Nutrition

Nutrition

Frequency of eating per day

About 46.8 percent of the people could afford a three square meal per day at morning – afternoon – evening intervals. The average number of times children ate daily was 1.8. It is medically recommended to eat three times per day or whenever the body is hungry for food. This must be done with caution to give relief to the digestive system and the utilization of nutrients from the food taken. A medical fact is that the body needs nutritious food to undergo processes of growth and development and to meeting the challenges of body exercises and work. With the mean time of eating estimated at 1.8 times daily in the study locations, the healthiness of the population depends on the nutritious components of the food intake in vitamins, proteins and carbohydrates. Those who could afford twice meal per day engaged in child labour such as hawking of products

Types of foods intake

Child nutrition is a complex concept. Children need dozens of different vitamins, minerals, and other assorted nutrients each day, and those needs change as children grow. In fact, infant nutrition is quite different from child nutrition.
Nutrition guidelines recommended for adults are inappropriate for most children. This is because young children only have small tummies and so need plenty of calories and nutrients in a small amount of food to ensure they grow properly. While low-fat diets are recommended for older children and adults, under-fives need diets that contain good amounts of fat.
In this study, types of food intake were classified into different categories, carbohydrate, proteins and vitamins. Children were made to indicate the types / frequencies of specific food intake. Findings show that Yam remains the most staple food for the people in the study areas. Most inhabitants engage in yam cultivation in large quantities for consumption and commercial purposes. Over 88 percent took yam variety of foods daily. This is similar to the intake of rice, maize and cassava varieties food intake which recorded the highest percent of 37.5, 44.4 and 46.7 percent among the children. It can be inferred from findings that yam varieties intake had the highest percent of all food varieties intake among the people. Several reasons were adduced to this, included, availability, relatively cheap price, and the ability to grow them in at least consumable quantities at low costs. Findings further show that rice, maize and yams were taken in different varieties such as gaari, akpu, flour and fufu. The proteinous food intake was made of beans varieties. Beans was grown in subsistence quantities, among farmers. Some of these varieties include moinmoin, akara and beans cake. One-fifth of total sample (21.5 percent) took beans variety monthly between 1-10 times. The remaining 78.5 percent took food of beans varieties between 11-20 times monthly.

As food supplement, just a percent could afford tea with milk above 5 times monthly. Milk is a reliable source of multivitamins intake and normally taken in the morning before the days work. Maize is another source of carbonhydrate food intake. It is grown in large scale by most farmers not only for subsistence purposes but for market. A considerable proportion of those who engaged in farming earned their living from maize cultivation.

Major fruits in the research area include orange, cashew, carrot, mango and pineapple. Fruits are major source of vitamin supplements. Findings show that these fruits are common on seasonal basis and are largely grown in the Southern part of the research locations. The average number of times children took beans varieties, maize related foods and fruits were 7, 8, 10 times per month based on this survey. This indicates that daily, 0.2, 0.27, 0.3, proportion of sample food intakes were derived from proteins, vitamins and carbohydrate sources.

Cross Tabulation

In this sub-section, various socio-economic characteristics of the sample are correlated with their patterns of feeding to unearth the extent at which the influence or determine each other. The patterns of eating are classified into carbohydrate, and proteins and fruits. The criterion for carbohydrate intake was the consumption of yam, maize and cassava varieties of food while the intake of beans varieties of food was used for protein intake, fruits intake include cashew, mango, pawpaw and orange.

Age / food Intake

Carbohydrate

The data show that yam/yam related foods are among major foods for the people with an average intake of 22 times per month, 0.73 times per day. There is no significant relationship between age and yam intake. At a linear by linear Association value at 0.018, the Pearson chi-square test was found at 48.7, df (v) 15 and X2t = at 0.05 level of significance Yam is widely grown by indigenes. However, the higher the age, the higher the tendency for gaari intake and vice versa. This indicates that older children consume gaari more than the younger people. The general frequency of garri intake was higher than that of yam. The average number of garri intake per month was 34 per month indicating, 1.1 times per day. Maize related foods were consumed mostly by children between 8 - 14 years of age than those in other age cohorts.

Proteins Intake

The monthly average of the intake of proteins related foods was 15 times with the daily average of 0.5. This is lower than the daily/monthly average of cabonhydrate intake. There is no disparity between age and proteins intake, the monthly average spread across all age cohorts. While a little proportion of beans was grown in some study locations, some areas could not venture into the growth of beans because of the unfavorable climate and land composition.

Fruits Intake

The intake of fruits varieties varied directly with age. Older children have the tendency to take fruits more than the younger ones. Major fruits in the area are cashew, mango, orange, pineapple and banana. These fruits are grown in large quantities in the area. Research evidences have indicated that most of these fruits often waste in large quantities during season.

SELF CARE

Interventions (Nursing Interventions Classification)

The nurse may encounter the patient with a self-care deficit in the hospital or in the community. The deficit may be the result of transient limitations, such as those one might experience while recuperating from surgery; or the result of progressive deterioration that erodes the individual’s ability or willingness to perform the activities required to care for himself or herself. Careful examination of the patient’s deficit is required in order to be certain that the patient is not failing at self-care because of a lack in material resources or a problem with arranging the environment to suit the patient’s physical limitations. The nurse coordinates services to maximize the independence of the patient and to ensure that the environment that the patient lives in is safe and supportive of his or her special needs.

