Cette brochure est le fruit d’un travail collectif, mené par des groupes ‘publics’ et ‘professionnels’ sous la coordination de Prométhée, Réseau des Hépatites en Isère.
This was a group presentation at our faculty of pharmacy ain shams university supervised by department of pharmaceutics we were a team of ten members but i was the one concerned with organizing data , collecting photos , choosing a powerpoint template ,adjusting it to fit in with the topic.
This document provides information about immunization and vaccination. It discusses how immunization works to protect the body from infectious diseases through vaccination or exposure to antigens. The document also includes Nigeria's national immunization schedule, which recommends vaccines for diseases like polio, diphtheria, pertussis, and measles at various ages from birth through adolescence. It notes that minor side effects like fever or rashes are normal after some vaccinations. Only high fever or other severe reactions require medical attention.
This document discusses different types of immunization and vaccination. It describes passive immunization, which provides immediate protection by injecting pre-formed antibodies, and active immunization, which activates the immune system to produce its own antibodies. Vaccines can be live attenuated, inactivated, toxoid, subunit, DNA, or recombinant vector-based. They are administered through various routes and involve primary vaccination and booster shots to maintain immunity. The document covers different vaccine-preventable diseases and periods of immunity conferred.
Market Research Report : Cold Chain Market in India 2011Netscribes, Inc.
For the complete report, get in touch with us at : info@netscribes.com
"The Cold Chain Market in India has been growing consistently and has huge potential to grow in the near future, especially since now it has strong government backing. The cold chain market was valued at INR 89 and is expected to grow at a CAGR of 11%. Government backing will help boost the capacity creation for cold storages while new players are gradually venturing into the more profitable refrigerated transport services.
The report begins with an introduction to the cold chain market and its value chain. The market overview section provides an insight into the overall cold chain market, its market size and growth along with its segmentation. It further delves into the two segments – surface storage and refrigerated transport – providing an overview for both the segments. This is followed by a section on the development scenario of cold chains in India which covers investment opportunities, private participation and government initiatives.
An analysis of the drivers explain the factors for growth of the industry including growth in organized retail, shift towards horticultural crops, growth in processed food sector, demand from pharmaceutical sector and changing consumption pattern. The key challenges of the market include lack of logistical support, uneven distribution of cold chains, cost structure and power supply. Key trends in the market have also been analyzed which includes entry of foreign players, rail based reefers, cold chains facilities at airports and backward integration.
The competition section provides an overview of the competitive landscape in the industry and includes a brief profile of the major players in the market."
Cette brochure est le fruit d’un travail collectif, mené par des groupes ‘publics’ et ‘professionnels’ sous la coordination de Prométhée, Réseau des Hépatites en Isère.
This was a group presentation at our faculty of pharmacy ain shams university supervised by department of pharmaceutics we were a team of ten members but i was the one concerned with organizing data , collecting photos , choosing a powerpoint template ,adjusting it to fit in with the topic.
This document provides information about immunization and vaccination. It discusses how immunization works to protect the body from infectious diseases through vaccination or exposure to antigens. The document also includes Nigeria's national immunization schedule, which recommends vaccines for diseases like polio, diphtheria, pertussis, and measles at various ages from birth through adolescence. It notes that minor side effects like fever or rashes are normal after some vaccinations. Only high fever or other severe reactions require medical attention.
This document discusses different types of immunization and vaccination. It describes passive immunization, which provides immediate protection by injecting pre-formed antibodies, and active immunization, which activates the immune system to produce its own antibodies. Vaccines can be live attenuated, inactivated, toxoid, subunit, DNA, or recombinant vector-based. They are administered through various routes and involve primary vaccination and booster shots to maintain immunity. The document covers different vaccine-preventable diseases and periods of immunity conferred.
Market Research Report : Cold Chain Market in India 2011Netscribes, Inc.
For the complete report, get in touch with us at : info@netscribes.com
"The Cold Chain Market in India has been growing consistently and has huge potential to grow in the near future, especially since now it has strong government backing. The cold chain market was valued at INR 89 and is expected to grow at a CAGR of 11%. Government backing will help boost the capacity creation for cold storages while new players are gradually venturing into the more profitable refrigerated transport services.
