Advantages of Breastfeeding

1. Optimal Nutrition:

  • Breast milk is tailor-made for the infant, providing all essential nutrients.
  • Rich in antibodies, boosts the baby’s immune system.Are you a nursing mom? Pay attention to these 3 effective breastfeeding positions | HealthShots

2. Bonding and Emotional Well-being:

  • Skin-to-skin contact during breastfeeding fosters emotional connection.
  • Releases oxytocin, promoting maternal-infant bonding.

3. Lowered Risk of Infections:

  • Colostrum (first milk) contains antibodies and immunoglobulins.
  • Reduces the risk of respiratory, ear, and gastrointestinal infections.

4. Cognitive Development:

  • Omega-3 fatty acids in breast milk support brain development.
  • Linked to higher IQ and improved cognitive function.

5. Reduced Allergies and Asthma:

  • Lower incidence of allergies, eczema, and asthma in breastfed infants.
  • Protective factors in breast milk.

Your Baby and Breastfeeding

6. Digestive Health:

  • Easier to digest than formula, reducing the risk of constipation.
  • Decreases the likelihood of colic and gastroesophageal reflux.

7. Weight Management:

  • Promotes healthy weight gain in infants.
  • Decreases the risk of childhood obesity.

8. Cost-Efficient:

  • Breast milk is free, eliminating the need for formula.
  • Fewer doctor visits due to better health outcomes.

9. Environmental Sustainability:

  • Reduced carbon footprint compared to formula production.
  • Decreases plastic waste from formula containers.

10. Maternal Health Benefits: – Helps with postpartum weight loss. – Reduces the risk of postpartum depression. – Lowers the risk of breast and ovarian cancer.

Does breastfeeding hurt? | baby gooroo


  • Breastfeeding is a crucial foundation for a healthy start in life.
  • Provides numerous advantages for both infants and mothers.
  • Promotes health, bonding, and environmental sustainability.
  • Encouraging breastfeeding contributes to a brighter and healthier future.

Dengue fever

DENGUE AND SMOG | Transport DepartmentDengue fever is a mosquito-borne viral infection that can cause flu-like symptoms and, in severe cases, potentially life-threatening complications. It is caused by the dengue virus, which is transmitted to humans primarily through the bite of infected female Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. Dengue fever is common in tropical and subtropical regions of the world, including parts of Southeast Asia, the Pacific Islands, the Caribbean, and Central and South America.

Here are some key points about dengue fever:


The symptoms of dengue fever typically appear 4-10 days after being bitten by an infected mosquito and can include high fever, severe headache, pain behind the eyes, joint and muscle pain, rash, and mild bleeding. In some cases, dengue fever can progress to a more severe form known as dengue hemorrhagic fever or dengue shock syndrome, which can be life-threatening.

Dengue fever presents with a wide range of signs and symptoms that can vary in severity. The disease typically has an incubation period of 4-10 days after being bitten by an infected mosquito. The symptoms of dengue fever can be categorized into three phases: the febrile phase, the critical phase, and the recovery phase. Not all individuals with dengue infection will progress through all three phases, and the severity of symptoms can vary from mild to severe. Here are the common signs and symptoms associated with each phase:

  1. Febrile Phase (Acute Phase):

High Fever: Sudden onset of high fever, often reaching up to 104°F (40°C).

Severe Headache: Intense frontal headache, which is a common feature of dengue fever.

Pain Behind the Eyes: Pain or discomfort, especially when moving the eyes.

Joint and Muscle Pain: Severe joint and muscle pain, often referred to as “breakbone fever.”

Rash: A rash may develop, typically starting a few days after the onset of fever. It can be maculopapular (red and raised) and sometimes itchy.

Fatigue: Extreme fatigue and weakness.

Nausea and Vomiting: Some individuals may experience nausea and vomiting.

Mild Bleeding: Minor bleeding manifestations such as nosebleeds, gum bleeding, or easy bruising can occur.

