Friday, October 31, 2014

Measles: Supplementary Immunization Activity in Pakistan Year 2014 (Field Guide)

Measles is an infectious disease, largely affecting the children. It presents with fever, flu, red eyes, white patch on the inner side of the mouth and rashes over the body. The rashes start from the face and neck and then spread over the other parts of the body. Measles becomes fatal if not managed on time.
In 2012, Pakistan had to face a number of cases and deaths with measles. Now measles immunization is the part of extended program immunization schedule (EPI schedule) in Pakistan. Children are given measles vaccine injections at 9th and 25th months of age. The following images are the photos field guide for measles supplementary immunization activity 2014 in Pakistan. All the photos show text in Urdu language. The pictures below cover the following topics about measles:
What is supplementary immunization activity?
How to maintain measles cold chain?
How to inject measles vaccine?
How to protect measles vaccine?
What are the adverse events following immunization (AEFIs) and how to manage them?
How to mobilize people for measles vaccination?
How to spread the news?
How to monitor measles vaccine activity?
How to monitor and supervise measles vaccination activity?
Answers to frequently asked questions?

Field Guide: Supplementary immunization activity (SIA)

List of topics covered


Words of Thanks!

Supplementary immunization activity

Cold Chain Management

Wednesday, October 22, 2014

Selsun 2.5%: An Effective Antidandruff Shampoo

Selsun 2.5%, an effective antidandruff shampoo, is a rich lathering hair and scalp conditioner. Selsun shampoo contains selenium sulfide 2.5% W/V for the control of dandruff with regular use. It is marketed by Sanofi-Aventis Pakistan Limited. The price of one bottle of Selsun shampoo is Rs. 170.
Selsun 2.5%

How to use Selsun shampoo?

First of all shake the Selsun shampoo bottle well. Wash your hair with bland soap and rinse them fully. Apply one to two teaspoonful of Selsun suspension (shampoo) into your scalp using warm water to lather. Be careful about your eyes and avoid contact with the eyes. Wait for 2-3 minutes so that the suspension system breaks to be active on to the scalp. Rinse your scalp thoroughly after 2-3 minutes. You can also use bland soap to help remove the Selsun suspension. Also, wash your hands thoroughly to avoid eye contact of shampoo. Use Selsun shampoo twice a week for two weeks and then reduce to once a week as needed.
Selsun shampoo is only for external use. Avoid exposure to heat and light and keep away from your children to avoid accidental ingestion by the children.

Questions and Answers:

What is dandruff?
Dandruff refers to a diffuse, slight-to-moderate scaling or flaking of the scalp with varying degrees of itching or erythema.

What causes dandruff?
Dandruff may be caused by seborrheic dermatitis thought to be caused by yeast organism Malassezia. Dandruff is also the sign of psoriasis and fungal infection.

What is selsun shampoo?
Selsun is an antidandruff shampoo marketed by Sanofi-Aventis Pakistan Limited.

What is the formula contained in Selsun?
Selsun contains selenium sulfide 2.5% W/V.

What is selenium sulfide?
Selenium sulfide is a chemical which controls dandruff through its anti-Pityrosporum and anti-seborrheic properties. It also reduces scalp cell turnover through its cytostatic effect on the epidermis and follicular epithelium.

What is the price of Selsun (selenium sulfide 2.5%)?
The price of Selsun (selenium sulfide 2.5%) is Rs. 170.

Is Selsun shampoo gluten free?
Selsun suspension is synthetically prepared and the company does not guarantee of its gluten free property as it is not tested for its gluten sensitivity.

Does Selsun shampoo contain animal products?
Although Selsun suspension is prepared synthetically; however, Sanofi-Aventis does not guarantee of not having animal products in its Selsun suspension.

How long should the shampoo be on your head?
You should wait for 2-3 minutes before rinsing your hair.

When can I use Selsun suspension?
Selsun shampoo can be used when you have dandruff and seborrheic dermatitis. Selsun shampoo is useful controlling itch, flakes and flakes caused by dandruff and seborrheic dermatitis.

When not to use Selsun shampoo?
Do not use Selsun shampoo on acutely inflamed scalp.

What are the precautions to be taken while using Selsun shampoo?
Shake well before use; keep away from children; avoid its exposure to heat and light; avoid contact with eyes.

What are the side effects of Selsun shampoo?
Side effects of Selsun shampoo are rare. However, stop the use of Selsun shampoo and immediately contact your doctor if any allergic reaction happens to occur. Allergic reaction may present with itching, redness, peeling, skin irritation and difficult breathing. 