The report begins with an introduction to the cold chain market and its value chain. The market overview section provides an insight into the overall cold chain market, its market size and growth along with its segmentation. It further delves into the two segments – surface storage and refrigerated transport – providing an overview for both the segments. This is followed by a section on the development scenario of cold chains in India which covers investment opportunities, private participation and government initiatives.
An analysis of the drivers explain the factors for growth of the industry including growth in organized retail, shift towards horticultural crops, growth in processed food sector, demand from pharmaceutical sector and changing consumption pattern. The key challenges of the market include lack of logistical support, uneven distribution of cold chains, cost structure and power supply. Key trends in the market have also been analyzed which includes entry of foreign players, rail based reefers, cold chains facilities at airports and backward integration.
The competition section provides an overview of the competitive landscape in the industry and includes a brief profile of the major players in the market."
This document discusses vaccines, including their history, types, production methods, and components. It explains that vaccines induce immunity by triggering an antibody response to antigens from weakened or killed disease-causing microorganisms. Vaccines are produced using live attenuated microbes, inactivated pathogens, recombinant DNA technology, or as mixtures targeting multiple diseases. Large-scale production involves growing microbes, inactivating or attenuating them, and adding stabilizers or adjuvants to the purified antigen formulations.
Clinical Vaccine Development Introductionrwmalonemd
This document provides an overview of clinical vaccine development from a US perspective. It discusses general considerations for vaccine development including safety, efficacy, disease incidence and risk factors. It reviews key FDA guidance documents on topics like Good Clinical Practice standards and the vaccine approval process. It also covers practical clinical development considerations for vaccine trials including safety evaluation, immunogenicity assessment, route of administration, dosing, and the use of boosters. The document is intended as a guide for those developing new vaccines.
Recombinant vaccines are more effective than conventional vaccines. They have several advantages: they are reliable and safer since only a single protein is used rather than the whole organism; this also reduces the risk of illness. Recombinant technology allows scientists to control the type of vector used and choose specific antigens. While only one recombinant vaccine has been approved by the FDA so far, the technology produces a strong protective immune response similar to a natural infection and may be less expensive to produce in the future. However, developing recombinant vaccines is currently very expensive and some ethical concerns remain regarding the use of human subjects in testing.
This document summarizes cellular adhesion molecules that are involved in the inflammatory process. It discusses selectins, integrins, and their roles and ligands in leukocyte trafficking and extravasation from blood vessels into tissues during inflammation. Selectins such as L-selectin, E-selectin, and P-selectin mediate initial tethering and rolling of leukocytes on endothelial cells, while integrins such as LFA-1 and VLA-4 are involved in tight adhesion and transmigration. Diseases associated with deficiencies in these adhesion molecules and attempts to target them therapeutically in human allergic inflammation and diseases like asthma are also summarized.
1. Acute inflammation is a short-term process lasting from a few minutes to a few days that is characterized by redness, heat, swelling, pain, and loss of function. It involves vasodilation, increased vascular permeability, and cellular changes.
2. The cellular changes in acute inflammation include the migration of neutrophils, macrophages, and other white blood cells to the site of injury to remove foreign substances and damaged tissue through phagocytosis.
3. There are two main types of acute inflammation - suppurative inflammation, which involves pus formation caused by pyogenic bacteria, and non-suppurative inflammation, which does not involve pus formation and can be catarrhal, fibrinous,
The universal immunization programme in India aims to protect infants and pregnant women against six vaccine preventable diseases. It is the largest immunization program in the world, targeting over 27 million infants and 30 million pregnant women annually. The national immunization schedule outlines vaccines to be administered according to age, including BCG, DPT, polio, hepatitis B, measles and more. Proper cold chain storage and handling of vaccines is essential to maintain their potency, as different vaccines have varying sensitivity to heat, cold, and light.
