The document discusses vaccine recommendations for pregnant women. It recommends that routinely recommended vaccines like Tdap be administered between 27-36 weeks of gestation to protect both the mother and fetus. It also recommends the flu vaccine during any trimester. Live vaccines like MMR are generally not recommended in pregnancy due to theoretical risks, but may be considered if the woman is at high risk of exposure to the disease. The timing and types of vaccines recommended vary according to trimester and disease risk factors. The overall goals are to provide protection to both mother and baby through vaccination and passive immunity.
Vaccination in pregnancy by dr alka & dr apurva mukherjee nagpur m.s. indiaalka mukherjee
Maternal immunization provides important health benefits to both pregnant women and to their fetus. Vaccine-preventable diseases cause significant morbidity and mortality among maternal, neonatal, and young infant. Some infections are so serious even they can waste pregnancy, harm her baby during pregnancy or after delivery. These complications can be protected with vaccination. This is why vaccinations are so important for pregnant mothers. Vaccines strengthen the immune systems of body that can fight off serious infectious diseases. A vaccine can help in protection of the mother's body from infections and this immunity passes to her baby during pregnancy. This immunity keeps the child safe during the first few months of life until baby gets his own vaccination. Vaccination also protects mothers from getting a serious disease that could affect future pregnancies. Fetus getting any risk after vaccination of the mother during pregnancy primarily is theoretical. Globally, no scientific study exist which shows the risk of fetus after vaccination of pregnant women with inactivated vaccines or bacterial vaccines or toxoids. Even live vaccines causing risk to fetus is theoretical. Benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm. Not all vaccinations are safe during pregnancy but some of inactivated vaccines are considered safe which can be give to pregnant women who might be at risk of infection.
Vaccination in pregnancy by dr alka & dr apurva mukherjee nagpur m.s. indiaalka mukherjee
Maternal immunization provides important health benefits to both pregnant women and to their fetus. Vaccine-preventable diseases cause significant morbidity and mortality among maternal, neonatal, and young infant. Some infections are so serious even they can waste pregnancy, harm her baby during pregnancy or after delivery. These complications can be protected with vaccination. This is why vaccinations are so important for pregnant mothers. Vaccines strengthen the immune systems of body that can fight off serious infectious diseases. A vaccine can help in protection of the mother's body from infections and this immunity passes to her baby during pregnancy. This immunity keeps the child safe during the first few months of life until baby gets his own vaccination. Vaccination also protects mothers from getting a serious disease that could affect future pregnancies. Fetus getting any risk after vaccination of the mother during pregnancy primarily is theoretical. Globally, no scientific study exist which shows the risk of fetus after vaccination of pregnant women with inactivated vaccines or bacterial vaccines or toxoids. Even live vaccines causing risk to fetus is theoretical. Benefits of vaccinating pregnant women usually outweigh potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm. Not all vaccinations are safe during pregnancy but some of inactivated vaccines are considered safe which can be give to pregnant women who might be at risk of infection.
prostaglandin, labour, pregnancy, obstetrics, delivery, normal labour, normal delivery, first stage of labour, induction of labour, pph, post partum haemorrhage, bleeding in pregnancy, abortion
prostaglandin, labour, pregnancy, obstetrics, delivery, normal labour, normal delivery, first stage of labour, induction of labour, pph, post partum haemorrhage, bleeding in pregnancy, abortion
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
Important pregnancy vaccines that mommies to-be should getNavya_Sharma
Maternal vaccines help in preventing serious infections like the ones above. If you have more questions regarding the right vaccination for you, please consult your gynecologist. Visit, https://www.cordlifeindia.com/blog/important-pregnancy-vaccines-mommies-get/
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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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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.
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
5. Objectives of Maternal Vaccination
Protects both the mother and fetus from the morbidity
Provide the infant passive protection
Passive immunity by trans-placental transfer of antibodies
Vaccinating pregnant women in third trimester for influenza
63% decreased incidence of lab-confirmed influenza in infant
Decreased respiratory illness 36% within first 6 months of life
Zaman K et al, 2008
6. Vaccine recommendations in Pregnancy
by ACIP(Advisory committee on immunization practice)
Vaccines
Recommended
Consider if otherwise indicated
Recommended to avoid
ACIP:
7. Types of Immunization
Live vaccines (Varicella, MMR, Zoster, LAIV)
Potential for infecting fetus
No harm ever reported
Discouraged unless at high risk for exposure and suboptimal
morbidity/mortality from infection
If pregnancy occurs within 4 weeks of immunization
Counsel woman on theoretical risk
Termination : Not indicated
8. Types of Immunization
Toxoids, inactivated vaccines, immune globulin preparations
Considered safe
Wait until 2nd trimester (except flu)
Fetal development
Adverse first trimester events (miscarriage, birth defects)
9. Vaccine General Recommendation for Use in Pregnant Women
Hepatitis A Recommended if otherwise indicated.
Hepatitis B Recommended in some circumstances.
Human Papillomavirus (HPV) Not recommended.
Influenza (Inactivated) Recommended.
Influenza (LAIV) Contraindicated.
MMR Contraindicated.
MCV4 (MenACWY) May be used if otherwise indicated.
PCV13 Inadequate data for specific recommendation.
PPSV23 Inadequate data for specific recommendation.
Polio May be used if needed.
Td Should be used if otherwise indicated.
Tdap Recommended.
