Tetanus is caused by Clostridium tetani bacteria, whose spores are found worldwide in soil. The bacteria produces a neurotoxin called tetanospasmin that causes painful muscle contractions. Tetanus is transmitted through puncture wounds, burns, and other injuries that provide a route of entry for spores. The disease is entirely preventable through active immunization with tetanus toxoid vaccines as part of routine childhood immunization schedules and during pregnancy to prevent neonatal tetanus. Passive immunization with tetanus immunoglobulin provides temporary protection.
Tetanus Presentation
77 slides
Including drip rates of muscle relaxants
PDF : http://www.mediafire.com/download/k00ciibf73d7y6p/
For more, visit www.medicalgeek.com
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
Tetanus Presentation
77 slides
Including drip rates of muscle relaxants
PDF : http://www.mediafire.com/download/k00ciibf73d7y6p/
For more, visit www.medicalgeek.com
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
Measles is a highly contagious viral infection.
It is exanthematous disease with fewer, cough, coryza (rhinitis) and conjunctivitis.
Before the widespread use of measles vaccines, it was estimated that measles caused between 5 million and 8 million deaths worldwide each year.
Tetanus, Lock Jaw, Opisthotonus, Tetanus Immunoglobulins, Immunization, Cephalic Tetanus. A much feared topic among residents explained in a simple way.
all about rabies
epidemiology of rabies,
pathogenesis of rabies,
clinical features of rabies,
treatment of rabies,
prevention of rabies,
rabies virus,
post exposure prophylaxis,
rabies in dogs
overview of rabies and rabies post exposure administration.pptxBirhanu Hurisa
Rabies is neglected disease with 100% case fatality. Rabies kills more than 55,000 people each year in which 99% of the deaths are from developing countries. Rabies has been recognized in Ethiopia for centuries, and the disease has become endemic since the early 17th century. By estimation, 2771 to 10,000 people die of rabies each year in Ethiopia.
The only vaccine available for human rabies post-exposure prophylaxis is the obsolete sheep brain-based Fermi vaccine, and has been manufactured since early 1950s in Ethiopia. According to Ethiopian Ministry of Health, the annual performance report, the maximum manufacturing capacity for the Nervous Tissue Vaccine (NTV) of the country is about 32,000 doses, which is far below demand. The NTV is immunogenic, more reactogenic, life threatening and caused neurological adverse reactions in 0.3-0.8 per 1000 vaccinated people.
Rabies is neglected disease with 100% case fatality. Rabies kills more than 55,000 people each year in which 99% of the deaths are from developing countries. Rabies has been recognized in Ethiopia for centuries, and the disease has become endemic since the early 17th century. By estimation, 2771 to 10,000 people die of rabies each year in Ethiopia.
The only vaccine available for human rabies post-exposure prophylaxis is the obsolete sheep brain-based Nervous Tissue vaccine (Fermi vaccine) and has been manufactured since early 1950s in Ethiopia. According to Ethiopian Ministry of Health, the annual performance report, the maximum manufacturing capacity for the Nervous Tissue Vaccine (NTV) of the country is about 32,000 doses, which is far below demand. The NTV is immunogenic, more reactogenic, life threatening and caused neurological adverse reactions in vaccinated people.
by epidemiological point of view
also covering a glance to its prevalence in India and world.
showing introduction to disease, causes, signs and symptoms, epidemiological triad and epidemiological factors affecting it, at last having prevention to that disease.
Immunization is a process of protecting an individual from a disease through introduction of live attenuated, killed or organisms or antibodies in the individual system.
Immunization is the process of protecting an individual by active or passive method.
The immunizing agents are
Vaccines, Immunoglobulins and antisera
Why vaccination?
Prevention of deadly and debilitating diseases.
Keeps child from suffering through a preventable illness.
Less doctor visits
No hospitalization
This presentation aims at helping the pediatric trainees and practitioners to brush up their knowledge in Immunization. The schedule is based on the Universal Immunisation Programme. I have tried to cover as much as possible in terms of individual vaccines and hope it is beneficial to the reader.