Defining Characteristics:
■Inability to feed self independently
■Inability to dress self independently
■Inability to bathe and groom self independently
■Inability to perform toileting tasks independently
■Inability to transfer from bed to wheelchair
■Inability to ambulate independently
■Inability to perform miscellaneous common tasks such as telephoning and writing
Related Factors:
■Neuromuscular impairment, secondary to cerebrovascular accident (CVA)
■Musculoskeletal disorder such as rheumatoid arthritis
■Cognitive impairment
■Energy deficit
■Pain
■Severe anxiety
■Decreased motivation
■Environmental barriers
■Impaired mobility or transfer ability
Expected Outcomes
■Patient safely performs (to maximum ability) self-care activities.
■Resources are identified which are useful in optimizing the autonomy and independence of the patient.

Body Temperature, Fever Mechanism, and Immunity

Body Temperature, Fever Mechanism, and Immunity

It is commonly believed that human body temperature is regulated near
98.6 degrees Fahrenheit. How does this regulation work? What are the
temperature sensors? What reference (i.e. temperature standard) is
used within the body to regulate the temperature within a narrow
range? What triggers the body?s control logic mechanisms to raise or
lower the body temperature? What mechanisms are used to increase and
decrease the temperature? Is it unusual to have a ?normal? body
temperature remain significantly below 98.6? Are there known
syndromes, circumstances, or medical conditions related to chronically
low body temperature, or other irregularities in regulating body
temperature?

Related to this, what sensors, control logic, and temperature control
mechanisms comprise the fever mechanism?

Finally, what effect does higher or lower body temperature have on the
human immune response? We know that viruses cannot thrive at
temperatures much above those caused by a fever. Does the increased
body temperature associated with a fever improve the immune response
by weakening viruses, or by speeding chemical reactions? Does
(artificially) reducing a fever prolong an infection? What conditions
could lead to a person suffering from an infection but not running a
fever?

An acceptable answer will address many of these questions, and cite
authoritative references to substantiate the information provided.

HIV - AIDS

Acquired immune deficiency syndrome

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV).
This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV is transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk.
This transmission can involve anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids.

AIDS is now a pandemic. In 2007, it was estimated that 33.2 million people lived with the disease worldwide, and that AIDS had killed an estimated 2.1 million people, including 330,000 children. Over three-quarters of these deaths occurred in sub-Saharan Africa, retarding economic growth and destroying human capital.

Genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century. AIDS was first recognized by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s.

Although treatments for AIDS and HIV can slow the course of the disease, there is currently no vaccine or cure. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but these drugs are expensive and routine access to antiretroviral medication is not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organizations promoting safe sex and needle-exchange programmes in attempts to slow the spread of the virus.

Symptoms

The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

Opportunistic infections are common in people with AIDS. HIV affects nearly every organ system.

People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas. Additionally, people with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss. The specific opportunistic infections that AIDS patients develop depend in part on the prevalence of these infections in the geographic area in which the patient lives.

Courtesy: Wikipedia

Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork

Joint FAO/WHO/OIE Statement on influenza A(H1N1) and the safety of pork

In the ongoing spread of influenza A(H1N1), concerns about the possibility of this virus being found in pigs and the safety of pork and pork products have been raised.

Influenza viruses are not known to be transmissible to people through eating processed pork or other food products derived from pigs.

Heat treatments commonly used in cooking meat (e.g. 70°C/160°F core temperature) will readily inactivate any viruses potentially present in raw meat products.

Pork and pork products, handled in accordance with good hygienic practices recommended by the WHO , Codex Alimentarius Commission and the OIE, will not be a source of infection

Authorities and consumers should ensure that meat from sick pigs or pigs found dead are not processed or used for human consumption under any circumstances.

Assessing the severity of an influenza pandemic

Assessing the severity of an influenza pandemic
The major determinant of the severity of an influenza pandemic, as measured by the number of cases of severe illness and deaths it causes, is the inherent virulence of the virus. However, many other factors influence the overall severity of a pandemic’s impact.

Even a pandemic virus that initially causes mild symptoms in otherwise healthy people can be disruptive, especially under the conditions of today’s highly mobile and closely interdependent societies. Moreover, the same virus that causes mild illness in one country can result in much higher morbidity and mortality in another. In addition, the inherent virulence of the virus can change over time as the pandemic goes through subsequent waves of national and international spread.

Properties of the virus
An influenza pandemic is caused by a virus that is either entirely new or has not circulated recently and widely in the human population. This creates an almost universal vulnerability to infection. While not all people ever become infected during a pandemic, nearly all people are susceptible to infection.

The occurrence of large numbers of people falling ill at or around the same time is one reason why pandemics are socially and economically disruptive, with a potential to temporarily overburden health services.

The contagiousness of the virus also influences the severity of a pandemic’s impact, as it can increase the number of people falling ill and needing care within a short timeframe in a given geographical area. On the positive side, not all parts of the world, or all parts of a country, are affected at the same time.

