What is Zika virus disease (Zika)?

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What is Zika virus disease (Zika)?

Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.

Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon / evening hours)
Reservoir: Unknown (WHO, 2016).

Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week (CDC. 2016).

What are the symptoms of Zika?

according (CDC, 2016) About 1 in 5 people infected with Zika will get sick. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected.


The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin 2 to 7 days after being bitten by an infected mosquito
1. Zika virus infection is characterized by low grade fever (less than 38.5 ° C).
2. arthralgia, notably of small joints of hands and feet, with possible swollen joints.
3. myalgia
4. headache, retro-ocular headaches
5. conjunctivitis
6. rash
7. post-infection asthenia which seems to be frequent.



The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days (2-7 days).


How is Zika transmitted?

Zika virus is primarily transmitted to humans through bites from Aedes mosquitoes, which often live around buildings in urban areas and are usually active during daylight hours (peak biting activity occurs in early mornings and late afternoons).

Some evidence suggests Zika virus can also be transmitted to humans through blood transfusion, perinatal transmission and sexual transmission. However, these modes are very rare. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth.

Zika virus disease outbreaks were reported for the first time from the Pacific in 2007 and 2013 (Yap and French Polynesia, respectfully), and in 2015 from the Americas (Brazil and Colombia) and Africa (Cape Verde). In addition, more than 13 countries in the Americas have reported sporadic Zika virus infections indicating rapid geographic expansion of Zika virus (WHO, 2016).

See image Down for Countries where the Zika Virus is spreading.

Who is at risk of being infected?

Anyone who is living in or traveling to an area where Zika virus is found who has not already been infected with Zika virus is at risk for infection, including pregnant women.


Prevention

Mosquitoes and their breeding sites pose a significant risk factor for Zika virus infection. Prevention and control relies on reducing mosquitoes through source reduction (removal and modification of breeding sites) and reducing contact between mosquitoes and people.

This can be done by using insect repellent; wearing clothes (preferably light-coloured) that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean or cover containers that can hold water such as buckets, flower pots or tyres, so that places where mosquitoes can breed are removed.

Special attention and help should be given to those who may not be able to protect themselves adequately, such as young children, the sick or elderly.

During outbreaks, health authorities may advise that spraying of insecticides be carried out. Insecticides recommended by the WHO Pesticide Evaluation Scheme may also be used as larvicides to treat relatively large water containers.

Travellers should take the basic precautions described above to protect themselves from mosquito bites

Treatment

Zika virus disease is usually relatively mild and requires no specific treatment. People sick with Zika virus should get plenty of rest, drink enough fluids, and treat pain and fever with common medicines. If symptoms worsen, they should seek medical care and advice. There is currently no vaccine available.

according (CDC, 2016)
There is no vaccine or specific medicine to treat Zika virus infections.

Treat the symptoms:

1. Get plenty of rest.
2. Drink fluids to prevent dehydration.
3. Take medicine such as acetaminophen to reduce fever and pain.
4. Do not take aspirin or other non-steroidal anti-inflammatory drugs.
5. If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication

Related to

Read More about What is H1N1 "Swine" flu?

Read More about How does the H1N1 flu differ from the seasonal flu?

Read More about Ebola virus disease ... Symptoms ... Treatment

Refernceses 

- http://www.who.int/mediacentre/factsheets/zika/en/

- http://www.wpro.who.int/mediacentre/factsheets/fs_05182015_zika/en/

- http://www.cdc.gov/zika/disease-qa.html

- http://www.health.govt.nz/our-work/diseases-and-conditions/zika-virus

- http://waer.org/post/upstate-infectious-disease-expert-zika-virus-spreading-not-threat-cny

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Do you know the level of your intelligence؟.. Test yourself for free

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Intelligence test IQ free ... "Raven's"

Raven's Progressive Matrices (often referred to simply as Raven's Matrices) or RPM is a nonverbal group test typically used in educational settings. It is usually a 60 item test used in measuring abstract reasoning and regarded as a non-verbal estimate of fluid intelligence.It is the most common and popular test administered to groups ranging from 5-year-olds to the elderly. It is made of 60 multiple choice questions, listed in order of difficulty. This format is designed to measure the test-taker's reasoning ability, the eductive ("meaning-making") component of Spearman's g. (g is often referred to as general intelligence.) The tests were originally developed by John C. Raven in 1936. In each test item, the subject is asked to identify the missing element that completes a pattern. Many patterns are presented in the form of a 6x6, 4x4, 3x3, or 2x2 matrix, giving the test its name (wikipedia).

