VACCINATION SCHEDULE 2021-22

20yrs female c/o intractable hiccups since 1month CBC uric acid .BL urea Srcret tsh normal what other investigations needed to diagnosis

Hi Curofians, here are some vaccine-preventable diseases. I have prepared slides on the signs and symptoms of these diseases. It could be prevented with vaccinations. We should support the Child and Adult Immunization and spread the information to the community.

According to the World Health Organization , waterborne diseases account for an estimated 3.6% of the total DALY (disability- adjusted life year) global burden of disease , and cause about 1.5 million human deaths annually. The World Health Organization estimates that 58% of that burden, or 842,000 deaths per year, is attributable to a lack of safe drinking water supply, sanitation and hygiene (summarized as WASH ). [1] Overview The term waterborne disease is reserved largely for infections that predominantly are transmitted through contact with or consumption of infected water. Trivially, many infections may be transmitted by microbes or parasites that accidentally, possibly as a result of exceptional circumstances, have entered the water, but the fact that there might be an occasional freak infection need not mean that it is useful to categorise the resulting disease as "waterborne". Nor is it common practice to refer to diseases such as malaria as "waterborne" just because mosquitoes have aquatic phases in their life cycles, or because treating the water they inhabit happens to be an effective strategy in control of the mosquitoes that are the vectors . Microorganisms causing diseases that characteristically are waterborne prominently include protozoa and bacteria , many of which are intestinal parasites , or invade the tissues or circulatory system through walls of the digestive tract. Various other waterborne diseases are caused by viruses . (In spite of philosophical difficulties associated with defining viruses as " organisms ", it is practical and convenient to regard them as microorganisms in this connection.) Yet other important classes of water- borne diseases are caused by metazoan parasites. Typical examples include certain Nematoda , that is to say "roundworms". As an example of water-borne Nematode infections, one important waterborne nematodal disease is Dracunculiasis . It is acquired by swallowing water in which certain copepoda occur that act as vectors for the Nematoda. Anyone swallowing a copepod that happens to be infected with Nematode larvae in the genus Dracunculus , becomes liable to infection. The larvae cause guinea worm disease . [2] Another class of waterbornemetazoan pathogens are certain members of the Schistosomatidae , a family of blood flukes . They usually infect victims that make skin contact with the water. [2] Blood flukes are pathogens that cause Schistosomiasis of various forms, more or less seriously affecting hundreds of millions of people worldwide. [3] Long before modern studies had established the germ theory of disease , or any advanced understanding of the nature of water as a vehicle for transmitting disease, traditional beliefs had cautioned against the consumption of water, rather favouring processed beverages such as beer , wine and tea . For example, in the camel caravans that crossed Central Asia along the Silk Road , the explorer Owen Lattimore noted, "The reason we drank so much tea was because of the bad water. Water alone, unboiled, is never drunk. There is a superstition that it causes blisters on the feet." [4] Socioeconomic impact Waterborne diseases can have a significant impact on the economy, locally as well as internationally. People who are infected by a waterborne disease are usually confronted with related costs and not seldom with a huge financial burden. This is especially the case in less developed countries. The financial losses are mostly caused by e.g. costs for medical treatment and medication, costs for transport, special food, and by the loss of manpower. Many families must even sell their land to pay for treatment in a proper hospital. On average, a family spends about 10% of the monthly households income per person infected. [5] Infections by type of pathogen Protozoan Disease and Transmission Microbial Agent Sources of Agent in Water Supply General Symptoms Amoebiasis (hand-to-mouth) Protozoan ( Entamoeba histolytica ) (Cyst-like appearance) Sewage , non- treated drinking water , flies in water supply, saliva transfer (if the other person has the disease) Abdominal discomfort, fatigue , weight loss, diarrhea , bloating , fever Cryptosporidiosis (oral) Protozoan ( Cryptosporidium parvum ) Collects on water filters and membranes that cannot be disinfected , animal manure , seasonalrunoff of water. Flu-like symptoms , watery diarrhea, loss of appetite, substantial loss of weight, bloating , increased gas, nausea Cyclosporiasis Protozoan parasite ( Cyclospora cayetanensis ) Sewage , non- treated drinking water cramps , nausea, vomiting , muscle aches, fever, and fatigue Giardiasis (fecal- oral) (hand-to- mouth) Protozoan ( Giardia lamblia ) Most common intestinal parasite Untreated water, poor disinfection, pipe breaks, leaks, groundwater contamination, campgrounds where humans and wildlife use same source of water. Beavers and muskrats createponds that act as reservoirsfor Giardia. Diarrhea, abdominal discomfort, bloating , and flatulence Microsporidiosis Protozoan phylum ( Microsporidia ), but closely related to fungi Encephalitozoon intestinalis has been detected in groundwater , the origin of drinking water [6] Diarrhea and wasting in immunocompromised individuals. Bacterial Disease and Transmission Microbial Agent Sources of Agent in Water Supply General Symptoms Botulism Clostridium botulinum Bacteria can enter an open wound from contaminated water sources. Can enter the gastrointestinal tract through consumption of contaminated drinking water or (more commonly) food Dry mouth, blurred and/or double vision , difficulty swallowing, muscle weakness, difficulty breathing, slurred speech, vomiting and sometimes diarrhea . Death is usually caused by respiratory failure . Campylobacteriosis Most commonly caused by Campylobacter jejuni Drinking water contaminated with feces Produces dysentery like symptoms along with a high fever . Usually lasts 2–10 days. Cholera Spread by the bacterium Vibrio cholerae Drinking water contaminated with the bacterium In severe forms it is known to be one of the most rapidly fatal illnesses known. Symptoms include very watery diarrhea, nausea , cramps , nosebleed , rapid pulse , vomiting, and hypovolemic shock (in severe cases), at which point death can occur in 12–18 hours. E. coli Infection Certain strains of Escherichia coli (commonly E. coli ) Water contaminated with the bacteria Mostly diarrhea. Can cause death in immunocompromised individuals, the very young, and the elderly due to dehydration from prolonged illness. M. marinum infection Mycobacterium marinum Naturally occurs in water, most cases from exposure in swimming poolsor more frequently aquariums ; rare infection since it mostly infects immunocompromised individuals Symptoms include lesions typically located on the elbows, knees, and feet (from swimming pools ) or lesions on the hands ( aquariums ). Lesions may be painless or painful. Dysentery Caused by a number of species in the genera Shigella and Salmonella with the most common being Shigella dysenteriae Water contaminated with the bacterium Frequent passage of feces with blood and/ or mucus and in some cases vomiting of blood. Legionellosis(two distinct forms: Legionnaires' disease and Pontiac fever) Caused by bacteria belonging to genus Legionella (90% of cases caused by Legionella pneumophila ) Legionella is a very common organism that reproduces to high numbers in warm water; [7] but only causes severe disease when aerosolized. [8] Pontiac fever produces milder symptoms resembling acute influenza without pneumonia . Legionnaires' disease has severe symptoms such as fever , chills , pneumonia (with cough that sometimes produces sputum ), ataxia , anorexia , muscle aches, malaiseand occasionally diarrhea and vomiting Leptospirosis Caused by bacterium of genus Leptospira Water contaminated by the animal urine carrying the bacteria Begins with flu-like symptoms then resolves. The second phase then occurs involving meningitis , liver damage (causes jaundice ), and renal failure Otitis Externa (swimmer's ear) Caused by a number of bacterial and fungal species. Swimming in water contaminated by the responsible pathogens Ear canal swells, causing pain and tenderness to the touch Salmonellosis Caused by many bacteria of genus Salmonella Drinking water contaminated with the bacteria. More common as a food borne illness . Symptoms include diarrhea , fever , vomiting, and abdominal cramps Typhoid fever Salmonella typhi Ingestion of water contaminated with feces of an infected person Characterized by sustained fever up to 40 °C (104 °F), profusesweating ; diarrhea may occur. Symptoms progress to delirium , and the spleen and liver enlarge if untreated. In this case it can last up to four weeks and cause death. Some people with typhoid fever develop a rash called "rose spots", small red spots on the abdomen and chest. Vibrio Illness Vibrio vulnificus , Vibrio alginolyticus , and Vibrio parahaemolyticus Can enter wounds from contaminated water. Also acquired by drinking contaminated water or eating