The contagiousness of the virus will influence the speed of spread, both within countries and internationally. This, too, can influence severity, as very rapid spread can undermine the capacity of governments and health services to cope.

Pandemics usually have a concentrated adverse impact in specific age groups. Concentrated illnesses and deaths in a young, economically productive age group will be more disruptive to societies and economies than when the very young or very old are most severely affected, as seen during epidemics of seasonal influenza.

Population vulnerability
The overall vulnerability of the population can play a major role. For example, people with underlying chronic conditions, such as cardiovascular disease, hypertension, asthma, diabetes, rheumatoid arthritis, and several others, are more likely to experience severe or lethal infections. The prevalence of these conditions, combined with other factors such as nutritional status, can influence the severity of a pandemic in a significant way.

Subsequent waves of spread
The overall severity of a pandemic is further influenced by the tendency of pandemics to encircle the globe in at least two, sometimes three, waves. For many reasons, the severity of subsequent waves can differ dramatically in some or even most countries.

A distinctive feature of influenza viruses is that mutations occur frequently and unpredictably in the eight gene segments, and especially in the haemagglutinin gene. The emergence of an inherently more virulent virus during the course of a pandemic can never be ruled out.

Different patterns of spread can also influence the severity of subsequent waves. For example, if schoolchildren are mainly affected in the first wave, the elderly can bear the brunt of illness during the second wave, with higher mortality seen because of the greater vulnerability of elderly people.

During the previous century, the 1918 pandemic began mild and returned, within six months, in a much more lethal form. The pandemic that began in 1957 started mild, and returned in a somewhat more severe form, though significantly less devastating than seen in 1918. The 1968 pandemic began relatively mild, with sporadic cases prior to the first wave, and remained mild in its second wave in most, but not all, countries.

Capacity to respond
Finally, the quality of health services influences the impact of any pandemic. The same virus that causes only mild symptoms in countries with strong health systems can be devastating in other countries where health systems are weak, supplies of medicines, including antibiotics, are limited or frequently interrupted, and hospitals are crowded, poorly equipped, and under-staffed.

Assessment of the current situation
To date, the following observations can be made, specifically about the H1N1 virus, and more generally about the vulnerability of the world population. Observations specific to H1N1 are preliminary, based on limited data in only a few countries.

The H1N1 virus strain causing the current outbreaks is a new virus that has not been seen previously in either humans or animals. Although firm conclusions cannot be reached at present, scientists anticipate that pre-existing immunity to the virus will be low or non-existent, or largely confined to older population groups.

H1N1 appears to be more contagious than seasonal influenza. The secondary attack rate of seasonal influenza ranges from 5% to 15%. Current estimates of the secondary attack rate of H1N1 range from 22% to 33%.

With the exception of the outbreak in Mexico, which is still not fully understood, the H1N1 virus tends to cause very mild illness in otherwise healthy people. Outside Mexico, nearly all cases of illness, and all deaths, have been detected in people with underlying chronic conditions.

In the two largest and best documented outbreaks to date, in Mexico and the United States of America, a younger age group has been affected than seen during seasonal epidemics of influenza. Though cases have been confirmed in all age groups, from infants to the elderly, the youth of patients with severe or lethal infections is a striking feature of these early outbreaks.

In terms of population vulnerability, the tendency of the H1N1 virus to cause more severe and lethal infections in people with underlying conditions is of particular concern.

For several reasons, the prevalence of chronic diseases has risen dramatically since 1968, when the last pandemic of the previous century occurred. The geographical distribution of these diseases, once considered the close companions of affluent societies, has likewise shifted dramatically. Today, WHO estimates that 85% of the burden of chronic diseases is now concentrated in low- and middle-income countries. In these countries, chronic diseases show an earlier average age of onset than seen in more affluent parts of the world.

In these early days of the outbreaks, some scientists speculate that the full clinical spectrum of disease caused by H1N1 will not become apparent until the virus is more widespread. This, too, could alter the current disease picture, which is overwhelmingly mild outside Mexico.

Apart from the intrinsic mutability of influenza viruses, other factors could alter the severity of current disease patterns, though in completely unknowable ways, if the virus continues to spread.

Scientists are concerned about possible changes that could take place as the virus spreads to the southern hemisphere and encounters currently circulating human viruses as the normal influenza season in that hemisphere begins.

The fact that the H5N1 avian influenza virus is firmly established in poultry in some parts of the world is another cause for concern. No one can predict how the H5N1 virus will behave under the pressure of a pandemic. At present, H5N1 is an animal virus that does not spread easily to humans and only very rarely transmits directly from one person to another.

The current WHO phase of pandemic alert is 6.

The current WHO phase of pandemic alert is 6.

In nature, influenza viruses circulate continuously among animals, especially birds. Even though such viruses might theoretically develop into pandemic viruses, in Phase 1 no viruses circulating among animals have been reported to cause infections in humans.

In Phase 2 an animal influenza virus circulating among domesticated or wild animals is known to have caused infection in humans, and is therefore considered a potential pandemic threat.

