This document discusses acute viral encephalitis and meningitis. It defines encephalitis as inflammation of the brain parenchyma that can be caused by over 100 viruses worldwide. The most common viral causes include herpes simplex virus, enteroviruses, influenza, and arboviruses such as Japanese encephalitis virus and West Nile virus. Clinical manifestations vary but often include fever, headache, seizures, and altered mental status. Diagnosis involves CSF analysis, imaging, and PCR testing. Treatment focuses on supportive care and antivirals like acyclovir. Outcomes depend on the causal virus and status of the patient at presentation.
Clinical Approach To Aseptic Meningitis and Encephalitis
Virology Rotation (R2) , Clinical Microbiology Residency
King Fahd Hospital of The University
23/4/2019
Infectious mononucleosis Made Extremely Simple!!! DrYusraShabbir
A brief description of a very common illness causing fever, rash and sore throat. Blood profile is altered. Commonly seen in adults as well as young children. Extremely useful for doctors, medical students, MD, dermatologists, pediatricians and Nurses.
Clinical Approach To Aseptic Meningitis and Encephalitis
Virology Rotation (R2) , Clinical Microbiology Residency
King Fahd Hospital of The University
23/4/2019
Infectious mononucleosis Made Extremely Simple!!! DrYusraShabbir
A brief description of a very common illness causing fever, rash and sore throat. Blood profile is altered. Commonly seen in adults as well as young children. Extremely useful for doctors, medical students, MD, dermatologists, pediatricians and Nurses.
infestation with or disease caused by Clonorchis sinensis
invades bile ducts of the liver after ingestion in uncooked fish and when present in large numbers causes severe systemic reactions
Acute meningoencephalitis Powerpoint presentation.
It comprises of acute meningitis and acute encephalitis, their clinical features, physical assesment, diagnosis and treatment.
infestation with or disease caused by Clonorchis sinensis
invades bile ducts of the liver after ingestion in uncooked fish and when present in large numbers causes severe systemic reactions
Acute meningoencephalitis Powerpoint presentation.
It comprises of acute meningitis and acute encephalitis, their clinical features, physical assesment, diagnosis and treatment.
Pierre Janin is an intensivist with many interests. For example you may have seen his fantastic echo guide or his talk on transcranial doppler. One of his other passions is microbiology, and at BCC last year he gave this talk on Fungal infections. He often proudly shows pictures of his fungal balls on ward rounds.
Rabies.pptx(Epidemiology,pathophysiology.clinical features and prevention)Melaku Yetbarek,MD
As rabies is one of public health important health issue,particularly in developing countries,this slide gives an overview of epidemiology,clinical features and prevention of rabies.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. Introduction
• Encephalitis is an acute inflammatory process affecting the brain
parenchyma
• Meningoencephalitis
• Encephalomyelitis
• Encephalomyeloradiculitis
• Viral infection is the most common and important cause, with
over 100 viruses implicated worldwide
• Incidence of 3.5-7.4 per 100,000 persons per year
• ~20,000 cases reported anually in USA
3. Causes of Viral Encephalitis
• Herpes viruses – HSV-1, HSV-2, varicella zoster virus, cytomegalovirus, EpsteinBarr virus, human herpes virus 6
• Adenoviruses
• Influenza A
• Enteroviruses, poliovirus
• Measles, mumps, and rubella viruses
• Rabies
• Arboviruses – examples: Japanese encephalitis; St. Louis encephalitis virus;
West Nile encephalitis virus; Eastern, Western and Venzuelan equine
encephalitis virus; tick borne encephalitis virus
• Bunyaviruses – examples: La Crosse strain of California virus
• Reoviruses – example: Colorado tick fever virus
• Arenaviruses – example: lymphocytic choriomeningitis virus
4. What Is An Arbovirus?
• Arboviruses = arthropod-borne viruses
• Arboviruses are maintained in nature through biological
transmission between susceptible vertebrate hosts by bloodfeeding arthropods
• Vertebrate infection occurs when the infected arthropod
takes a blood meal
5. Major Arboviruses That Cause
Encephalitis
• Flaviviridae
• Japanese encephalitis
• St. Louis encephalitis
• West Nile
• Togaviridae
• Eastern equine encephalitis
• Western equine encephalitis
• Bunyaviridae
• La Crosse encephalitis
8. Japanese Encephalitis
• Flavivirus related to St. Louis
encephalitis
• Most important cause of
arboviral encephalitis worldwide,
with over 45,000 cases reported
annually
• Transmitted by culex mosquito,
which breeds in rice fields
• Mosquitoes become infected by
feeding on domestic pigs and wild
birds infected with Japanese
encephalitis virus. Infected
mosquitoes transmit virus to
humans and animals during the
feeding process.