This document discusses biotechnology, including its definition, history, applications in different fields like agriculture, medicine, and industry. It covers topics such as drug production using biotechnology techniques, pharmacogenomics, gene therapy, and genetic testing. Drug production through isolation and genetic engineering of enzymes is described. The use of biotechnology to develop medicines and pharmaceuticals for treating diseases is also summarized.
This document provides information on immunization including key terms, vaccination schedules, and maintaining the cold chain. It discusses immunization as a key child survival strategy and outlines the national immunization schedule in India. Full immunization requires 3 doses of DPT and OPV vaccines and 1 dose of BCG, measles, and tetanus toxoid vaccines. The cold chain system is crucial for transporting and storing vaccines at the proper temperatures. Proper maintenance of equipment like ILRs and cold boxes is needed to ensure vaccine efficacy. Adverse events following immunization are usually minor but can occasionally be more severe.
Vaccines have been revolutionary for the prevention of infectious diseases. Despite worldwide immunization of children against the six devastating diseases, 20% of infants are still left un-immunized; responsible for approximately two million unnecessary deaths every year, especially in the remote and impoverished parts of the globe. This is because of the constraints on vaccine production, distribution and delivery. One hundred percent coverage is desirable, because un-immunized populations in remote areas can spread infections and epidemics in the immunized safe areas, which have comparatively low herd immunity. For some infectious diseases, immunizations either do not exist or they are unreliable or very expensive. Immunization through DNA vaccines is an alternative but is an expensive approach, with disappointing immune response. Hence the search is on for cost-effective, easy-to-administer, easy-to-store, fail-safe and socio-culturally readily acceptable vaccines and their delivery systems. As Hippocrates said, Let thy food be thy medicine, scientists suggest that plants and plant viruses can be genetically engineered to produce vaccines against diseases such as dental caries; and life-threatening infections like diarrhea, AIDS, etc (Lal et al., 2007)
This document discusses inflammation and its triggers, objectives, and results. It describes the cardinal signs of inflammation as redness, swelling, heat, pain, and loss of function. It differentiates between acute and chronic inflammation and discusses the cells, mediators, and systemic effects involved in each. Key aspects of the inflammatory response like increased vascular permeability, leukocyte recruitment, recognition of pathogens, and termination signals are explained.
This document discusses different types of vaccines and factors that can lead to vaccine failure. It describes several types of vaccines including live attenuated, inactivated/killed, toxoid, subunit, recombinant subunit, recombinant vector, DNA, and transitional vaccines. It compares advantages and disadvantages of different vaccine types. The document also lists numerous potential causes of vaccine failure, such as use of expired vaccines, improper storage, genetic resistance, health status of individuals receiving the vaccine, immunosuppression, mycotoxins, stress, genetics, administration errors, water quality, and presence of maternal antibodies or variants in the field.
The document summarizes inflammation and its processes. It describes the sequence of events in acute inflammation, from vasodilation to resolution. It lists chemical mediators involved like histamine, cytokines, and eicosanoids. Acute inflammation can resolve completely, form scar tissue, or progress to chronic inflammation. Chronic inflammation involves lymphocytes, macrophages and plasma cells and can be caused by persistent infection, prolonged insult, or autoimmunity.
The document provides an overview of the history and development of vaccines. It discusses key events like Jenner's development of the smallpox vaccine in 1796 and the eradication of smallpox. It describes different types of vaccines including live-attenuated, inactivated, toxoid, subunit, conjugate, and DNA vaccines. The mechanisms of how vaccines work and produce immunity are also explained. The document traces the evolution of vaccines from whole organism approaches to modern techniques like recombinant DNA technology.
This document discusses autoimmune diseases, specifically systemic lupus erythematosus (SLE). It describes how SLE results from a loss of self-tolerance causing autoantibodies or autoreactive cells to damage organs. Key points are that SLE is associated with over 25 autoantibodies, most notably double-stranded DNA antibodies and antihistone antibodies. Diagnosis involves screening for antinuclear antibodies via fluorescent antinuclear antibody testing, with double-stranded DNA antibodies being highly specific for SLE diagnosis. The disease presents with diverse, nonspecific symptoms and can affect many organ systems like the skin, joints, and kidneys.