undercooked oysters . Symptoms include abdominal tenderness, agitation, bloody stools, chills, confusion, difficulty paying attention (attention deficit), delirium, fluctuating mood, hallucination, nosebleeds, severe fatigue, slow, sluggish, lethargic feeling, weakness. [9][10] Viral Disease and Transmission Viral Agent Sources of Agent in Water Supply General Symptoms SARS(Severe Acute Respiratory Syndrome) Coronavirus Manifests itself in improperly treated water Symptoms include fever , myalgia , lethargy , gastrointestinal symptoms , cough , and sore throat Hepatitis A Hepatitis A virus (HAV) Can manifest itself in water (and food) Symptoms are only acute (no chronic stage to the virus) and include Fatigue , fever, abdominal pain, nausea, diarrhea, weight loss, itching, jaundice and depression . Poliomyelitis (Polio) Poliovirus Enters water through the feces of infected individuals 90-95% of patients show no symptoms, 4-8% have minor symptoms (comparatively) with delirium , headache , fever , and occasional seizures , and spastic paralysis , 1% have symptoms of non- paralytic aseptic meningitis . The rest have serious symptoms resulting in paralysisor death Polyomavirus infection Two of Polyomavirus : JC virus and BK virus Very widespread, can manifest itself in water, ~80% of the population has antibodies to Polyomavirus BK virus produces a mild respiratory infection and can infect the kidneys of immunosuppressed transplantpatients. JC virus infects the respiratory system , kidneys or can cause progressive multifocal leukoencephalopathy in the brain (which is fatal). [6][11] Algal Disease and Transmission Microbial Agent Sources of Agent in Water Supply General Symptoms Desmodesmus infection desmodesmus

Todays Herb ALOE VERA (Kumari) Ras -Tikta kashay virya- Shit vipak- Katu Doshghnata- Kapha pitta

Hepatitis *Hepatitis* refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection, but there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.  Timeline 8th Century:  Infectious Nature of HBV suggested 17th-19th Centuries:  Outbreaks of epidemics of jaundice in military and civilian populations during wars 1883:  Lurman reports outbreaks of serum hepatitis follwing vaccination of dockers 1908: McDonald postulates that the infectious jaundice is caused by a virus 1939-1945: WWII-A series of outbreaks after vaccination for measles and yellow fever 1947: MacCallum classifies viral hepatitis into two types- Viral hepatitis A—> Infectious hepatitisViral hepatitis B—> Serum hepatitis 1965: Blumberg discovers Australia antigen (HBsAg) in aborigines and shows presence of antigen at high frequency in patients with leukemia and children with Down’s syndrome 1970: Dane discovers the Dane particle (complete HBV particle) 1972: Discovers HBeAg 1973: Feinstone and Purcell identifies HAV 1977: Rizzetto describes delta antigen HDV 1983: Recovery of HEV 1988: Chiron group (Choo, Kuo, Houghton) closes and identifies HCV. 1995: Abbot group reports GB Virus-C (GBV-C) and Genelabs group reports in 1996 hepatitis G virus (HGV)—GBV-C=HGV 1996: Chang’s group at NTUH reports in JAMA the successful prevention of HBV infection by nation-wide vaccination on newborn babies launched in 1984 in Taiwan. 1997: Chang’s group at NTUH reports in NEJM a decrease in annual incidence rate of hepatocellular carcinoma in children ascribed to nation-wide vaccination against HBV on newborn babies launched in 1984 in Taiwan. Epidemiology Globally, viral It was the seventh leading cause of death in 2013, up from the 10th leading cause in 1990. Worldwide, HAV is responsible for an estimated 1.4 million infections annually.  About 2 billion people in the world have evidence of past or current HBV infection, with 240 million chronic carriers of HBsAg. HBV, along with the associated infection by the hepatitis D virus, is one of the most common pathogens afflicting humans. HBV leads to 650,000 deaths annually as a result of viral hepatitis–induced liver disease. The worldwide annual incidence of acute HCV infection is not easily estimated, because patients are often asymptomatic. An estimated 71 million people are chronically infected with HCV worldwide.  About 55-85% of these people infected progress to chronic HCV infection, with a 15-30% risk of developing liver cirrhosis within two decades.  China, the United States, and Russia have the largest populations of anti-HCV positive injection drug users (IDUs). It is estimated that 6.4 million IDUs worldwide are positive for antibody to hepatitis B core antigen (HBcAg) (anti-HBc), and 1.2 million are HBsAg-positive. Types and causes Viral infections of the liver that are classified as hepatitis include hepatitis A, B, C, D, and E. A different virus is responsible for each type of virally transmitted hepatitis. Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women. Hepatitis A Hepatitis A is caused by an infection with the hepatitis A virus (HAV). This type of hepatitis is most commonly transmitted by consuming food or water contaminated by feces from a person infected with hepatitis A. Hepatitis B Hepatitis B is transmitted through contact with infectious body fluids, such as blood, vaginal secretions, or semen, containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner, or sharing razors with an infected person increase your risk of getting hepatitis B. It’s estimated by the CDC that 1.2 million people in the United States and 350 million people worldwide live with this chronic disease. Hepatitis C Hepatitis C comes from the hepatitis C virus (HCV). Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact. HCV is among the most common bloodborne viral infections in the United States. Approximately 2.7 to 3.9 million Americans are currently living with a chronic form of this infection. Hepatitis D Also called delta hepatitis, hepatitis D is a serious liver disease caused by the hepatitis D virus (HDV). HDV is contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B. It’s very uncommon in the United States. Hepatitis E Hepatitis E is a waterborne disease caused by the hepatitis E virus (HEV). Hepatitis E is mainly found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply. This disease is uncommon in the United States. However, cases of hepatitis E have been reported in the Middle East, Asia, Central America, and Africa, according to the CDC. Autoimmune Hepatitis Autoimmune hepatitis is a rare form of chronic hepatitis. Like other autoimmune disorders, its exact cause is unknown. Autoimmune hepatitis may develop on its own or it may be associated with other autoimmune disorders, such as systemic lupus erythematosus. In autoimmune disorders, a misdirected immune system attacks the body’s own cells and organs (in this case the liver). Symptoms When symptoms occur, they can include: Jaundice (a yellowing of the skin and eyes)Abdominal painLoss of appetiteNausea and vomitingDiarrheaFeverClay-colored bowel movementsPainful joints  Yellowing of skin and eye  Complications of hepatitis Chronic hepatitis B or C can often lead to more serious health problems. Because the virus affects the liver, people with chronic hepatitis B or C are at risk for: Chronic liver diseaseCirrhosisLiver cancer When your liver stops functioning normally, liver failure can occur. Complications of liver failure include: Bleeding disordersA buildup of fluid in your abdomen, known as ascitesIncreased blood pressure in portal veins that enter your liver, known as portal hypertensionKidney failureHepatic encephalopathy , which can involve fatigue, memory loss, and diminished mental abilities due to the buildup of toxins, like ammonia, that affect brain functionHepatocellular carcinoma, which is a form of liver cancerDeath People with chronic hepatitis B and C are encouraged to avoid alcohol because it can accelerate liver disease and failure. Certain supplements and medications can also affect liver function. If you have chronic hepatitis B or C, check with your doctor before taking any new medications. Diagnosis and test History and physical exam To diagnose hepatitis, first your doctor will take your history to determine any risk factors you may have for infectious or noninfectious hepatitis. During a physical examination, your doctor may press down gently on your abdomen to see if there’s pain or tenderness. Your doctor may also feel to see if your liver is enlarged. If your skin or eyes are yellow, your doctor will note this during the exam. Liver function tests Liver function tests use blood samples to determine how efficiently your liver works. Abnormal results of these tests may be the first indication that there is a problem, especially if you don’t show any signs on a physical exam of liver disease. High liver enzyme levels may indicate that your liver is stressed, damaged, or not functioning properly. Other blood tests If your liver function tests are abnormal, your doctor will likely order other blood tests to detect the source of the problem. These tests can check for the viruses that cause hepatitis. They can also be used to check for antibodies that are common in conditions like autoimmune hepatitis. Ultrasound An abdominal ultrasound uses ultrasound waves to create an image of the organs within your abdomen. This test allows your doctor to take a close at your liver and nearby organs. It can reveal: Fluid in your abdomenLiver damage or enlargementLiver tumoursAbnormalities of your gallbladder Sometimes the pancreas shows up on ultrasound