9. History of Japanese
Encephalitis
• 1800s – recognized in Japan
• 1924 – Japan epidemic. 6125 cases, 3797 deaths
• 1935 – virus isolated in brain of Japanese patient
who died of encephalitis
• 1938 – virus isolated from Culex mosquitoes in
Japan
• Today – extremely prevalent in South East Asia.
30,000-50,000 cases reported each year.
12. West Nile Virus
• Flavivirus
• Primary host – wild
birds
• Principal arthropod
vector – mosquitoes
• Geographic distribution
- Africa, Middle East,
Western Asia, Europe,
Australia, North
America, Central
America
http://www.walgreens.com/images/library/healthtips/july02/westnilea.jpg
14. St. Louis Encephalitis
• Flavivirus
• Most common
mosquito-transmitted
human pathogen in the
US
• Leading cause of
epidemic flaviviral
encephalitis
15. Eastern Equine Encephalitis
• Togavirus
• Caused by a virus transmitted to
humans and horses by the bite of
an infected mosquito.
• 200 confirmed cases in the US
1964-present
• Human cases occur relatively
infrequently, largely because the
primary transmission cycle takes
place in swamp areas where
populations tend to be limited.
16. Western Equine Encephalitis
• Togavirus
• Mosquito-borne
• 639 confirmed cases in
the US since 1964
• Important cause of
encephalitis in horses
and humans in North
America, mainly in the
Western parts of the US
and Canada
17. La Crosse Encephalitis
• Bunyavirus
• On average 75 cases per year
reported to the CDC
• Most cases occur in children under
16 years old
• Zoonotic pathogen that cycles
between the daytime biting treehole
mosquito, and vertebrate amplifier
hosts (chipmunk, tree squirrel) in
deciduous forest habitats
• 1963 – isolated in La Crosse, WI from
the brain of a child who died from
encephalitis
18. Summary – Confirmed and Probable
Human Cases in the US
Virus
Years
Total cases
Eastern Equine
1964-2000
182
Western Equine 1964-2000
649
La Crosse
1964-2000
2,776
St. Louis
1964-2000
4,482
West Nile
1999-present
> 9,800
21. Symptoms
• Fever
• Headache,
• Malaise, Anorexia, Nausea and Vomiting
• Abdominal pain
• Altered level of consciousness
• Mild lethargy to Coma
• Behavioral changes, hallucinations, agitations,
personality changes, frank psychosis
22. • Focal neurologic deficits:
• Virtually every possible focal neurological disturbance
has been reported.
• Aphasia
• Ataxia
• Weakness: Hemiparesis with hyperactive tendon
reflexes
• Cranial nerve deficits
• Involantary movements- tremors, myoclonic jerks
• Seizures >50% patients
• SIADH
23. Patient History
• Detailed history critical to determine the likely cause of encephalitis.
• Prodromal illness, recent vaccination, development of few days →
Acute Disseminated Encephalomyelitis (ADEM) .
• Biphasic onset: systemic illness then CNS disease → Enterovirus
encephalitis.
• Abrupt onset, rapid progression over few days → HSE.
• Recent travel and the geographical context:
• Africa → Cerebral malaria
• Asia → Japanese encephalitis
• High risk regions of Europe and USA → Lyme disease
• Recent animal bites → Tick borne encephalitis or Rabies.
• Occupation
• Forest worker, exposed to tick bites
• Medical personnel, possible exposure to infectious diseases.
24. Lab Investigation
• CSF examination: Should be performed in all the
patients until contraindicated
• Diagnosis is usually based on CSF
•
•
•
•
•
Mild increase in protein
Inrease cells with predominantly lymphocytes
Normal glucose
Absence of bacteria on culture.
Viruses occasionally isolated directly from CSF
• Less than half are identified
25. Laboratory Diagnosis
• CSF PCR techniques
• Detect specific viral DNA in CSF
• Usually available for HSVCMV, EBV, HHV6, ENTEROVIRUS, VZV
• CSF CULTURE
26. MRI/ CT Scan
• Can exclude subdural bleeds, tumor, and sinus
thrombosis
• Help by
• Focal or diffuse ence4phalitis process
• In HSV encephalitis- 80% abnormalities in temporal lobe
29. EEG
• In HSV: Periodic focal temporal lobe spikes on a background of
slow or low amplitude activity.