  1. Critical Phase (Warning Signs):

Around the 3-7 day mark, some patients with dengue fever may progress to a critical phase. Warning signs indicate increased severity and the potential for complications. These signs include:

Persistent Abdominal Pain: Severe abdominal pain may develop, which can be a sign of impending complications like dengue hemorrhagic fever.

Vomiting with Blood: Vomiting blood (hematemesis) or passing blood in the stool (melena) can occur.

Bleeding: Severe bleeding, such as from the nose or gums, petechiae (small red or purple spots on the skin), or hematuria (blood in the urine).

Rapid Breathing: Increased respiratory rate and difficulty breathing.

Cold or Clammy Skin: Skin may become cold, pale, or clammy.

Restlessness: Agitation or restlessness may be observed.

  1. Recovery Phase:

After the critical phase, most patients gradually recover over the next few days to weeks.

The fever subsides, and other symptoms begin to improve.

Convalescence: Patients may experience fatigue and weakness during the recovery phase, which can persist for an extended period.

It’s important to note that not all individuals with dengue fever progress to the critical phase or develop severe symptoms. The majority of cases are mild, and with proper medical care and supportive treatment, the prognosis is usually favorable. However, severe dengue (such as dengue hemorrhagic fever or dengue shock syndrome) can be life-threatening and requires immediate medical attention.

If you or someone you know exhibits the warning signs of dengue fever, it’s crucial to seek medical care promptly to prevent complications and ensure appropriate treatment and monitoring.

Diagnosis: Dengue fever is usually diagnosed through blood tests that detect the presence of the dengue virus or antibodies produced in response to the virus.

Laboratory findings play a significant role in the diagnosis and management of dengue fever. The results of various laboratory tests can help confirm the presence of the dengue virus, assess the severity of the infection, and guide treatment decisions. Here are some of the key laboratory findings associated with dengue fever:

Dengue Serology (Antibody Tests):

IgM Antibodies: In the early stages of the illness (usually within the first week), dengue-specific IgM antibodies can be detected in the patient’s blood. The presence of IgM antibodies suggests a recent dengue infection.

IgG Antibodies: Dengue-specific IgG antibodies may appear later and persist for a more extended period. Elevated IgG levels may indicate a past dengue infection.

Polymerase Chain Reaction (PCR) Test:

Dengue PCR: This test detects the genetic material (RNA) of the dengue virus in a patient’s blood. It is most useful in the early days of infection, even before the appearance of IgM antibodies. PCR can help confirm an acute dengue infection and identify the specific serotype of the virus.

Complete Blood Count (CBC):

Platelet Count: One of the hallmark laboratory findings in dengue fever is a decrease in platelet count (thrombocytopenia). Platelets are essential for blood clotting, and low platelet levels can lead to bleeding tendencies.

Hematocrit (Hct) Levels: An elevated hematocrit (a measure of the proportion of red blood cells in the blood) can indicate hemoconcentration, which is common in dengue fever due to plasma leakage.

Liver Function Tests:

AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase): Elevated levels of these liver enzymes are often seen in dengue patients, indicating liver involvement.

Coagulation Profile:

PT (Prothrombin Time) and APTT (Activated Partial Thromboplastin Time): These tests assess the blood’s clotting ability. Prolonged PT and APTT may be seen in severe cases of dengue with bleeding tendencies.

Electrolyte Levels:

Sodium (Na) and Potassium (K): Abnormal electrolyte levels can occur due to fluid imbalances in dengue patients, especially those with severe symptoms.

Creatinine and Urea Levels:

Kidney Function Tests: Elevated creatinine and urea levels may indicate kidney involvement in severe dengue cases.

Other Tests:

NS1 Antigen Test: This test can detect the presence of the dengue virus NS1 antigen in a patient’s blood and is useful for early diagnosis.

Dengue Serotyping: In areas with multiple dengue virus serotypes, it’s important to identify the specific serotype causing the infection as some serotypes are associated with more severe disease.