With what brand names selenium sulfide is marketed?
Selsun 2.5%, Selsun Blue, Chattem Inc., Exsel 2.5%, Selseb, Head & Shoulders

What is the treatment of severe dandruff?
Nizoral shampoo (ketoconazol) is useful for severe dandruff. Selsun is effective for moderate to severe dandruff.

Keywords: Dandruff, Selsun shampoo, Selenium, Seborrheic dermatitis, Psoriasis, Malassezia, Antidandruff shampoo, Head & shoulders, Nizoral shampoo

Tuesday, October 21, 2014

PIMS Advertisement for MD/MS/PhD Programs for Session January 2015

Pakistan Institute of Medical Sciences (PIMS)/Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) has announced admissions in MD, MS and PhD programs for the session January 2015. All the applicants/candidates will have to appear in the test for GAT (Medicine & Allied), GAT (Surgery & Allied), GAT (Chemical Pathology) and GAT (Haematology) in accordance with their field of application. NTS test fee will be Rs. 2000/-. Last date for the forms submission is October 27, 2014. Check the PIMS ad for MS, MD and PhD admissions for the session January 2015 below:
Keywords: PIMS admissions 2015, MS, MD programs 2015, PhD programs, GAT for PIMS, NTS test for PIMS 2015, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, SZABMU, Residency training programs, Download NTS application form

Thursday, October 16, 2014

Types of Hypersensitivity with Examples

Hypersensitivity refers to an undesirable reaction of  the body's immune system. This reaction may be a kind of allergy or may be the manifestation of an autoimmune condition. Medically, hypersensitivity has been divided into four types:

  • Type I hypersensitivity- anaphylactic and atopic
  • Type II hypersensitivity- antibody mediated
  • Type III hypersensitivity- Immune complex medicated
  • Type IV hypersensitivity- delayed or T-cell mediated
Type of hypersensitivity
Type I hypersensitivity- anaphylactic and atopic

Antigen provokes presensitized mast cells and basophils through IgE, causing the release vasoactive amines like histamine. Histamine acts on postcapillary venules.

  • Bee stings
  • Food allergy
  • Asthma
  • Rhinitis
  • Hay fever
  • Eczema
  • Hives

Drug allergy

Allergic or atopic conditions like:

Type II hypersensitivity- antibody mediated

Antibodies IgM or IgG bind to the antigen present on the enemy’s cell and trigger lysis or phagocytosis. Three mechanisms can be explained: opsonizing the cells or activating the complement system, recruiting neutrophils and macrophages for tissue damage, and binding to the normal cellular receptors to cause dysfunction.

  • Hemolytic anemia
  •  Pernicious anemia 
  • Erythroblastosis fetalis 
  • ITP (Idiopathic thrombocytopenic purpura)
  •  Acute hemolytic transfusion reaction
  • Rheumatic fever
  •  Goodpasture’s syndrome
  • Bullous pemphigoid
  •  Pemphigus vulgaris 
  • Myasthenia gravis
  •  Grave’s disease
  •  SLE (only blood manifestations)

Type III hypersensitivity- Immune complex medicated

Immune complexes provoke complement system which in turn attacks neutrophils. Neutrophils release lysosomal enzymes, causing tissue damage.

  • SLE (Systemic lupus erythematosus) 
  • Rheumatoid arthritis 
  • Polyarteritis nodosum 
  • Serum sickness 
  • Arthus reaction (swelling and inflammation after certain vaccine administration) 
  • Farmer’s lung (Hypersensitivity pneumonitis) 
  • Post streptococcal glomerulonephritis
Type IV hypersensitivity- delayed or T-cell mediated

Sensitized lymphocytes encounter/confront antigens by releasing lymphokines which in turn activate macrophages.

  • Type I diabetes mellitus 
  • Multiple sclerosis 
  • GBS (Guillain-Barre syndrome) 
  • PPD test for tuberculosis 
  • Contact dermatitis (e.g. poison ivy, nickel allergy, skin tattooing) 
  • Graft-versus-host (GVH) disease 
  • Hashimoto’s thyroiditis

The table given below describes each type of hypersensitivity with examples:

Keywords: Type I hypersensitivity, Anaphylaxis, Atopic conditions, Type II hypersensitivity, Antibody mediated reaction, Type III hypersensitivity, Immune complex medicated reaction, Type IV hypersensitivity- delayed or T-cell mediated

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