* Raven’s Progressive Matrices have a wide variety of applications including:

• - In educational settings the Matrices have a long history of application and use. Scores are relatively unaffected by linguistic and ethnic background and can be used as a good predictor of success in an educational context for both children and adults.
• - In clinical settings the reliability of the measures and lack of bias makes them ideal tools in neuropsychological assessment, working with elderly people and many clinical groups whose particular needs make the demands of more traditional cognitive testing unrealistic.
• - For many years the Matrices have found wide application in numerous research studies. Their strong theoretical background, lengthy citation count and application across multiple language, ethnic and cultural groups make them ideal tools for investigations requiring measurements of cognitive abilities in a wide range of organisational, educational and clinical settings.

Raven's Progressive Matrices

For Test Click Here

References

- http://www.pearsonclinical.co.uk

- https://en.wikipedia.org/wiki/Raven%27s_Progressive_Matrices

- https://www.raventest.net/

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How does the H1N1 flu differ from the seasonal flu?

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How does the H1N1 flu differ from the seasonal flu?

     Flu (influenza) viruses are divided into three broad categories: influenza A, B or C. Influenza A is the most common type. H1N1 flu is a variety of influenza A.

Even though the H1N1 virus and the seasonal flu are the same in many ways, they are two different types of influenza.

What Makes Them the Same?
• Both flu 'symptoms include fever, body aches, headache, sore throat, cough,
runny / stuffy nose, chills, fatigue and possibly diarrhea and / or vomiting.
• Both viruses are spread mainly from person-to-person through coughing or
sneezing. Sometimes people can get the flu by touching something with flu
viruses on it and then touching their eyes, mouth or nose.
• Both types of flu are treated using fever reducing medication, plenty of fluids,
antivirals and rest.

What Makes Them Different?

•  The H1N1 virus is new, so not as many people are immune to it.
•  Unlike seasonal flu, people 65 and over are less likely to get the H1N1 flu.
•  The CDC reports the H1N1 virus has affected more people younger than 25 years old vs. the older population.
• Unlike seasonal flu, swine flu can be passed from person to person in warm weather and cold weather.
• Seasonal flu, which peaks during late December through early March, is most efficiently passed from person to person through droplets in the air when the weather is cold. "When it warms up in the spring, transmission stops
• Another significant way that the viruses differ is that in a third of the cases that have come to medical attention H1N1 affects the gastrointestinal tract as well as the respiratory system. "That's just something that we do not see in seasonal flu, which is really a respiratory virus," (www.newyorkpresbyterianhospital.com, 2009).
• Pregnant women are dramatically more affected by H1N1.

Seasonal flu: Typical influenza viruses infect the cells lining the main airway and nasal tract, according to Earl Brown, a virologist at the University of Ottawa. H1N1: The virus also infects the airway, but in some individuals, it continues to move down and infect the lungs. It's "very unusual" for seasonal flu viruses to infect lungs, Dr. Brown said. The H1N1 virus causes lung infection much more often and "more completely," he said, which is why some people have ended up in intensive care units or even dying from complications of the virus. (www.theglobeandmail.com, 2012). 

Read More What is H1N1 "Swine" flu?

Read More  Signs and Symptoms








































































































































References
- http://www.stfranciscare.org/uploadedFiles/H1N1_vs_Seasonal_web_final.pdf
- http://www.newyorkpresbyterianhospital.com/enews/whats-the-difference-h1n1-seasonal-flu.html
- http://www.mayoclinic.org/diseases-conditions/swine-flu/expert-answers/influenza-a/faq-20058309
- http://www.theglobeandmail.com/life/health-and-fitness/health/conditions/h1n1-v-seasonal-flu-how-to-tell-the-difference/article4290774/
- http://www.mtoliveboe.org/cmsAdmin/uploads/cold_flu_swine_flu-1_001.pdf

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What is H1N1 "Swine" flu?

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What is H1N1 flu?
This is an influenza virus that had never been identified as a cause of infections in people before the current H1N1 pandemic. Genetic analysis of this virus have shown that it originated from animal influenza viruses and is unrelated to the human seasonal H1N1 viruses that have been in general circulation among people since 1977 (WHO, 2009).