In Phase 3, an animal or human-animal influenza reassortant virus has caused sporadic cases or small clusters of disease in people, but has not resulted in human-to-human transmission sufficient to sustain community-level outbreaks. Limited human-to-human transmission may occur under some circumstances, for example, when there is close contact between an infected person and an unprotected caregiver. However, limited transmission under such restricted circumstances does not indicate that the virus has gained the level of transmissibility among humans necessary to cause a pandemic.

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause “community-level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion.

Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.

Phase 6, the pandemic phase, is characterized by community level outbreaks in at least one other country in a different.The current WHO phase of pandemic alert is 6.

During the post-peak period, pandemic disease levels in most countries with adequate surveillance will have dropped below peak observed levels. The post-peak period signifies that pandemic activity appears to be decreasing; however, it is uncertain if additional waves will occur and countries will need to be prepared for a second wave.

Previous pandemics have been characterized by waves of activity spread over months. Once the level of disease activity drops, a critical communications task will be to balance this information with the possibility of another wave. Pandemic waves can be separated by months and an immediate “at-ease” signal may be premature.

In the post-pandemic period, influenza disease activity will have returned to levels normally seen for seasonal influenza. It is expected that the pandemic virus will behave as a seasonal influenza A virus. At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly. An intensive phase of recovery and evaluation may be required.

H1N1 swine flu (Influenza A)

What is swine flu?

Like people, pigs can get influenza (flu), but swine flu viruses aren't the same as human flu viruses. Swine flu doesn't often infect people, and the rare human cases that have occurred in the past have mainly affected people who had direct contact with pigs. But the current swine flu outbreak is different. It's caused by a new swine flu virus that has spread from person to person — and it's happening among people who haven't had any contact with pigs.

H1N1 swine flu (Influenza A)

What is influenza A(H1N1 swine flu)?

How do people become infected with influenza A(H1N1)?

Outbreaks in humans are now occurring from human-to-human transmission. When infected people cough or sneeze, infected droplets get on their hands, drop onto surfaces, or are dispersed into the air. Another person can breathe in contaminated air, or touch infected hands or surfaces, and be exposed. To prevent spread, people should cover their mouth and nose with a tissue when coughing, and wash their hands regularly.

What are the signs and symptoms of infection?

Early signs of influenza A(H1N1) are flu-like, including fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting or diarrhoea.

What can I do to protect myself from catching influenza A(H1N1)?

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing. You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:

•avoid touching your mouth and nose;

•clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);

•avoid close contact with people who might be ill;

•reduce the time spent in crowded settings if possible;

•improve airflow in your living space by opening windows;

•practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask.

If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards.

If you are sick and must travel or be around others, cover your mouth and nose.

Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection.

How do I know if I have influenza A(H1N1)?

You will not be able to tell the difference between seasonal flu and influenza A(H1N1) without medical help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache, body aches, sore throat and runny nose. Only your medical practitioner and local health authority can confirm a case of influenza A(H1N1).

What should I do if I think I have the illness?

If you feel unwell, have high fever, cough or sore throat:

•stay at home and keep away from work, school or crowds;

•rest and take plenty of fluids;

•cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;

•if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;

•use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;

•inform family and friends about your illness and try to avoid contact with other people;

•If possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

Should I take an antiviral now just in case I catch the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the Internet.

What about breastfeeding? Should I stop if I am ill?

No, not unless your health care provider advises it. Studies on other influenza infections show that breastfeeding is most likely protective for babies - it passes on helpful maternal immunities and lowers the risk of respiratory disease. Breastfeeding provides the best overall nutrition for babies and increases their defense factors to fight illness.

What should I do if I need medical attention?

•If possible, contact your health care provider before traveling to a health facility, and report your symptoms. Explain why you think you have influenza A (H1N1) (e.g. if you have recently traveled to a country where there is an outbreak in people). Follow the advice given to you.

•If you cannot contact your health care provider before traveling to a health facility, tell a health care worker of your suspicion of infection immediately after arrival at the clinic or hospital.

•Cover your nose and mouth during travel.

Should I go to work if I have the flu but am feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home and away from work through the duration of your symptoms. This is a precaution that can protect your work colleagues and others.

Can I travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you have any doubts about your health, you should check with your health care provider.

Are some people more at risk?

More study is needed to determine if some populations (i.e. younger or older people, or people with other medical conditions) could be affected by the outbreak, of if they are at higher risk for severe illness. WHO recommends that everyone take precautions to prevent the spread of infection.

Are there any special recommendations for pregnant women?

Yes, they are vulnerable. Like everyone, they should take all the necessary precautions.

Microbiology

Microbiology

Microbiology (from Greek μῑκρος, mīkros, "small"; βίος, bios, "life"; and -λογία, -logia) is the study of microorganisms, which are unicellular or cell-cluster microscopic organisms. This includes eukaryotes such as fungi and protists, and prokaryotes, which are bacteria and archaea. Viruses, though not strictly classed as living organisms, are also studied. In short; microbiology refers to the study of life and organisms that are too small to be seen with the naked eye.