2. C A U S E O F D E A T H W O R L D W I D E
68%
32%
Non-Communicable disease
Communicable disease
WHO, 2012
Surat Piwsawang MD
3. C O M M U N I C A B L E D I S E A S E S
Surat Piwsawang MD
4. C O M M U N I C A B L E D I S E A S E S
• Anthrax
• Chickenpox
• Chikungunya
• Cholera
• Dengue
• Diarrhea - ROTA
• Diphtheria
• Dysentery,Amoebic
• Dysentery,Bacillary
• Encephalitis
• Meningitis
• Filariasis
• Food Poisoning
• H.conjunctivitis
• Hand,foot and mouth
disease
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hepatitis E
• Hib
• HIV
• HPV
• Influenza
• Japanese B
encephalitis
• Kala azar
• Leptospirosis
• Malaria
• Measles
• Melioidosis
• Meningococcal
Meningitis
• Mumps
• Paratyphoid
• Pertussis
• Pneumonia
• Poliomyelitis
• PUO
• Rabies
• Rubella
• Scarlet fever
• Scrub Typhus
• Streptococcus suis
• Tetanus
• Trichinosis
• Tuberculosis
• Typhoid
Surat Piwsawang MD
5. C O M M U N I C A B L E D I S E A S E S
• Anthrax
• Chickenpox
• Chikungunya
• Cholera
• Dengue
• Diarrhea - ROTA
• Diphtheria
• Dysentery,Amoebic
• Dysentery,Bacillary
• Encephalitis
• Meningitis
• Filariasis
• Food Poisoning
• H.conjunctivitis
• Hand,foot and mouth
disease
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Hepatitis D
• Hepatitis E
• Hib
• HIV
• HPV
• Influenza
• Japanese B
encephalitis
• Kala azar
• Leptospirosis
• Malaria
• Measles
• Melioidosis
• Meningococcal
Meningitis
• Mumps
• Paratyphoid
• Pertussis
• Pneumonia
• Poliomyelitis
• PUO
• Rabies
• Rubella
• Scarlet fever
• Scrub Typhus
• Streptococcus suis
• Tetanus
• Trichinosis
• Tuberculosis
• Typhoid
Surat Piwsawang MD
6. I M M U N I Z A T I O N
Active immunizationPassive immunization
Natural
Artificial
Vaccine
Post-infectionBreast Milk
Serum/Ig
Surat Piwsawang MD
11. T U B E R C U L O S I S
• Pathogen: Mycobacterium tuberculosis
• Symptoms: Chronic cough, weight loss, chronic fever
• Transmission: Airborne
Surat Piwsawang MD
12. B C G
• ถ้าไม่มีแผลเป็น และไม่มีหลักฐานว่าเคยได้รับมาก่อน อายุ > 6 mให้ฉีดได้ทันที
Efficacy: 80% for TB meningitis, miliary TB
~50% for pulmonary TB
Adverse effect:
• Local abscess, regional lymphadenitis
• Distant BCG osteitis, arthritis
• Disseminate (mostly in immunocompromised)
Surat Piwsawang MD
13. H B V
• Pathogen: Viral hepatitis B
• Symptoms: Fever, jaundice, fatigue, vomiting
• Transmission: Blood, secretion, IVDU, Sexual intercourse,
maternal to fetal transmission
Surat Piwsawang MD
14. H B V V A C C I N E
• หากผลเลือดมารดา
- HBsAg +ve, HBeAg +ve: ให้ HBIG (0.5 mL )+ HBV ภายใน 12 hr (ฉีดอย่างละข้าง)
- HBsAg +ve, HBeAg -ve : ควรให้ HBIG + HBV ภายใน 12 hr (ยังไงก็เสี่ยง)
• หากไม่สามารถให้ HBIG ได้ ต้องเปลี่ยน HBV2 เป็นฉีดที่ 1 เดือนแทนที่ 2 เดือน
• ตรวจ HBsAg และ Anti-HBs ที่อายุ 9-18 m
- HBs Ag -ve, Anti-HBs >= 10 mIU/mL -- protected
- HBsAg -ve, Anti-HBs < 10 mIU/mL -- ให้ซ้าอีก 3 dose (0-2-6) ตรวจซ้าที่ 1-2 m หลังdose สุดท้าย
- if < 10 mIU/mL: ไม่ต้องซ้าแล้ว advice ให้ HBIG เมื่อเกิด event
- HBsAg +ve - appropriate follow up
Surat Piwsawang MD
15. D I P H T H E R I A
Pathogen: Corynebacterium diphtheria
Symptoms: Low-grade fever, extensive neck swelling with cervical
lymphadenitis (bull neck), obstructive laryngotracheitis
Transmission: Droplets & Contact with discharges from skin lesion
Surat Piwsawang MD
16. T E T A N U S
Pathogen: Clostridium tetani
Symptoms: Trismus (spasm & stiffness in jaw muscles), difficult swallowing,
fever, sweating
Transmission: Spores of bacterial are found in soil, dust and animal feces.