Varicella Contraindicated.
Zoster Contraindicated.
Guidelines for Vaccinating Pregnant Women by CDC
10. Timing of maternal immunization
Pre-conception counseling on immunizations is ideal
Prenatal counseling
High risk of exposure
Infection would be hazardous to mother or fetus
Immunizing agent if benign
13. Preconception vaccination
MMR
Measles
More serious measles infection, higher risk of complications
Preterm birth, low birth weight, and miscarriage
no definite evidence of a higher rate of birth defects among offspring
of infected gravida
Mumps
Miscarriage and fetal death in first trimester
Endocardial fibroelastosis
14. Preconception vaccination
Rubella
Miscarriage and fetal death
Congenital rubella syndrome
hearing loss, cataracts, cardiac abnormalities, bone lesions, growth
restriction, and neurologic abnormalities including intellectual
disability
Document immunity via IgG
15. Preconception vaccination
Varicella
congenital varicella syndrome
limb hypoplasia, microcephaly, dermal scarring, ocular defects
2 percent of fetuses infected in first 20 weeks of gestation
9 cases : 20 and 28 weeks of gestation
In utero exposure to maternal varicella
Herpes zoster in infancy or early childhood
16. Antenatal vaccination
Benefits to both mother and fetus should outweigh the risks
Live vaccines should be avoided during pregnancy
Minimize their risk of exposure to infections
avoiding travel to high risk locations
Household members are immunized
Maintaining good hygienic practices
17. Tetanus
Infection caused by ClostridiumTetani. Found in soil, dust, and animal feces
Enters in body by puncture wounds, splinters, insect bites, burns etc.
Causes uncontrollable muscle spasms, Bacteria binds to motor nerve, spinal
cord and brain stem leading to lock jaw, coma and DEATH!!!
18. Tetanus Vaccine
Vaccine given to infants at 2 months, 4 months, and 6 months.
Children get a booster at 4 or 5 years of age prior to school.
Additional booster given at age 12.This should be aTdap.
Continued boosters every 10 years or every 5 year if puncture
wound/burn
19. Antenatal vaccination
Pertussis
Bordetella pertussis.
Life threatening to newborns and infants
May start as a runny nose, low grade fever or cough.
Immunity wanes and disease is increasing
House members can transmit, especially mothers (50%)
Tdap during each pregnancy, optimally between 27 and 36 weeks of
gestation
20. Recommendation of Tdap
No, incomplete, or unknown immunization against tetanus and diphtheria
Start or complete the series at 0, 4 weeks and 6-12months
A dose ofTdap should replace one of theTd doses
Between 27 and 36 weeks of gestation.
Td immunization complete and up to date
Tdap at 27 to 36 weeks of gestation
More than 5 or 10 years since lastTd booster
Tdap at 27 to 36 weeks of gestation
21. Antenatal vaccination
Influenza
Serious morbidity / mortality in pregnant and postpartum women
Vaccination
Reduce risk of medical and pregnancy complication
Provides passive protection to the neonate
Inactivated influenza vaccine in October or the first half of November
Regardless of gestational age
22. Selective immunization of high risk groups
Occupation, habits, travel plans, or the area in which they reside
No immunization is more harmful than the disease
23. Hepatitis B
selective immunization
Recombinant vaccine
Complete a series
High risk women
Sexually active individuals and/or partner
Intravenous drug users
Healthcare workers
Having a hepatitis B Ag-positive sex partner
24. Hepatitis A
selective immunization
Preterm delivery
In utero infection
Meconium peritonitis, fetal ascites, and polyhydramnios
Can give passive immunization with immune globulin for postexposure
prophylaxis
25. Other disease
selective immunization
Pnemococcus : Give after 1st trimester
Yellow fever : mosquito-borne viral hemorrhagic fever
South America and sub-Saharan Africa
Avoid travel
Yellow fever vaccine can cause serious adverse effects in the mother
Poliovirus
Haemophilus influenza: Give for prior splenectomy
Meningococcal
26. Other diseases
selective immunization
Typhoid:Travel
Small pox: Live virus vaccine
Not recommended
Rabies
Give if exposed
Cholera, plague, Japanese encephalitis
Give if high risk of exposure
Tuberculosis
Not recommended
27. Postpartum vaccination
Both inactivated and live vaccines( except smallpox and yellow fever) are
safe for lactating mothers
Two vaccines that should be given before discharge to protect mother and
newborn
MMR
Varicella
Tdap
28. Summary and Recommendation
Nonpregnant women of childbearing age who may become pregnant
Clinically indicated immunizations at least one month prior to
conception
Before administering any vaccine,
if she is pregnant or could become pregnant in the next four weeks and
counseling her about the potential risks of vaccination during pregnancy
or just before conception.
During influenza season
Influenza vaccination regardless of trimester of pregnancy
29. Summary and Recommendation
Pregnant women should minimize their risk of exposure to infections
Avoiding travel to high risk locations
Immunization of household members
Maintaining good hygienic
Pregnancy within 1month of immunization with the live vaccine
Termination of pregnancy for this indication is unwarranted.
Toxoids, inactivated virus vaccines, or immune globulin preparations
Conception
30. Summary and Recommendation
MMR and varicella vaccines
Postpartum women who are breastfeeding
Tdap
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine
All pregnant women in each pregnancy between 27 and 36 weeks of
gestation
Passive immunity 2 to 6 months