H1N1 is a flu virus. When it was first detected in 2009, it was called "swine flu" because the virus was similar to those found in pigs.

The H1N1 virus is currently a seasonal flu virus found in humans. Although it also circulates in pigs, you can not get it by eating properly handled and cooked pork or pork products.

According Medline plus site; Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. In 2009 a strain of swine flu called H1N1 infected many people around the world.

The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

People who have it can spread it one day before they have any symptoms and as many as 7 days after they get sick. Kids can be contagious for as long as 10 days.

Like the regular flu, swine flu can lead to more serious problems including pneumonia, a lung infection, and other breathing problems. And it can make an illness like diabetes or asthma worse. If you have symptoms like shortness of breath, severe vomiting, pain in your belly or sides, dizziness, or confusion, call your doctor or Emergency right away.

What are the symptoms of H1N1 flu?

for see symptoms click here

What are the incubation flu?

based of CDC; In general, the incubation period for influenza is estimated to range from 1 to 4 days with an average of 2 days. Influenza virus shedding (the time during which a person might be infectious to another person) begins the day before illness onset and can persist for 5 to 7 days, although some persons may shed virus for longer periods, particularly young children and severely immunocompromised persons. The amount of virus shed is greatest in the first 2-3 days of illness and appears to correlate with fever, with higher amounts of virus shed when temperatures are highest.

Transmission
Spread of this pandemic influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.
Since pandemic influenza A [H1N1] is not directly associated pigs the issue of transmission through consumption of pork does not arise.

How long does the H1N1 virus last outside the body? 
Influenza viruses can survive on environmental surfaces like kitchen counters and door knobs, for up to 2-8 hours.

Are There Tests for Swine Flu?

Yes. Without one it's hard to tell whether you have swine flu or seasonal flu, because most symptoms are the same. If you have swine flu, you may be more likely to feel sick and your stomach and throw up than with regular flu. But a lab test is the only way to know. Even a rapid flu test you can get in your doctor's office will not tell you for sure.

Read More about Influenza Tests

high risk for life-threatening problems from swine flu, such as:

- Children under 5 years old

- People 65 or older

- Children and teens (under age 18) who are getting long-term aspirin therapy and who might be at risk for Reye's syndrome after being infected with swine flu. Reye's syndrome is a life-threatening illness linked to aspirin use in children.

- Pregnant women

- Adults and children with chronic lung, heart, liver, blood, nervous system, neuromuscular, or metabolic problems

- Adults and children who have weakened immune systems (including those who take medications to suppress their immune systems or who have HIV)

According (UpToDate; 2015); Indications - Based on the CDC guidelines, prompt initiation of antiviral therapy was recommended for children, adolescents, or adults with suspected or confirmed influenza infection and any of the following features [5,19]:

● Illness requiring hospitalization

● Progressive, severe, or complicated illness, regardless of previous health status

It was also recommended that early treatment be considered in patients with suspected or confirmed influenza infection who were at high risk for complications including:

● Children <5 years of age, particularly those <2 years of age

● Adults ≥65 years of age

● Pregnant women and women up to two weeks postpartum (including those who have had pregnancy loss)

●Individuals with certain medical conditions:

Individuals with chronic medical conditions including:

• Pulmonary disease, including asthma (particularly if systemic glucocorticoids have been required during the past year)

• Cardiovascular disease, except isolated hypertension

• Active malignancy

• Chronic renal insufficiency

• Chronic liver disease

• Diabetes mellitus

• Hemoglobinopathies, such as sickle cell disease

• Immunosuppression, including HIV infection (particularly if CD4 <200 cells / microL), organ and hematopoietic cell transplantation, inflammatory disorders treated with immunosuppressants

• Any neurologic condition that can compromise handling of respiratory secretions (eg, cognitive dysfunction, spinal cord injuries, seizure disorders, neuromuscular disorders)

● Individuals who are morbidly obese (body mass index [BMI] ≥40)

Complication 

Influenza complications include:

- Worsening of chronic conditions, such as heart disease and asthma

Pneumonia

- Neurological signs and symptoms, ranging from confusion to seizures

- Respiratory failure

How Is It Treated?