When they enter a deep flesh wound, spores grow into bacteria that can
produce a powerful toxin, tetanospasmin, which impairs the nerves that
control your muscles (motor neurons).
Surat Piwsawang MD
17. P E R T U S S I S
Pathogen: Bordetella pertussis
Symptoms: Progresses to cough over week to months
Transmission: Droplet
Surat Piwsawang MD
24. H I B
• Pathogen: Haemophilus influenza Type B
• Hib disease can also cause
• Pneumonia
• Severe swelling in the throat
• Infections of the blood, joints, bones, and covering of the heart
• Transmission: Droplet
Surat Piwsawang MD
25. H I B V A C C I N E
- แนะนาให้ 3 ครั้ง [2, 4, 6 m] และกระตุ้นที่ 12-18 (อาจไม่ต้องให้ในเด็กแข็งแรง และเด็กไทยไม่
จาเป็นต้อง boost)
- หากอายุ > 2 yr อาจไม่จาเป็นต้องฉีด ยกเว้นกลุ่มเสี่ยง: ไม่มีม้าม ม้ามทางานผิดปกติ หรือภูมิบกพร่อง
[2 เข็ม: 0(เข็มแรก), 2 m]
Surat Piwsawang MD
26. P O L I O
• Pathogen: Polio virus type 1, 2, 3
• Symptoms:
• Loss of reflex
• Severe muscle ache and weakness
• Transmission: Contact
Surat Piwsawang MD
27. P O L I O
V A C C I N E S- OPV (live) สามารถทาให้เกิด VAPP: Vaccine Associated Paralytic
Poliomyelitis
แต่ IPV (killed) ไม่เกิด
- ระยะฟักตัว 7-14 วันหลังรับ OPV เฝ้าระวัง monoplegia (LMN lesion),
areflexia (DTR 0)
- หากสงสัยต้องส่ง stool
- หาก dose แรกให้ IPV ไปแล้ว dose กระตุ้นใช้เป็น OPV ก็ได้ เนื่องจากมีภูมิแล้ว
- สามารถใช้ชนิดฉีดแทนชนิดกินได้ทุกครั้ง หากใช้ชนิดฉีดอย่างเดียวโดยตลอดอาจให้เพียง 4 ครั้ง
โดยงดเมื่ออายุ 18 เดือนได้ Surat Piwsawang MD
28. M U M P S
• Pathogen: Mumps virus
• Symptoms: Fever, salivary gland swelling and pain
• Transmission: Droplet
Surat Piwsawang MD
29. M E A S L E S
• Pathogen: Paramyxovirus
• Symptoms: Fever, conjunctivitis, Koplik spots, maculopapular
rash
• Transmission: Airborne
Surat Piwsawang MD
30. R U B E L L A
• Pathogen: Family Togaviridae
• Symptoms: Fever, maculopapular rash, suboccipital,
retroauricular, posterior cervical lymphadenopathy
• Transmission: Droplet
Surat Piwsawang MD
31. C H I C K E N P O X
• Pathogen: Varicella zoster virus
• Symptoms: Fever, various stage macule, papule and vesicle
rash
• Transmission: Airborne
Surat Piwsawang MD
32. M M R V A C C I N E