images as well. This can be a useful test in determining the cause of your abnormal liver function. Liver biopsy A liver biopsy is an invasive procedure that involves your doctor taking a sample of tissue from your liver. It can be done through your skin with a needle and doesn’t require surgery. Typically, an ultrasound is used to guide your doctor when taking the biopsy sample. This test allows your doctor to determine how infection or inflammation has affected your liver. It can also be used to sample any areas in your liver that appear abnormal. Treatment and medications Treatment options are determined by which type of hepatitis you have and whether the infection is acute or chronic. Hepatitis A Hepatitis A usually doesn’t require treatment because it’s a short-term illness. Bed rest may be recommended if symptoms cause a great deal of discomfort. If you experience vomiting or diarrhea , follow your doctor’s orders for hydration and nutrition. The hepatitis A vaccine is available to prevent this infection. Most children begin vaccination between ages 12 and 18 months. It’s a series of two vaccines. Vaccination for hepatitis A is also available for adults and can be combined with the hepatitis B vaccine. Hepatitis B Acute hepatitis B doesn’t require specific treatment. Chronic hepatitis B is treated with antiviral medications. This form of treatment can be costly because it must be continued for several months or years. Treatment for chronic hepatitis B also requires regular medical evaluations and monitoring to determine if the virus is responding to treatment. Hepatitis B can be prevented with vaccination. The CDC recommends hepatitis B vaccinations for all newborns. The series of three vaccines is typically completed over the first six months of childhood. The vaccine is also recommended for all healthcare and medical personnel. Hepatitis C Antiviral medications are used to treat both acute and chronic forms of hepatitis C. People who develop chronic hepatitis C are typically treated with a combination of antiviral drug therapies. They may also need further testing to determine the best form of treatment. People who develop cirrhosis (scarring of the liver) or liver disease as a result of chronic hepatitis C may be candidates for a liver transplant . Currently, there is no vaccination for hepatitis C. Hepatitis D No antiviral medications exist for the treatment of hepatitis D at this time. According to a 2013 study , a drug called alpha interferon can be used to treat hepatitis D, but it only shows improvement in about 25 to 30 percent of people. Hepatitis D can be prevented by getting the vaccination for hepatitis B, as infection with hepatitis B is necessary for hepatitis D to develop. Hepatitis E Currently, no specific medical therapies are available to treat hepatitis E. Because the infection is often acute, it typically resolves on its own. People with this type of infection are often advised to get adequate rest, drink plenty of fluids, get enough nutrients, and avoid alcohol. However, pregnant women who develop this infection require close monitoring and care. Autoimmune hepatitis Corticosteroids, like prednisone or budesonide, are extremely important in the early treatment of autoimmune hepatitis. They’re effective in about 80 percent of people with this condition.Azothioprine ( Imuran ), a drug that suppresses the immune system, is often included in treatment. It can be used with or without steroids.Other immune suppressing drugs like mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral) can also be used as alternatives to azathioprine for treatment. Prevention There are many steps you can take to reduce the risk of viral hepatitis: Consider getting vaccinated against hepatitis A and B if you weren’t vaccinated as a child. This is the number one way to prevent these illnesses.Wash your hands with soap and water after using the bathroom or changing a baby’s diaper and before handling food.When traveling in developing countries, avoid unpeeled or raw foods. Drink only bottled, boiled or chemically treated water.Practice safe sex. Hepatitis B is about 50–100 times more transmissible during sex than HIV. Condoms and other barrier methods greatly reduce the risk.Never share syringes, shaving razors, toothbrushes or tattooing or piercing supplies.Wear gloves when performing first aid.Disinfect blood spills (including dried ones) with diluted bleach and wear gloves during clean-up.Follow all occupational safety precautions in your workplace.If you are pregnant, seek early and regular prenatal care. To reduce the risk of non-viral hepatitis, avoid excessive alcohol consumption and consult with a healthcare professional about medications and supplements.