Laboratory findings in dengue fever can vary depending on the stage of the infection and the severity of the disease. These tests help healthcare providers confirm the diagnosis, assess the patient’s condition, and make decisions regarding treatment and monitoring. It’s important to note that dengue fever is a dynamic disease, and laboratory findings may change over the course of the illness, so repeated testing and close monitoring are often necessary, especially in severe cases.


The best way to prevent dengue fever is to avoid mosquito bites. This can be achieved by using insect repellent, wearing long-sleeved clothing, and staying in air-conditioned or screened-in accommodations. Additionally, efforts to reduce mosquito breeding sites, such as eliminating standing water around homes, are essential for dengue prevention.


As of my last knowledge update in September 2021, there was an approved dengue vaccine called Dengvaxia. However, its use and availability varied by country, and it was primarily recommended for individuals who had previously been infected with dengue. Vaccine availability and recommendations may have evolved since then, so it’s essential to check with local health authorities for the most up-to-date information on dengue vaccines.

It’s important to note that dengue fever can be a serious illness, and early detection and medical care are crucial for managing the disease effectively, especially in severe cases. If you suspect you have dengue fever or are in an area where the disease is prevalent, seek medical attention promptly.


There is no specific antiviral treatment for dengue fever. Management primarily involves relieving the symptoms and providing supportive care, such as staying hydrated and taking pain relievers like acetaminophen. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided because they can increase the risk of bleeding.

The medical and nursing management of dengue fever involves a combination of supportive care and monitoring to alleviate symptoms, prevent complications, and promote recovery. Here’s a comprehensive overview of the medical and nursing management of dengue fever:

Medical Management:

Diagnosis: Accurate diagnosis through clinical evaluation and laboratory tests (serology or PCR) is essential to confirm dengue fever.

Hospitalization: Depending on the severity of the illness, some patients may require hospitalization. Hospitalization is especially crucial for patients with severe dengue or those at risk of complications.

Fluid Replacement: Adequate hydration is a cornerstone of dengue management. Intravenous (IV) fluids are often administered to maintain fluid and electrolyte balance. Nurses closely monitor patients’ fluid intake and output.

Pain and Fever Management: Analgesics such as acetaminophen are given to relieve pain and reduce fever. Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin should be avoided, as they can increase the risk of bleeding.

Monitoring: Regular monitoring of vital signs, hematocrit levels, platelet counts, and other relevant parameters is crucial to assess the progression of the disease and the patient’s response to treatment.

Blood Transfusion: In severe cases of dengue with hemorrhagic manifestations, blood transfusion may be necessary to replace lost blood components.

Nursing Management:

Assessment: Nurses conduct a thorough assessment of the patient’s clinical status, including vital signs, hydration level, skin condition, and the presence of bleeding or shock symptoms.

Fluid Administration: Nurses administer IV fluids as prescribed by the physician, ensuring that the rate and type of fluid are appropriate for the patient’s condition.

Monitoring: Frequent monitoring of vital signs, especially blood pressure, pulse rate, and respiratory rate, is essential to detect any deterioration in the patient’s condition promptly.

Pain and Fever Control: Nurses administer pain relievers and antipyretics as ordered by the physician and monitor the patient’s response to these medications.

Emotional Support: Providing emotional support and reassurance to the patient and their family is essential, as dengue fever can be a distressing experience.

Education: Nurses educate patients and their families about the importance of hydration, medication compliance, and the signs and symptoms that require immediate medical attention.

Infection Control: Nurses ensure strict infection control measures to prevent the spread of the virus, particularly in healthcare settings. This includes proper hand hygiene and personal protective equipment (PPE) use.

Patient Education: Patients should be educated about the prevention of mosquito bites and the importance of seeking prompt medical care if their condition worsens.

Discharge Planning: When the patient is stable and ready for discharge, nurses provide instructions for continued care at home, including medication schedules and follow-up appointments.