Microbiology is a broad term which includes virology, mycology, parasitology, bacteriology and other branches. A microbiologist is a specialist in microbiology.

Microbiology is researched actively, and the field is advancing continually. We have probably only studied about one percent of all of the microbe species on Earth. Although microbes were first observed over three hundred years ago, the field of microbiology can be said to be in its infancy relative to older biological disciplines such as zoology and botany.

History

Ancient
The existence of microorganisms was hypothesized for many centuries before their actual discovery in the 17th century. In 600 BCE, the ancient Indian surgeon Susruta held microbes responsible for several diseases and explained in Sushruta Samhita that they can be transmitted through contact, air or water. Theories on microorganisms was made by Roman scholar Marcus Terentius Varro in a book titled On Agriculture in which he warns against locating a homestead in the vicinity of swamps:

“ ...and because there are bred certain minute creatures which cannot be seen by the eyes, which float in the air and enter the body through the mouth and nose and there cause serious diseases.[4] ”

This passage seems to indicate that the ancients were aware of the possibility that diseases could be spread by yet unseen organisms.

In The Canon of Medicine (1020), Abū Alī ibn Sīnā (Avicenna) stated that bodily secretion is contaminated by foul foreign earthly bodies before being infected.[5] He also hypothesized on the contagious nature of tuberculosis and other infectious diseases, and used quarantine as a means of limiting the spread of contagious diseases.
When the Black Death bubonic plague reached al-Andalus in the 14th century, Ibn Khatima hypothesized that infectious diseases are caused by "minute bodies" which enter the human body and cause disease.

In 1546 Girolamo Fracastoro proposed that epidemic diseases were caused by transferable seedlike entities that could transmit infection by direct or indirect contact or even without contact over long distances.

All these early claims about the existence of microorganisms were speculative in nature and not based on any data or science. Microorganisms were neither proven and observed, nor correctly and accurately described until the 17th century. The reason for this was that all these early inquiries lacked the most fundamental tool in order for microbiology and bacteriology to exist as a science, and that was the microscope.

Toxinology

Toxinology

Toxinology is the specialized area of science that deals specifically with animal, plant, and microbial toxins. Prof. Dietrich Mebs has defined toxinology as "the scientific discipline dealing with microbial, plant and animal venoms, poisons and toxins". Additionally stating that "toxinology includes more than just the chemistry and mode of action of a toxin. It deals also with the biology of venom- or poison-producing organism, the structure and function of the venom apparatus, as well as the use of the venom or poison, the ecological role of these compounds." Prof. Jurg Meier has defined toxinology as "the science of toxic substances produced by or accumulated in living organisms, their properties, and their biological significance for the organisms involved".

There is an International Society on Toxinology, founded in 1962, catering for toxinologist and their research, with an international Congress every three years and regional sectional meetings in intervening years.

Toxins and toxinology
Toxins are natural substances, or substances produced by living organisms, in contrast to toxic substances from chemicals, which are toxicants. Living organisms producing or using toxins do so as either venoms or poisons. Venoms are toxins, or more commonly, collections of varying toxins, that are used actively against prey or predators, most commonly to subdue, kill and digest prey, or dissuade predators. Poisons of natural origin, that is containing toxins and used by living organisms, are passive and generally used for defence. A predator attempting to molest or eat a poisonous animal, plant or mushroom will suffer adverse effects from the toxins in the poison, varying from mild discomfort to rapid death. Particularly food poisons, but also for a few venoms, the component toxins are not produced by the deploying animal/plant, but are made by micro-organisms and concentrated and used by the deploying animal/plant. A good example is tetrodotoxin, used by a variety of poisonous animals and by a few venomous animals.

Toxins and toxinology is not solely focussed on adverse effects. An increasing number of toxins are important as research tools, unlocking secrets of disease, or as diagnostic agents in hospital laboratories, or as therapeutic agents to treat human disease, including anti-cancer agents, anti-epileptic agents, anti-clotting agents, analgesics, anti-hypertensive drugs, to name but a few. This is a very rich field for research.

Clinical toxinology
Within toxinology there is a clinical subgroup, clinical toxinologists, who focus on the medical effects in humans of exposure to the toxins in animal venoms or plant poisons. This includes such problems as venomous snakebite, currently considered to afflict >2.5 million people each year, with >100,000 deaths. Information on these medical consequences of toxins can be found in diverse sources, such as the Clinical Toxinology Resources Website and books such as Prof. Mebs book and the CRC book on toxinology.

ADVERSE REACTIONS TO DRUGS

ADVERSE REACTIONS TO DRUGS



An adverse reaction to a drug has been defined as any noxious or unintended reaction to a drug that is administered in standard doses by the proper route for the purpose of prophylaxis, diagnosis, or treatment. Some drug reactions may occur in everyone, whereas others occur only in susceptible patients. A drug allergy is an immunologically mediated reaction that exhibits specificity and recurrence on re-exposure to the offending drug.



