koren is the Ivey Chair in Molecular Toxicology, Department of
Medicine, University of Western Ontario, and he holds the Research Leader-
ship for Better Pharmacotherapy during Pregnancy and Lactation at The Hos-
pital for Sick Children, Toronto, Ont.
Funding: The Japan Drug Information Institute in Pregnancy is supported by
the Japanese Ministry of Health, Labor and Welfare. This report is supported
by the National Center for Child Health and Development–Motherisk Collab-
orative Research Fund.
Competing interests: None declared.
Contributors: Toshihiro Tanaka conceived and initiated this project, searched
the literature, collected information, and drafted and revised the manuscript. Ken
Nakajima searched Japanese literature, analyzed and interpreted the follow-up
data collected from the Japan Drug Information Institute in Pregnancy, and
drafted the paper. Atsuko Murashima critically interpreted the follow-up data
collected from Japan Drug Information Institute in Pregnancy and drafted the
paper. Facundo Garcia-Bournissen conceived the project, searched the Spanish
literature, provided critical interpretation of the collected information and criti-
cally revised the draft. Gideon Koren provided critical interpretation of the data
and revised the manuscript for key content. Shinya Ito searched literature, pro-
vided critical interpretation of the data, drafted the paper and revised it critically.
All of the authors approved the final version submitted for publication.
This article has been peer reviewed.
4. Practice
CMAJ • JULY 7, 2009 • 181(1-2)58
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Correspondence to: Dr. Shinya Ito, Division of Clinical
Pharmacology and Toxicology, Department of Paediatrics, The
Hospital for Sick Children, 555 University Ave., Toronto ON
M5G 1X8; fax 416 813-7562; shinya.ito@sickkids.ca