The medical and nursing management of dengue fever should be tailored to the individual patient’s condition and may vary based on the severity of the illness. Close collaboration between healthcare providers, including physicians, nurses, and other healthcare staff, is crucial to ensure optimal patient care and recovery.

Application to Basic Mathematics to Medication Dosage

Conversion of the SI, British and Household systems of the selected problems:

Household to Household Conversion

  1. Convert 6 teaspoons to table spoons.

1 Solution:

Step– 1: Equivalent?

As we know that 1 tablespoon = 3 teaspoon              conversion factor = 3.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

6 teaspoon = 6 / 3 = 2

Hence 6 teaspoon = 2 tablespoon

For practice

  1. 7 T = ___ t
  2. 12t = ___ T
  3. ____T = 23 t

SI and Household Conversion

  1. ____ mL = 3t


Step– 1: Equivalent?

As we know that 1 teaspoon = 5 mL              conversion factor = 5.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

3 teaspoon = 3 X 5 = 15 mL

Hence 3 teaspoon = 15 mL

For practice:

Calculate the equivalent measures.

  1. _____ mL = 4 t
  2. _____ mL = 3T
  3. _____ mL     = 7t
  4. 30 mL = _____ Tablespoon
  5. 20 mL = _____ teaspoons

SI and British Conversion

  1. ____ mL = 3 ounce


Step– 1: Equivalent?

As we know that 1 ounce = 30 mL                 Conversion factor = 30.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

3 ounces = 3 X 30 = 90 mL

Hence 3 ounces = 90 mL

For practice:

Convert the following:

  1. 2 ounces = _____ mL
  2. 120 mL  = _____ ounces
  3. 2 T = _______ ounces


Other Drug Measures (Units and milliequivalents) 

Quantities of drugs may be included in units (U) or milliequivalents (mEq). Conversions for either milliequivalents or units are un-necessary. Drugs in these measurements are prescribed, prepared, and administered all in the same system.

Units and milliequivalents

A Unit (not a weight measurement) is an amount of a drug which produces a certain effect. The meaning of units varies with the particular drug being measured, since the amounts and the related effects of various drugs differ. Insulin is a familiar drug administered in Units.

A milliequivalent is a measurement of the weight of a drug contained in a certain volume of solution.  

The quantities of the Units and milliequivalents are written Arabic numerals followed by the appropriate symbol, U or mEq.

SYMBOLIC NOTATION                                       MEANING

10, 25, or 10,000 U etc                                                           10, 25 or 10,000 units

5,,10, or 25 mEq etc                                                               25 milli equivalents etc


  1. Generic and Brand Name of the Drug

Most labels, however, identify a drug by two names, one is the official (generic) name of the drug, the other name is the brand or trade name which is identified by ®, the registration symbol.

For example:                                                        

Generic Brand Name


Ibuprofen Brufen


diclofenace sodium Tab: Dicloran, Dyclo, Voltral,

Cap: Philogen etc.


cephradine Velocef,


co-trimaxazole Septran, Penetrin, Biotran, Nicotrim etc.


Note:  Name of drug to be given (trade/brand name is started with capital letter & generic name is written with small letters)

  1. Dosage strength (weight of the drug)

The dosage strength or weight of the drug is written on the label with a unit of measure such as gram, milligram, Units, mEq, for example 250 mg, 2g, 250 U, 1000 U, 20 mEq etc.


Combination drugs are preparations which contain a mixture of several drugs together. Often the dosage strength is not listed for combination drug. They are ordered by tablet, capsule, or by milliliters, and not by dosage strength.

  1. Form of the drug

The drug may be in solid (tablet, capsule, etc) or liquid form (syrup, suspension, etc.). A tablet or capsule contains a certain weight of a drug. A volume of solution (usually stated in mL or cc) contains a certain weight of a drug.

  1. Supply Dosage (On Hand Dosage)

The supply dosage or On-Hand Dosage is the dosage strength (weight) together with the form of drug.