Classification of adverse reactions to drugs

Reactions that may occur in anyone

Drug overdose -Toxic reactions linked to excess dose or impaired excretion, or to both
Drug side effect - Undesirable pharmacological effect at recommended doses
Drug interaction - Action of a drug on the effectiveness or toxicity of another drug

Reactions that occur only in susceptible subjects

Drug intolerance - A low threshold to the normal pharmacological action of a drug
Drug idiosyncrasy - A genetically determined, qualitatively abnormal reaction to a drug related to a metabolic or enzyme deficiency.
Drug allergy - An immunologically mediated reaction, characterised by specificity, transferability by antibodies or lymphocytes, and recurrence on re-exposure
Pseudoallergic reaction - A reaction with the same clinical manifestations as an allergic reaction (eg, as a result of histamine release) but lacking immunological specificity


Incidence

Adverse reactions to drugs are very common in everyday medical practice. A French study of 2067 adults aged 20-67 years attending a health centre for a check up reported that 14.7% gave reliable histories of systemic adverse reactions to one or more drugs. In a Swiss study of 5568 hospital inpatients, 17% had adverse reactions to drugs. Fatal drug reactions occur in 0.1% medical inpatients and 0.01% of surgical inpatients. The main drugs implicated are antibiotics and non-steroidal anti-inflammatory drugs. Adverse reactions to drugs occurring during anaesthesia (muscle relaxants, general anaesthetics, and opiates), although less common (1 in 6000 patients receiving anaesthesia), are life threatening, with a mortality of about 6%.

Numerous mechanisms have been implicated in adverse reactions to drugs. However, these mechanisms are not fully understood, which may explain the difficulty in differentiating drug allergy from other forms of drug reactions and in assessing the incidence of drug allergy, evaluating risk factors, and defining management strategies.

DEGREE OF IONISATION

Degree of ionisation

This is really important with regard to local anaesthetics. The essential fact to know is that highly ionized drugs cannnot cross lipid membranes (basically they can't go anywhere) and unionised drugs can cross freely. Morphine is highly ionised, fentanyl is the opposite. Consequently the latter has a faster onset of action. The degree of ionisation depends on the pKa of the drug and the pH of the local environment. The pKa is the the pH at which the drug is 50% ionised. Most drugs are either weak acids or weak bases. Acids are most highly ionised at a high pH (i.e. in an alkaline environment). Bases are most highly ionised in an acidic environment (low pH). For a weak acid, the more acidic the environment, the less ionised the drug, and the more easily it crosses lipid membranes. If you take this acid, at pKa it is 50% ionised, if you add 2 pH points to this (more alkaline), it becomes 90% ionised, if you reduce the pH (more acidic) by two units, it becomes 10% ionised. Weak bases have the opposite effect.

Local anaesthetics are weak bases: the closer the pKa of the local anaesthetic to the local tissue pH, the more unionised the drug is. That is why lignocaine(pKa 7.7) has a faster onset of action than bupivicaine (pKa 8.3). If the local tissues are alkalinised (e.g. by adding bicarbonate to the local anaesthetic), then the tisssue pH is brought closer to the pKa, and the onset of action is hastened.

GI SYSTEM ANATOMY and PROTEIN BINDING

INTERACTION BETWEEN HUMAN BODY AND DRUGS

Introduction

Drugs are the substance that are used to treat a disease. These are chemical substances derived from different sources (living or non- living things) which are sued to alter the functions of living/ bacterial tisseus by reacting with them.

Uses of drugs

Drigs are used for:

1. Diagnosis of diseases

2. Prevention of diesases

3. Treatment of diseases.

This chapter deals with the relationship between drug and the human body; the mechanism of drung' action, uses of drugs and the body's response to drugs.

Drugs are prepared in laboratories and experimented so that they are free of unacceable toxic substances which can harm the clients. Then only they are approved for use of human. The study of action of drug in man is called clinical pharmacology.

Clinical Pharmacology can be divided into two brances.

1. Pharmacokinetics.

Means what the human body dees to drungs it is the study of the movement of drugs in the body.

2. Pharmacodynamics

Means what a drug does to the human body. The knowledge about pharmacokinetics and pharmacodynamics is essential to know how the drugs are used for the best advantade of the patient.

Protein Binding

Most drugs bind to proteins, either albumin or alpha-1 acid glycoprotein (AAG), to a greater or lesser extent. Drugs prefer to be free, it is in this state that they can travel throughout the body, in and out of tissues and have their biological effect. The downside of this is that they are easy prey for metabolising enzymes.

As you would expect, more highly bound drugs have a longer duration of action and a lower volume of distribution. Generally high extraction ratio drugs' clearance is high because of low protein binding and, conversely, low extraction ratio drugs' clearance is strongly dependent on the amount of protein binding.

Why is this important? If a drug is highly protein bound, you need to give loads of it to get a theraputic effect; as so much is stuck to protein. But what happens if another agent comes along and starts to compete with the drug for the binding site on the protein? Yes, you guessed it, the amount of free drug is increased. This is really important for drugs that are highly protein bound: if a drug is 97% bound to albumin and there is a 3% reduction in binding (displaced by another drug), then the free drug concentration doubles; if a drug is 70% bound and there is a 3% reduction in binding, this will make little difference.