- ถ้าระบาด ฉีดเร็วได้เลย อายุต่าสุดที่ฉีดได้คือ
6 เดือน แต่เข็มนั้นจะไม่นับ เมื่ออายุ 1 ปีต้องนัดฉีด MMR1 ใหม่
- ถ้า MMR1 ฉีดเมื่อ 9 เดือน MMR2 ต้องฉีดที่ 2
1/2 yr
- ถ้า MMR1 ฉีดเมื่อ 12 เดือน MMR2 ฉีดที่ 4 ปี
- ยังพบ Mump ได้ แม้ฉีด MMR แต่ vaccine ก็
ช่วยลดอุบัติการณ์ลงได้
Post exposure prophylaxis
+ Measle
- age < 6 mo ไม่ต้องให้ เนื่องจากมีภูมิจากแม่
- MMR: effective if given within 3 daysafter exposure to
measle
- Immunoglobulin: effective for as long as 6 days after
exposure
- ให้ในเด็ก < 1 ปีที่ exposed measle พร้อมให้ MMR vacine
หากให้ภายใน 3 วัน
- ไม่แนะนาให้ในเด็กที่เคยได้รับ MMR มาแล้ว 1 ครั้งที่อายุ 1 ปี หรือ
เด็กที่อายุเกิน 1 ปี
- ยกเว้นกลุ่ม severe immunocompromised ให้ไม่จากัดอายุ
+ Mumps/Rubella
33. V Z V V A C C I N E
• 1-12 yr: 2 dose (ห่างกันอย่างน้อย 3 เดือน) - อาจฉีด 1 dose ได้ แต่ efficacy จะ
ลดลง
แนะนาเข็ม 1 ตอนอายุ 12-18 เดือน
แนะนาเข็ม 2 ตอนอายุ 4-6 ปี อาจฉีดก่อน 4 ปีได้ หากระบาด
หากเป็น HIV infection ให้ dose 2 ห่างจากเข็มแรก 3 เดือน (ต้องมี
CD4 > 15%)
• >= 13 yr: 2 dose (ห่างกันอย่างน้อย 1 เดือน)
Surat Piwsawang MD
34. J A P A N E S E E N C E P H A L I T I S
• Pathogen: Japanese B encephalitis virus
• Symptoms: High grade fever, headache, vomiting
• Transmission: pig -> mosquito -> human
Surat Piwsawang MD
35. J E
Inactivated vaccine: 3 dose (0,1,12 m : เข็มแรก 9-18 m)
- MB-JE: Mouse brain JE
- JEVAC (R): vero cell
Live vaccine: 2 dose
- CD-JEVAX (R): 2 dose (0, 3-12 m: เข็มแรก 9-12 m)
- IMOJEV (R): 2 dose (0, 12-24 m : เข็มแรก 12 m) (no gelatin เหมาะกับคนแพ้)
Surat Piwsawang MD
37. H A V
• Pathogen: Viral hepatitis A
• Symptoms: Fever, jaundice, fatigue, vomiting
• Transmission: Personal contacts, IVDU, Sexual intercourse
Surat Piwsawang MD
38. H A V V A C C I N E
• ฉีดได้ตั้งแต่ อายุ 1 ปีขึ้นไป
• 2 dose ห่างกัน 6-12 m
Surat Piwsawang MD
39. H A V V A C C I N E
• แนะนาให้ใน
- ผู้ป่วย chronic liver disease
- ผู้ที่จะไปเที่ยวหรือทางานใน endemic area
- MSM (รักร่วมเพศ)
- ผู้ที่มีภาวะ clotting-factor disorder
Surat Piwsawang MD
40. F L U
• Pathogen: Influenza virus A, B
• Symptoms: Fever, cough, rhinorrhea, respiratory failure
• Transmission: Droplet
Surat Piwsawang MD