Dosage strength form Supply dosage On-Hand Dosage


Solid: 50 mg In        1 tablet 50 mg/tablet
Solid: 50 mg In         1cc 50 mg/cc
Solid: 200 mg In       1 capsule 200 mg/capsule
Liquid: 200mcg In        5 mL 200 mcg/5 mL
Liquid: 1000 U In        1 mL 1000 U/1 mL

 Note: The dosage ordered by the Physician may be expressed in terms of weight only. The order may not state the number of milliliters (or cc) necessary to deliver that dosage.

  1. Total Container Volume

The total number of milliliters (mL) or cubic centimeter (cc) in the container (bottle) is listed on the label. Today, many tablets or capsules are packed in unit dosage; that is, a single tablet or capsule in a blister pack. A container may hold multiple doses; while the total number of tablets or capsules is identified.

  1. Direction for mixing or Reconstituting powdered Drugs

Certain drugs that are supplied in powder form must be dissolved in a liquid before they can be administered. The directions for preparing solutions from powdered drugs may be printed on the drug label or may be included in the drug literature or inserters.

  1. Expiration Date and Additional Information

The expiration date is the last date on which the drug be used. Expiration may be abbreviated as EXP. Warnings regarding storage and the use of the drug are examples of other information which may be included on the drug label.

Basic Drug Abbreviations and Conversions

Conversion of units within the system: 

Length Conversions:

Convert 2.85 Kilometer to Meter.

Step– 1: Equivalent?

As we know that 1 km = 1000 m                    conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

2.85 km = 2.85 x 1000 = 2850 m

Hence 2.85 km = 2850 m

  1. 25 mm = ____ cm

Step– 1: Equivalent?

As we know that 1 cm = 10 mm                     conversion factor =10.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

25 mm = 25 / 10 = 2.5 cm

Hence 25 mm = 2.5 cm

  1. _____ m = 57 mm

Step– 1: Equivalent?

As we know that 1 m = 1000 mm                   conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

57 mm = 57 ÷ 1000 = 0.057 m

Hence 0.057 m = 57 mm

  1. 0.04 m = _____ cm

  Step– 1: Equivalent?

As we know that 1 m = 100 cm                      conversion factor =100.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

0.04 m = 0.04 X 100 = 4 cm

Hence 0.04 m = 4 cm 

Length Conversion between Metric and English

  1. Convert 5 inches to centimeters.

Step– 1: Equivalent?

As we know that 1 in = 2.5 cm                       conversion factor =2.5.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

5 in = 5 x 2.5 = 12.5 cm

Hence 5 in = 12.5 cm

  1. Convert 5 feet 7 inches to centimeters

Step– 1: 5 feet 7 inches (5¢ 7²) must be converted to inches before converting to centimeters. 

As we know that 1 ft = 12 in then 5¢ 7² = (5 X 12) + 7 = 67 inches = 67²

Step– 2: Equivalent?

1 in =2.5 cm                            conversion factor =2.5.

Step-3: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

67² in = 67 x 2.5 = 167.5 cm

Hence 5¢ 7²  = 167.5 cm

  1. Convert 0.75 meter to inches

Step– 1: Equivalent?

As we know that 1 m = 39 in              conversion factor = 39.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

0.75 m = 0.75 x 39 = 29.55 in

Hence 0.75 m = 29.55 in

Conversion of units within the system:

S I Length Conversions:

  1. Convert 2.85 Kilometer to Meter.

Step– 1: Equivalent?

As we know that 1 km = 1000 m                    conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

2.85 km = 2.85 x 1000 = 2850 m,    Hence 2.85 km = 2850 m

On the Job Practice
  1. The heights of two patients were recorded. Convert the units.
  2. 1.8 m = _____ cm.
  3. 1.025 m = _____ cm.
  4. The range of lengths of newborn babies is 45-55 centimeters. Express the length in millimeters.

_______ mm – ________ mm.

  1. During a physical assessment, a mole on a patient’s back was noted and measured.

Mole: 21 mm = _____ cm.