The drugs that you really need to keep an eye on are: warfarin, diazepam, propranolol and phenytoin. For example, a patient on warfarin is admitted with seizures, you treat the patient with phenytoin, next thing you know - his INR is 10.

The amount of albumin does not appear to be hugely relavent. In disease states such as sepsis, the serum albumin drops drastically, but the free drug concentration does not appear to increase

NURSING EDUCATION

Nepal

A large number of female students would like to join Nursing after SLC. They think that nursing is a sellable and demanding job throughout the world. Joining nursing after SLC is known as PCL nursing. There are plenty of nursing colleges where PCL nursing is taught.

Scope of Nursing

Nursing profession itself is a rewarding and service oriented. The profession is in high demand nowadays and has globally become a much sought after profession. Demand of well qualified nurses is growing everyday in Nepal and abroad. Increasing number of hospital and nursing home inside the countries will create hundreds of vacancies each year. Western world and the gulf country are in shortage of nurses. However it should not mean that all nurses of Nepal can go abroad. Equal importance should be given to English language. Roughly speaking, a score of 7 in each band of IELTS test can open doors to many countries. In Nepal 1600 staff nurses, 120 BN nurses and 200 B Sc nurses qualify each year and most of them are absorbed in Hospitals, nursing homes, medical colleges and NGOS and 150-200 nurses go abroad for job and higher qualification. Improvement in English language or alternate European language (French, Danish, German, etc.) can increase the number of outgoing nurses by many folds.

- PCL nursing colleges are categorized into two standards:

a) Government College

b) Private College

Government College is highly prolific. They are cheaper and maintain higher standard than private colleges in the terms of quality education and practical knowledge because they have their own hospitals. Private colleges also maintain high standard but they have to tie up with other hospitals.

They should have secure 45%in SLC to join private college (CTEVT affiliated) and 50% to appear the entrance exam of government colleges.

Fee of government colleges is always remarkably less than private college.

It costs Rs.2, 25,000 to Rs.3, 50,000 in private colleges, fees vary according to colleges.

Entrance exam for private college is taken by CTEVT in the month of Bhadra/Asoj

Entrance of government colleges is taken in the month of Chaitra.

List of some government colleges - IOM , Maharajgunj Campus

- Patan Hospital Campus

- Biratnagar Campus

- Birjung Campus

- Nepalgunj Campus

- Pokhara Campus

 

BPKIHS,Dharan

Eligibility: Students securing 45% in aggregate in the SLC Time for calling for the application: on the third week of jestha

Question pattern:

General Science: 40 Mathematics: 20 English/Health: 40 total 100

Total seats : 40 (16+16+2+1+5)

The allocated seat are as

16 seats for open- category students

2 seats for Dalit category

5 seats reserved for foreign students

16 seats reserved for hill-district students

1 seat for BPKIHS staff category

the districts included under Hill districts are Bajhang, Bajura, Darchula, dolpa, Humla, jajarkot,Jumla, Kalikot,Mugu,Manang,mustang rukum and Solukhumbu.

Kathmandu University

Total seats:40

Eligibility : Students securing 45% in aggregate in the SLC

Selection criteria: entrance examination + interview

Time for calling for the application: on the first week of Ashadh

Question pattern:

Science 30 English 30

Math 25 Health & G.K 15

K.U has got 40 seats in PCL - Nursing out of which 30% of the seats are reserved for institutional sponsored candidates.

Interview: Students passing the written examination should appear for an interview for the final selection.

Note: The SLC marks are only calculated for eligibility not for selection.