41. I N F L U E N Z A V A C C I N E S
- 6 m - 18 yr (โดยเฉพาะ 2 yr แรก, เด็กที่มี U/D, BMI > 35, asthma, HIV, Thalasemia,
preg trimeter 2-3 ซึ่งจะช่วยป้องกันในทารกอายุ < 6 m ที่ฉีดวัคซีนไม่ได้, DM, CRF)
- ถ้าอายุ < 9 yr การฉีดในปีแรก ต้อง 2 เข็ม ห่างกัน 1 เดือน
หากปีแรกฉีดเข็มเดียว ปีถัดมาก็ต้อง 2 เข็ม ปีถัดไปจึงจะฉีดปีละเข็มได้
- ถ้าอายุ < 3 yr ลดขนาดครึ่งหนึ่ง (0.25 mL)
Surat Piwsawang MD
42. R O T A D I A R R H E A
• Pathogen: Rota virus
• Symptoms: Anorexia, low-grade fever, watery/bloodless diarrhea,
vomiting, abdominal cramps
• Transmission: Contact
Surat Piwsawang MD
43. R O T A V A C C I N E S
• 1st dose: min 6 wk, max 15 wk
• last dose: max age last 8 m
- RotaRix (R) (Monovalent): 2 dose (2, 4 m)
- RotaTeq (R) (Pentamalent): 3 dose (2, 4, 6 m)
Surat Piwsawang MD
44. C E R V I C A L C A N C E R
• Cause: Many cause and human papilloma virus 16, 18
Surat Piwsawang MD
45. H P V V A C C I N E S
• Bivalent (16,18): Cervarix: female only (0, 1, 6 m)
• Quadrivalent (6,11,16,18): Gardasil: male and female (0, 2, 6 m)
- อายุ 9-26 yr
- ในเด็ก 9-13 ปี สามารถให้ 2 เข็ม 0, 6 ได้
- ในเด็ก 14 ปีขึ้นไป ให้ฉีด 0, 1, 6 m (Cervarix) or 0, 2, 6 m (Gardasil) เท่านั้น
Surat Piwsawang MD
47. I P D : I N V A S I V E P N E U M O C O C C A L D I S E A S E
• Pathogen: Streptococcus pneumoniae
• Symptoms: depending on the site of infection
• Pneumonia
• Acute otitis media
• Meningitis
• Bacteremia
Surat Piwsawang MD
48. I P D : I N V A S I V E P N E U M O C O C C A L D I S E A S E
• PCV: Pneumococcal conjugate vaccine: ให้ในอายุ < 2 yr ได้, กระตุ้น T-cell เกิด Memory ได้ดี
- Synflorix: 10 สายพันธุ์ [2, 4, 6, 12-15 m]
- Prevnar 13: 13 สายพันธุ์ [2, 4, 6, 12-15 m]
• Pneumococcal polysaccharide vaccine: ห้ามให้ในอายุ < 2 yr, ไม่ค่อยเกิด memory
- PS-23 ให้ในเด็กกลุ่มเสี่ยงที่อายุ > 2 ปี ไม่ว่าจะเคยฉีด PCV มาหรือไม่ก็ตาม
- ที่มีจาหน่ายในไทย คือ Pneumo 23
Surat Piwsawang MD
49. I P D : I N V A S I V E P N E U M O C O C C A L D I S E A S E
• ควรให้ในเด็ก
• มีความเสี่ยง ได้แก่ เด็กที่ตัดม้าม ธาลัสซีเมีย โรคปอด หัวใจ ตับ ไต
เบาหวาน
• เด็กเสี่ยงให้ PCV13 เท่านั้น
• เด็กแข็งแรงปกติที่อายุ < 5 ปี ที่ประสงค์จะป้องกันโรค