Some of the same antiviral drugs that are used to treat seasonal flu also work against H1N1 swine flu. Oseltamivir (Tamiflu), peramivir (Rapivab), and zanamivir (Relenza) seem to work best, although some kinds of swine flu do not respond to oseltamivir.

These drugs can help you get well faster. They can also make you feel better. They work best when you take them within 48 hours of the first flu symptoms, but they can help even if you get them later on.

Antibiotics will not do anything for you. That's because flu is caused by a virus, not bacteria.

According medscape, 2014 site; H1N1 Influenza (Swine Flu) Treatment & Management

Medical Care

Treatment is largely supportive and consists of bedrest, increased fluid consumption, cough suppressants, and antipyretics and analgesics (eg, acetaminophen, nonsteroidal anti-inflammatory drugs) for fever and myalgias. Severe cases may require intravenous hydration and other supportive measures. Antiviral agents may also be considered for treatment or prophylaxis (see Medication).

Patients should be encouraged to stay home if they become ill, to avoid close contact with people who are sick, to wash their hands often, and to avoid touching their eyes, nose, and mouth. The CDC recommends the following actions when human infection with H1N1 influenza (swine flu) is confirmed in a community :

Patients who develop flu like illness (ie, fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer.

To seek medical care, patients should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician's office, or hospital.

Patients who have difficulty breathing or shortness of breath or who are believed to be severely ill should seek immediate medical attention.

If the patient must go into the community (eg, to seek medical care), he or she should wear a face mask to reduce the risk of spreading the virus in the community when coughing, sneezing, talking, or breathing. If a face mask is unavailable, ill persons who need to go into the community should use tissues to cover their mouth and nose while coughing.

While in home isolation, patients and other household members should be given infection control instructions, including frequent hand washing with soap and water. Use alcohol-based hand gels (containing at least 60% alcohol) when soap and water are not available and hands are not visibly dirty. Patients with H1N1 influenza should wear a face mask when within 6 feet of others at home.

Read More about Signs and Symptoms

Read More about How does the H1N1 flu differ from the seasonal flu?

Read More about Influenza Tests

Read More about Influenza (Flu) Vaccine(Inactivated or Recombinant):What you need to know PDF

Read More about CDC Says "Take 3" Steps To Fight The Flu PDF or Poster PDF

Read More about Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers PDF

References 

- https://www.nlm.nih.gov/medlineplus/h1n1fluswineflu.html

- http://www.webmd.com/cold-and-flu/flu-guide/h1n1-flu-virus-swine-flu

- http://www.cdc.gov/h1n1flu/vaccination/

- http://www.uptodate.com/contents/treatment-and-prevention-of-pandemic-h1n1-influenza-swine-influenza?source=search_result&search=h1n1&selectedTitle=1~86

- http://www.who.int/csr/disease/swineflu/frequently_asked_questions/about_disease/en/

- http://www.flu.gov/about_the_flu/h1n1/

- http://emedicine.medscape.com/article/1807048-treatment

- http://www.mayoclinic.org/diseases-conditions/swine-flu/basics/complications/con-20034916

- http://www.anejo.eu/wp-content/uploads/2013/03/CH5236.jpg

- http://en.trend.az/iran/society/2465878.html
- http://www.epid.gov.lk/web/attachments/article/146/Latest_fact_sheet_H1N1_Influenza.pdf
- https://www.cdph.ca.gov/HealthInfo/h1n1flufaqs/Pages/H1N1fluFAQs-03-Prevention.aspx

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Risk factors for Deep vein thrombosis "DVT"

Deep vein thrombosis occurs when a blood clot forms in the veins that are deep in your body, often in your legs. Blood clots can be caused by anything that prevents your blood from circulating normally or clotting properly.