As a chronic disease it is prevalent in both developed and developing countries, and affecting children(10-20%) as well as adults(20-40%).Excess weight gain invites many associated diseases.
One in every ten people is suffering from kidney related diseases and Approx 1.50 lakh new kidney patients are added every year.Investigating an outbreak and to find the susceptibles in an area 'ii be a great achievement.
Worlds largest and unique early childhood development programme Introduced on 2nd October 1975 has so many positive outcomes till date but yet to achieve its objectives....
A Successful Project Proposal helps the Organisation to explain to the authority, why they are fit for a proposal,their plan of action,time-line for execution with Budget.
Maternal Near Miss Operational GuidelinesRajesh Ludam
Maternal Near Miss guidelines is designed for the program managers at different levels of public health system.to provide quality services and identify the best practices.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Hemodialysis: Chapter 3, Dialysis Water Unit - Dr.Gawad
Tetanus
1. Tetanus
Dr. Rajesh Kumar Ludam
P.G Student ,Dept Of Community Medicine
V.S.S.M.C.H,Burla
2. TETANUS
INTRODUCTION
CAUSATIVE AGENT
EPIDEMIOLOGY
TRANSMISSION, HOST FACTORS,
ROUTE OF ENTRY
TYPES OF TETANUS
PREVENTION – ACTIVE & PASSIVE
IMMUNIZATION
3. Introduction
• Tetanos – a Greek word – to stretch
• First described by Hippocrates & Susruta
• Tetanus an neurological disease characterized
by an acute onset of hypertonia, painful
muscular contractions (usually of the muscles
of the jaw and neck), and generalized muscle
spasms without other apparent medical
causes.
• Only vaccine preventable disease that is
infectious but not contagious
4. CAUSATIVE AGENT
• Caused by CLOSTRIDIUM TETANI
• Anaerobic
• Motile
• Gram positive bacilli
• Oval, colorless, terminal spores – tennis racket
or drumstick shape.
• It is found worldwide in soil, in inanimate
environment, in animal faeces & occasionally
human faeces.
5. Clostridium tetani Gram Stain
NOTE: Round terminal spores give cells a
“drumstick” or “tennis racket” appearance.
6. Epidemiology
Tetanus is an international health problem, as spores
are ubiquitous. The disease occurs almost exclusively in
persons who are unvaccinated or inadequately
immunized.
Entirely preventable disease by immunization
Tetanus occurs worldwide but is more common in hot,
damp climates with soil rich in organic matter.
More common in developing and under developing
countries.
More prevalent in industrial establishment, where
agricultural workers are employed.
Tetanus neonatorum is common due to lack of MCH
care.
7. India-:
• Tetanus is important endemic infection in India.
• Causative factors
– Hand washing
– Delivery practices
– Traditional birth customs
– Interest in immunization
• Since 1983 Nationwide EPI recommended 2 doses of TT for
pregnant women during each pregnancy ( or one booster if <3 yrs
have passed since the prev. pregnancy)
• Prior to the national immunization programme estimated 3.5 lakh
children were dying annually. 70,000 cases continue to occur
largely in the states – Orissa, Bihar, MP, Assam, Rajasthan, UP,
where TT immunization coverage is less than national
coverage(70%) .
• In addition to Immunization clean delivery centers at hospitals
and a cadre of trained ANMs and other trained birth attendants
have contributed to reducing the burden of NT in INDIA.
8. • Depending on NT incidence rates, immunization
coverage levels, proportion of clean deliveries by trained
personals, Districts are divided into-:
NT High risk – Rate > 1/1000 live births or
TT2 coverage < 70% or attended deliveries < 50%
NT Control – Rate < 1/1000 live births or
TT2 coverage > 70% or attended deliveries > 50%
NT Elimination – Rate < 0.1/1000 live births or
TT2 coverage > 90% or attended deliveries > 75%
9. Agent Factor-:
1.Agent-: Cl. Tetani
• Oval, colorless, terminal spores
– tennis racket or drumstick shape.
• Spores are highly resistant to a number of injurious
agents, including boiling, phenol and autoclaving for 15
min at 120°c.