List of private Colleges

A) CTEVT Nursing Campuses

1. Himalayan Nursing Campus, Lalitpur 40 seats

2. Shradha nursing Campus, Bhaktapur 40

3. Mayadevi Technical Institute,Butwal 40

4. Manipal School of Nursing,Pokhara 40

5. OM Institute for Health Manpower Development,Ktm 40

6. Sushma Koirala Memorial Nursing Campus,Ktm 40

7. Nepalgunj Nursing Campus, Nepalgunj 40

8. Institute of Medical Technology, Bharatpur 40

9. Seti - Mahakali Nursing Campus, Mahendranagar 40

10. Tansen Nursing School, Palpa 30

11. Janakpur Nursing Campus, Janakpur 40

12. Kathmandu Model School of Nursing, Kathmandu 40

13. Balkumari College, Chitwan 40

14. Phulchoki Nursing Campus,Banepa 40

15. Madan Memorial Academy, Jhapa 40

16. Unique education Academy, Rajbiraj 40

17. College of Medical Sciences, Bharatpur 40

18. National Vision Nursing School, Kathmandu 40

19. People's Multiple Health Institute, Itahari 40

20. Birat Health College & Research Center, Biratnagar 40

21. Pokhara Technical Health Multipurpose, Pokhara 40

22. Gunraj Pathak Memorial Nursing Campus, Ktm 40

23. Nepal Institute of Health Sciences,Kathmandu 40

24. Green Tara nursing Campus, Kathmandu 40

25. Binayak College of Health Sciences, Kathmandu 40

26. The Himal Institute of Health Sciences, Birgunj 40

27. Chakraborty Hobby Education Academy,Bhaktapur 40

28. Khowpa Multiple Education Institute, Bhaktapur 40

29. Kathmandu Institute of Technical Science 40

30. Nepal Institute of Medical Science and Technology 40

31. Manmohan Memorial Hospital, Kathmandu 40

32. National Medical College, Birgunj 40

33. Chitwan Hospital & Health Foundation, Bharatpur 40

34. NPI Narayani Samudayak Hospital, Bharatpur 40

35. RJF Janaki Medical College, Janakpur 40

36. Lifeline Hospital, Damak, Jhapa 40

37. AMDA Hospital, Damak , Jhapa 40

38. Lumbini Medical College, Tansen, Palpa

39. Padma Nursing Home, Pokhara 40

40. Charak Hospital, Pokhara 40

41. Alka Hospital, Jawalakhel, Lalitpur 40

42. Kathmandu Hospital,Tripureshwor 40

43. Cho Rolpa General Hospital, Charikot, Dolkha 40

C) NAMS, Bir Hospital 40 seats

D) Other Nursing Campuses

1. Dhulikhel Medical Institute, Dhulikhel 35 seats

2. BPKIHS, Dharan 35 seats

Study B.SC. Nursing and BN

After passing +2 from science stream with biology, student can join B.SC. Nursing

It has also two categories:

- Government College

- Private College

Government College is cheaper than private college; students need very minimal amount to study in Government College.

Students have to appear entrance exam to be selected:

List of Government Colleges are:

a) IOM, Maharajgunj (TU)

b) B.P. Koirala, Dhahran (It is more expensive than IOM)

List of Private Colleges:

a) Dhulikhel nursing college (KU), it cost above 6.5 lakhs.

b) Purwnachal University affiliated colleges:

c) Nobel College ,Sinamangal (Pokhara University)

BN (Bachelor of Nursing)

- BN is studied by the students who have passed PCL nursing and have 3 years experience. It is also conducted in different colleges. It has also two categories

a) Government

b) Private

There is only one government college of BN

- IOM, Maharajgunj

There are other private colleges affiliated to Purwanchal University

For authentic advice and details:-

Sun Valley Technologies Pvt.Ltd.

Phone no.,9841402111 , 4485131

India

Now days a large number of students are going to study B.sc nursing in India. Student who has passed +2 educations from Bio stream can study B.sc Nursing in India. Most of the students prefer to go to Bangalore to any other city in India. Most of the collages in Bangalore are affiliated to 'Rajiv Gandhi University' of the Health science.

It you are going to study in India, you have to enquire about the recognition by nursing council of India. It must be recognized otherwise year certificate is not recognized.

Fee structure is about IRs. 4, 00000 for four years. This doesn't include pocket money University charge and travelling expenses.

Acharya group of Institution

Padma Shree Nursing Collage

Indo-Asia Collage of Nursing

Indian Academy for Nursing

CMR Collage of Nursing

Saint George Collage of Nursing

UK

Student who want to study nursing in the United Kingdom , can join Bachelor of Nursing in the Universities. You can join it after +2 in Science.

Fee structure is normally more expensive than other Countries.

Student after PCL Nursing also can join B.sc Nursing in the UK.

Generally student join NVQ and SNVQ course( like diploma in Nursing) in the collages. The length of the course is one to Two years.

After this course they can study B.sc Nursing in the universities.

It cost nearly Rs. 6,00,000 annully to study nursing diploma in the UK.

Fee structure is also cheaper than that of University.

Canada

A student can study B.sc nursing in Canada after +2. you can get B.sc Nursing in .. All the universities and fee structure is also moderate in comparision with other countries.

Besides +2 students who have done PCL nursing also can study 2- year associate nursing degree in Canada.

Students having +2 degree also can study associate nursing degree.

A student has to secure at least 6.0 in IELTS to study associate degree and 6.5 for B.sc nursing from any university.

A student can easily get job and PR (Permanent Residency ) in Canada after Nursing Education.

List of some University and colleges:

Humber college

Algonquin college

centennial college

Sheridan Institute of Technology and Advanced learning

University of Victoria

University of British Columbia

University of Manitoba

University of Waterloo

Brandon University

Red River Collage

Assiniboine community college

University collage of North

USA

Student who have passed +2 science can apply for B.sc Nursing in the USA.

They can get B.sc nursing in almost all universities of the USA.

They can also apply to scholarship if they have sound academic performance with TOFEL and SAT.

The students can feel the fee structure a bit more expensive than any other subject if they won't get scholarship.

Students have to produce at least Rs.6, 50000 for six month initially to staut B.sc nursing. They can also work during the period of study. So they can manage it by working.

Nursing students can get job more easily, salary is also more in comparison with other fields.

Student can find the name of the universities in this site also or they can find in www.utexas.edu/world/univ

Science nursing education is in high demand in USA, student can easily get job after complete ion of their study.

Europe

A student can study in some well- known countries like Finland/Sweaden/ Norway and Netherland where Nursing degree is in high demand.

You can apply for B.sc Nursing and M .sc Nursing to these countries and warmly accepted. You can get 100% scholarship while applying to the countries.

Student can apply themselves directly because agent is not entertained by there countries.