  1. A child was admitted to the emergency room with a cut which was noted in the records.

Cut: 95 mm = _____ cm.

Additional Practice:

Convert the following units as indicated

  1. 60 in = _____ cm
  2. 5’5” = _____ cm
  3. 6 ft = _____ cm  


Physician’s order is also called drug order. The order of physician to administer drug having the following information is called physician’s order.

  • Name of drug to be given(trade/brand name is started with capital letter & generic name is written with small letters)
  • Dosage and form
  • Route
  • Frequency
  • Additional description (for special instructions it may or may not be included)

Following are some examples of physician’s order

Name                                     Dosage                  Route                     Frequency                            additional description

Paracetamol                 500 mg tab      P.O                  q.3-4h. P.r.n.               severe muscle pain

NPH insulin                 25 units           SC                   q.d.                              a.c. breakfast

nitroglycerin                0.4 mg tab       SL                   p.r.n.                            chest pain

Interpretation of above drug orders:

  1. Administer a 500 mg tablet of Paracetamol by mouth every 3 to 4 hours as necessary for  severe muscle pain.
  2. Administer 25 units of NPH insulin subcutaneously every day before breakfast.
  3. Administer 0.4 mg tablet of nitroglycerin under the tongue as needed for chest pain.
On the Job Practice

Read the following and interpret the drug orders:

  1. morphine sulfate 15 mg SC       q4h.
  2. Tylenol 0.6 g                PO       q.6h                 p.r.n.    headache
  3. atropine sulfate(optic) 1% sol 2gtt OD      q.d.t.i.d.
  4. Demerol 75 mg IM       q.4h                 p.r.n.    pain

Dosage Measurement System

Discuss the equivalent of:

SI system

1.1.1 SI Units of Length

Metric Length Equivalents

 The conversion factor between meter and kilometer is 1000.          1 km   = 1000 m

The conversion factor between meter and millimeter is 1000.          1 m    = 1000 mm

The conversion factor between meter and centimeter is 100.          1 m    = 100 cm

The conversion factor between centimeter and millimeter is 10.      1 cm   = 10 mm

1.1.2 SI units of Volume 1 inch = 2.5 cm = 25 mm

Metric Volume Equivalents

 1 mL =         1 cc                                 The conversion factor is 1.

1 L     =       1000 mL                          The conversion factor is 1000.

1 L     =       1000 cc                            The conversion factor is 1000.

1.1.3 SI Units of Weight                                           

Metric Weight Equivalents

 1 kg   =       1000g                             The conversion factor is 1000.

1 g     =       1000 mg                          The conversion factor is 1000.

1mg   =       1000 mcg                         The conversion factor is 1000.

  • 2 Household System Units

 Household System Units of Volume and their Equivalent

 Unit                               Abbreviation                 Equivalent

Drop                              gtt                                 

Teaspoon                      t or tsp                           1t = 5mL   

Table spoon                   T or tbs                          1 T    = 3tsp =15mL



 1.3 Apothecaries’ System Equivalents

 Symbolic Notation                                          Meaning

i          =          viii                                                      1 ounce            = 8 drams

pt i       =          z 16                                         1 pint               = 16 ounces, 1 ounce = 30mL

qt i       =          pt ii                                                      1 quart             = 2 pints

gal i     =          qt iv                                                     1 gal                = 4 quarts

1.4 British System Equivalents                                                          

1 foot           =       12 inches

1 yard          =       3 feet      = 36 inches

1   mile                  =       1760 yards

  1. Convert SI weight from one unit to another unit and SI volume from one unit to another unit.

Conversion of SI weight from one unit to another unit

Convert the following:

  1. Convert 28.5 g into mg. 


Step– 1: Equivalent?

As we know that 1 g = 1000mg                      conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

28.5 g = 28.5 x 1000 = 28500 mg

Hence 28.5 g =28500 mg

  1.     _________ kg = 135 g
  2. Solution:


Step– 1: Equivalent?