• เด็กปกติ อาจฉีดแค่ 3 ครั้ง คือ 2, 4 และ 12-15 เดือน
Surat Piwsawang MD
50. I P D : I N V A S I V E P N E U M O C O C C A L D I S E A S E
• การฉีด PCV ก่อน ตามด้วย PS-23 ช่วยสร้างภูมิคุ้มกันได้ดีกว่า การฉีด PS-23 อย่างเดียว หรือ ฉีด PS-23 ตามด้วย PCV
• เพื่อการครอบคลุมหลาย serotype
• เด็ก อาจเริ่มจาก PCV 1-3 ครั้งแล้วแต่อายุ และกระตุ้นด้วย PS-23 x 1 ครั้ง
• ผู้ใหญ่ >=50 yo ให้ฉีด PCV13 x 1 เข็ม และตามด้วย PS-23 x 1 เข็ม ห่างกัน >= 8 wk
• การฉีดป้องกันในเด็กที่จะผ่าตัดม้าม ใช้ PS-23
dose 1: ก่อนตัดม้าม >=2 wk ในเด็กอายุ >=2 ปีและผู้ใหญ่
dose 2: อาจฉีดอีกครั้งเพื่อกระตุ้น (max ทั้งชีวิตไม่เกิน 2 เข็ม)
- อายุ < 10 ปี ฉีดกระตุ้นห่างจากเข็มแรก 3 ปี
- อายุ >= 10 ปี ฉีดกระตุ้นห่างจากเข็มแรก 5 ปี
Surat Piwsawang MD
51. D E N G U E F E V E R
• Pathogen: Dengue virus (arboviral)
• Symptoms: Fever, headache, retro-orbital pain, myalgia, anorexia
• Transmission: Mosquitoes of the genus Aedes aegypti
Surat Piwsawang MD
52. D E N G U E V A C C I N E
• ลดความรุนแรงของโรค: 93.2%
• ลดอัตราการนอน รพ.: 80.8%
• ป้องกันไข้เลือดออกได้: 65.6%
เหมาะสาหรับ
• อายุ 9-45 ปี ที่อยู่ในเขตโรคระบาด
การบริหารยา
• 3 เข็ม ห่างกันเข็มละ 6 เดือน
Surat Piwsawang MD
53. R A B I E S
• Pathogen: Rabies virus
• Symptoms: Anorexia, headaches, fever, chill, emesis, anxiety,
agitation, depression
• Transmission: Mammal bites
Surat Piwsawang MD
54. R A B I E S V A C C I N E
ลักษณะแผล
Gr 1: คลุกคลี ไม่มีรอยข่วน เลียผิวหนังที่ไม่มีแผล
Gr 2: รอยข่วน เลียผิวหนังที่มีแผล กัดผ่านผ้าเกิดรอยช้า
Gr 3: แผลลึก เลียเยื่อบุ กดที่หัว/ใบหน้า
Surat Piwsawang MD
55. R A B I E S V A C C I N E
Pre exposure
- อาจพิจาณาให้ในกรณีที่ผู้ป่วยมีปัจจัยเสี่ยงในการสัมผัส
โรค
- Rabies vaccine - IM 0, 7, 21 หรือ
0, 7, 28, หรือฉีดพร้อม. EPI
Post exposure
- RIG ให้ในแผล Gr 3 ทุกกรณี (ภายใน 7 วันเท่านั้น ถ้าเกิน + เพิ่งได้
vaccine มาตอนช่วงแรก ไม่ให้เนื่องจากจะไป block vaccine)+
Rabies vaccine
- Rabies vaccine
- แผล Gr 1: no / พิจารณาให้เป็น Pre exposure
vaccine x 3 dose [0, 7, 28]
- แผล Gr 2-3: vaccine x 5 dose [0, 3, 7 ,14,
28]
- หากเคยได้รับ vaccine อย่างน้อย 3 เข็ม ไม่ต้องให้ RIG และ
พิจารณาให้ vaccine
< 6 m: ฉีดกระตุ้น 1 เข็ม
> 6 m: ฉีดกระตุ้น 2 เข็ม [0, 3]
- คนท้องรักษาเหมือนปกติ
Surat Piwsawang MD