2.Reservoir of infection-: Natural Habitat-:Soil & Dust
• Also found in intestine of- Cattle,horses,goats,sheeps
and excreted in faeces
• Can survive for years in nature without causing ill effects
• Are blown about in dust and occur in wide variety of
situations
10. Sporulated Vegetative
3.Toxins-:
• When the oxygen levels in the surrounding tissue is sufficiently low, the
implanted C. tetani spore then germinates into a new, active vegetative cell that
grows and multiplies and most importantly produces tetanus toxin -
Tetanospasmin and Tetanolysin.
• Tetanolysin is not believed to be of any significance in the clinical course
of tetanus.
•Tetanospasmin is a neurotoxin and causes the clinical manifestations of
tetanus.
11. • Astounding lethal toxicity, exceeded only by Botulinum
Toxin.
• Lethal Dose-: 0.1mg for a 70 kg-man
• The toxin acts on 4 areas of nervous system-:
- Motor End Plates in Skeletal System
- Spinal Cord
- Brain
- Sympathetic System
• Principal Action is to block inhibition of spinal reflexes.
4. Period of Communicability-: None
13. Spores are extremely stable, although immersion in
boiling water for 15 minutes kills most spores.
Exposure to saturated steam under 15 lbs. of
pressure for 15-20 minutes at 121°c is highly
effective against spores .
Sterilization by dry heat is slower than by moist heat
(1 -3 hrs at 160 °C),but it is also effective against
spores.
Ethylene oxide sterilization is also sporocidal.
Autoclaving at 121°C for 15min kills the spores
readily.
Iodine(1% aqueous soon) and H2O2 (10 volume) kills
spores within few hours.
14. Host Factors
Age : It is the disease of active age (5-40 years),
New born baby, female during delivery or
abortion
Sex : Higher incidence in males than females
Occupation : Agricultural workers are at higher
risk
Rural –Urban difference: Incidence of tetanus in
urban areas is much lower than in rural areas
Immunity : Herd immunity does not protect the
individual
15. Environmental & Social Factors-:
• Tetanus is a positive environmental hazard.
• Depends upon man’s physical and ecological
surroundings.
• Factors Contributing-:
-Unhygienic custom habits
-Unhygienic delivery practices
-Ignorance of infection &
-Lack of primary health care services.
16. Routes Of Infections/Mode of Transmission-
- Trivial pin prick, Skin Abrasion
-Puncture wounds,Burns,Human Bites
- Animal bites and stings
- Unsterile Surgery,IUD
- Bowel Surgery & Dental Extraction
- Injections, Unsterile division of Umbilical Cord
-Compound Fractures,Otitis Media
-Chronic skin ulcers, Eye Infection
-Gangrenous Limb
Thus tetanus is an wound infection “ NO WOUND,
NO TETANUS”
17. Incubation Period-:
• Usually incubation period ranges from 3-21
days but can range from the day of injury to
several months.
• Average incubation period is 10 days.
• Depends on character, location, and extent of
wound.
19. Prevention
Tetanus is completely preventable
by active tetanus immunization.
Immunization is thought to provide
protection for 10 years.
Active Combined
Immunization
Monovalent
20. Tetanus prone wound
• A wound sustained more than 6 hr before surgical
treatment.
• compound fractures
• deep penetrating wounds
• wounds containing foreign bodies (especially wood
splinters)
• wounds complicated by pyogenic infections
• wounds with extensive tissue damage (e.g. contusions
or burns)
• any wound obviously contaminated with soil, dust
• Re-implantation of an avulsed tooth is also a tetanus-prone
event
21. 1.Active-:
A. Combined
- Offered routinely in combination with diphtheria vaccine
and killed B. pertussis organisms as DPT vaccine.