30. Brain Biopsy
• Is generally reserved for patients in whom CSF PCR fail to lead
a specific diagnosis
•
Reserved for patients who are worsening, have an undiagnosed
lesion after scan, or a poor response to acyclovir.
33. Supportive Therapy
• Fever, dehydration, electrolyte imbalances, and
convulsions require treatment.
• For cerebral edema severe enough to produce
herniation, controlled hyperventilation,
mannitol, and dexamethasone.
• Patients with cerebral edema must not be overhydrated.
• If these measures are used, monitoring ICP should be considered.
• If there is evidence of ventricular enlargement,
intracranial pressure may be monitored in
conjunction with CSF drainage.
34. Acyclovir
• Acyclovir is a synthetic purine nucleoside analogue with
inhibitory activity against HSV-1 and HSV-2, varicella-zoster
virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus
(CMV)
• In order of decreasing effectiveness
• Acyclovir 10 mg/kg 8 hrly 14-21day
35. Acyclovir Action
• Thymidine Kinase (TK) of uninfected cells does not use acyclovir as a
substrate.
• TK encoded by HSV, VZV and EBV2 converts acyclovir into acyclovir
monophosphate.
• The monophosphate is further converted into diphosphate by
cellular guanylate kinase and into triphosphate by a number of
cellular enzymes.
• Acyclovir triphosphate interferes with Herpes simplex virus DNA
polymerase and inhibits viral DNA replication.
• Acyclovir triphosphate incorporated into growing chains of DNA by
viral DNA polymerase.
• When incorporation occurs, the DNA chain is terminated.
• Acyclovir is preferentially taken up and selectively converted to the
active triphosphate form by HSV-infected cells.
• Thus, acyclovir is much less toxic in vitro for normal uninfected cells
because: 1) less is taken up; 2) less is converted to the active form.
36. • Ganicyclovir/Foscarnet: For CMV related CNS infection
• Ganicyclovir 5mg/kg (over 1 hr) 12 hrly during induction therapy
the od in maintenance therapy
• Foscarnet: 60mg/kg 8hrly during induction then maintenance 60120 mg/kg
37. Dexamethasone
• Synthetic adrenocortical steroid
• Potent anti-inflammatory effects
• Dexamethasone injection is generally administered initially via
IV then IM
• Side effects: convulsions; increased ICP after treatment;
vertigo; headache; psychic disturbances
38. Prognosis
• The mortality rate varies with etiology, and epidemics
due to the same virus vary in severity in different years.
• Bad: Eastern equine encephalitis virus infection, nearly 80% of
survivors have severe neurological sequelae.
• Not so Bad: EBV, California encephalitis virus, and Venezuelan
equine encephalitis virus, severe sequelae are unusual.
• Approximately 5 to 15% of children infected with LaCrosse virus
have a residual seizure disorder, and 1% have persistent
hemiparesis.
• Permanent cerebral sequelae are more likely to occur in
infants, but young children improve for a longer time
than adults with similar infections.
• Intellectual impairment, learning disabilities, hearing loss, and
other lasting sequelae have been reported in some studies.
39. Prognosis w/ Treatment
• Considerable variation in the incidence and severity of sequelae.
• Hard to assess effects of treatment.
• NIAID-CASG trials:
• The incidence and severity of sequelae were directly related to the age
of the patient and the level of consciousness at the time of initiation of
therapy.
• Patients with severe neurological impairment (Glasgow coma score 6) at
initiation of therapy either died or survived with severe sequelae.
• Young patients (<30 years) with good neurological function at initiation
of therapy did substantially better (100% survival, 62% with no or mild
sequelae) compared with their older counterparts (>30 years); (64%
survival, 57% no or mild sequelae).
• Recent studies using quantitative CSF PCR tests for HSV indicate that
clinical outcome following treatment also correlates with the
amount of HSV DNA present in CSF at the time of presentation.
40. Vaccination
• None for most Encephalitides
• JE
• Appears to be 91% effective
• There is no JE-specific therapy other than supportive
care
• Live-attenuated vaccine developed and tested in China
• Appears to be safe and effective
• Chinese immunization programs involving millions of children
• Vero cell-derived inactivated vaccines have been
developed in China
• 2 millions doses are produced annually in China and Japan
• Several other JE vaccines under development