Deep vein thrombosis (DVT) and acute pulmonary embolism (PE) are two manifestations of the same disorder, venous thromboembolism (VTE). DVT of the lower extremity is subdivided into two categories:
*  Distal (calf) vein thrombosis, in which thrombus remain confined to the deep calf veins
*  Proximal vein thrombosis, in which thrombosis involves the popliteal, femoral, or iliac veins


Risk factors for DVT

● History of immobilization or prolonged hospitalization / bed rest.
In hospital:
  - you are having an operation that takes longer than 90 minutes, or 60 minutes if the operation is on your leg, hip or abdomen.
  - you are having an operation for an inflammatory or abdominal condition, such as appendicitis
  - you are confined to a bed, unable to walk, or spending a large part of the day in a bed or chair for at least three days.
- A personal or family history of deep vein thrombosis or pulmonary embolism (PE). If you or someone in your family has had DVT or PE before, you're more likely to develop DVT.
● Recent surgery
● Obesity
Being overweight increases the pressure in the veins in your pelvis and legs.
● Prior episode (s) of venous thromboembolism
● Lower extremity trauma
● Malignancy
● Use of oral contraceptives or hormone replacement therapy
● Pregnancy or postpartum status
Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.

● Stroke
● Smoking;  affects blood clotting and circulation, which can increase your risk of DVT
● Age. Being over age 60 increases your risk of DVT, though it can occur at any age.







According (UpToDate site, 2016); Risk factors (causes) for the development of venous thrombosis:


Inherited thrombophilia:

Factor V Leiden mutation
Prothrombin gene mutation
Protein S deficiency
Protein C deficiency
Antithrombin (TAT) deficiency
Rare disorders
Dysfibrinogenemia

Acquired disorders:

Malignancy
Presence of a central venous catheter
Surgery, especially orthopedic
Trauma
Pregnancy
Oral contraceptives
Hormone replacement therapy
Tamoxifen, Thalidomide, Lenalidomide
Immobilization
Congestive failure
Antiphospholipid antibody syndrome
Myeloproliferative disorders
Polycythemia vera
Essential thrombocythemia
Paroxysmal nocturnal hemoglobinuria
Inflammatory bowel disease
Nephrotic syndrome


According (CDC site, 2015); Following is a list of factors that increase the risk of developing DVT

● Injury to a vein, often caused by:
Fractures,
Severe muscle injury, or
Major surgery (particularly involving the abdomen, pelvis, hip, or legs).
● Slow blood flow, often caused by:
Confinement to bed
(eg, due to a medical condition or after surgery);
Limited movement (eg, a cast on a leg to help heal an injured bone);
Sitting for a long time, especially with crossed legs; or
Paralysis.
● Increased estrogen, often caused by:
Birth control pills
Hormone replacement therapy, sometimes used after menopause
Pregnancy, for up to 6 weeks after giving birth
● Certain chronic medical illnesses, such as:
Heart disease
Lung disease
Cancer and its treatment
Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
● Other factors that increase the risk of DVT include:
Previous DVT or PE
Family history of DVT or PE
Age (risk increases as age increases)
Obesity
A catheter located in a central vein
Inherited clotting disorders

References:
- http://www.uptodate.com/contents/approach-to-the-diagnosis-and-therapy-of-lower-extremity-deep-vein-thrombosis?source=search_result&search=dvt&selectedTitle=1~150 
- http://www.nhs.uk/Conditions/Deep-vein-thrombosis/Pages/Causes.aspx
- http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/causes/con-20031922
- http://www.cdc.gov/ncbddd/dvt/facts.html
- http://www.parkhurstexchange.com/clinical-reviews/apr11/deep-vein-thrombosis-in-the-elderly

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G6PD .. Drugs that should be avoided

Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder that occurs most often in males. This condition mainly affects red blood cells, which carry oxygen from the lungs to tissues throughout the body. In affected individuals, a defect in an enzyme called glucose-6-phosphate dehydrogenase causes red blood cells to break down prematurely. This destruction of red blood cells is called hemolysis.

OR

G6PD Deficiency is a hereditary abnormality in the activity of an erythrocyte (red blood cell) enzyme. This enzyme, glucose-6-phosphate dehydrogenase (G-6-PD), is essential for ensuring a normal life span for red blood cells, and for oxidizing processes. This enzyme deficiency may provoke the sudden destruction of red blood cells and lead to hemolytic anemia with jaundice following the intake of fava beans, certain legumes and various drug.

For see Drugs that should be avoided - Official List Click Here


For see Gene (G6PD: glucose-6-phosphate dehydrogenase) Click Here























































































































































































References
- http://ghr.nlm.nih.gov/condition/glucose-6-phosphate-dehydrogenase-deficiency
- http://www.g6pd.org/g6pddeficiency.aspx
- http://www.ncbi.nlm.nih.gov/gene/2539

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