1st dose - 6th week (DPT)
2nd dose - 10th week (DPT)
3rd dose - 14th week (DPT)
1st booster - 18th month (DPT)
2nd booster 5th completed year (DT)
3rd booster - 10th year (TT)
4th booster – 16th years (TT)
22. B.Monovalent vaccines
• Purified tetanus Toxoid ( adsorbed ) supplanted the
plain Toxoid – higher & long lasting immunity
response
• Primary course of immunization – 3 doses
• Each 0.5 ml , injected into arm given at intervals of
0,2,12 months
• The longer the interval b/w two doses, better is the
immune response
• Booster doses : After 5 yr f/b Every 10 yrs
• Stored between +2 to +8°c and must not be allowed
to freeze at any time.
23. 2.Passive immunization
• Temporary protection – human tetanus
immunoglobulin /ATS
• Human Tetanus Hyper-immunoglobulin :
• 250-500 IU
• Produces protective antibody level for at-least 4-6
weeks.
• Does not cause serum sickness
• Longer passive protection compared to horse ATS( 30
days / 7 -10 days )
• Produced at Serum institute Pune.
24. • ATS ( EQUINE ) :
• If Human ATS not available
• 1500 IU s/c after sensitivity testing
• Protection-: 7 – 10 days
• High risk of serum sickness
• It stimulates formation of antibodies to it , hence a
person who has once received ATS tends to rapidly
eliminate subsequent doses.
25. Active & Passive Immunization
• In non immunized persons
• 1500 IU of ATS / 250-500 units of Human Ig in one
arm & 0.5 ml of adsorbed Tetanus Toxoid (PTAP or
APT) into other arm /gluteal region
• Followed 8 wks later by , 0.5 ml of Tetanus Toxoid
• 1 yr later , 0.5 ml of Tetanus Toxoid 3rd dose
• Again at 5 yr and 10 yrs…….
Purpose-: Immediate Temporary Protection + Long
Lasting Protection
26. Antibiotics
Theoretically, antibiotics may prevent multiplication
of C tetani, thus halting production of toxin.
Benzathine Penicillin is the drug of choice.
Penicillin: (1.2 MU IV in 2-4 divided doses-FOR 3-4
WEEKS
Erythromycin is alternative for penicillin allergic
patients 500mg 6hrly for 7 days.
Started as soon as possible after Injury.( around 6 hrs)
Alone it is ineffective in prevention of tetanus as it is
not a substitute to Immunization.
27. Prevention of neonatal tetanus
• Clean delivery practices alone is effective.(about 90%)
• 3 cleans : clean hands, clean delivery surface, clean
cord care
• Tetanus toxoid protects both mother & child
• Unimmunized pregnant women : 2 doses tetanus
toxoid (16th-36th week)
• 1st dose as early as possible during pregnancy
• 2nd dose – at least a month later / 3 wks before delivery
• Immunized pregnant women : a booster is sufficient
• No need of booster in every consecutive pregnancy.
• To newborn of unimmunized mother, 750 IU (HTIG)
within 6 hours of birth.
28. IMMUNITY CATEGORY
• A - has had a complete course of Toxoid or booster
dose with in the past 5 year
• B - has had a complete course of Toxoid or booster
dose more then 5 years ago & less then 10 years ago
• C - has had a complete course of Toxoid or a booster
dose more then 10 year ago
• D - has not had a complete course of Toxoid or
immunity status unknown
29. Post-exposure prophylaxis:
• All wound receive surgical toilet
Wounds less then 6 hours other wounds
Old , clean, non-penetrating,
& with negligible tissue damage
immunity treatment immunity treatment
category category
A nothing more required A nothing more
required
B Toxoid 1 dose B Toxoid 1 dose
C Toxoid 1 dose C Toxoid 1 dose +
D Toxoid complete course human tetanus Ig.
D Toxoid complete course +
human tetanus Ig
Editor's Notes
The bacterium was first isolated in 1899 by Kitasato while he was working with R. Koch in Germany. Kitasato also found the toxin responsible for tetanus and developed the first protective vaccine against the disease
Penicillin G : Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.
GABA antagonist effect of penicillins and third-generation cephalosporins,which may lead to CNS excitability.
Metronidazole : Active against various anaerobic bacteria and protozoa. Appears to be absorbed into cells, and intermediate-metabolized compounds that are formed bind DNA and inhibit protein synthesis, causing cell death.