As we know that 1 kg = 1000g                       conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

135 g = 135 / 1000 = 0.135 kg

Hence 0.135 kg = 135 g

  1. _________ g = 4.5 kg


Step– 1: Equivalent?

As we know that 1 kg = 1000 g                      conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

4.5 kg = 4.5 x 1000 = 4500 g

Hence 4500 g = 4.5 kg

 750 mg = _____ g


Step– 1: Equivalent?

As we know that 1 g = 1000mg                      conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

750 mg = 750 / 1000 = 0.75 g

Hence 750 mg = 0.75 g

  1. _____ mcg =0.4  mg


Step– 1: Equivalent?

As we know that 1 mg = 1000 mcg                conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

0.4 mg = 0.4 x 1000 = 400 mcg

Hence 400 mcg = 0.4 mg

On the Job Practice

 Convert the tablet dosage strength as indicated:

  1. Paracetamol 500 mg tablet              ______ g
  2. Triamcilone 4 mg tablet ______ g
  3. Codeine sulfate 0.03 g tablet ______ mg
  4. Morphine sulfate 0.015 g tablet ______ mg
  5. A premature baby, born before the 37-38 week of gestation, has a birth weight of less than 2.5 kilograms. 2.5 kg = _____ g

Conversion of SI Volume from one unit to another unit

  1. 2.85 L = _____ mL

Step– 1: Equivalent?

As we know that 1 L = 1000 mL                    conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

2.85 L = 2.85 x 1000 = 2850 mL

Hence 2.85 L = 2850 mL

  1. 750 mL = ____ L

Step– 1: Equivalent?

As we know that 1 L = 1000 mL                    conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

750 mL = 750 / 1000 = 0.75 L

Hence 750 mL = 0.75 L

  1. ____ cc = 0.85 L

Step– 1: Equivalent?

As we know that 1 L = 1000 cc                      conversion factor =1000.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

0.85 L = 0.85 X 1000 = 850 cc

Hence 850 cc = 0.85 L

  1. ____ mL = 25 cc

Step– 1: Equivalent?

As we know that 1 mL = 1 cc             conversion factor = 1

Step-2: Multiply or divide?

The Conversion is to the same size unit. The quantity of cubic centimeter will be equal to the quantity of milliliters.

Hence 25 mL = 25 cc. 

On the Job Practice

 The normal daily intake of fluid for an adult is about 1500- 2000 milliliters. Express this average in liters.

______ L = ______ L

  1. The average capacity of an adult urinary bladder is about 500 cc.

500 cc = _____ mL = _____ L

  1. The average adult excretes about 1200 – 1500 cc of urine every 24 hours. Express this range in milliliters first, then in liters.

1200 cc = _____ mL = _____ L

1500 cc = _____ mL = _____ L

  1. A given syringe holds 3cc of medication. The capacity of the syringe could be stated as _____ mL.
  2. A certain tuberculin syringe has a capacity of 0.5 mL. What is the volume of this syringe in cc. ____ cc.
  1. Convert kilogram to pound and pound to kilogram

Conversion between metric and English system 

  1. Convert 154 pounds to kilograms.

Step– 1: Equivalent?

As we know that 1 kg = 2.2 lb                        conversion factor =2.2.

Step-2: Multiply or divide?

Conversion is to larger units. Divide by the conversion factor.

154 lb = 154 ÷ 2.2 = 70 kg

Hence 154 lb = 70 kg

  1. Convert 15.5 kilogram to pounds.

Step– 1: Equivalent?

As we know that 1 kg = 2.2 lb                        conversion factor =2.2.

Step-2: Multiply or divide?

Conversion is to smaller units. Multiply by the conversion factor.

15.5 kg = 15.5 X 2.2 = 34.1 lb

Hence 15.5 kg = 34.1 lb

On the Job Practice
  1. Solve simple word problems based on these measurement systems.

The weights of three patients were recorded. Convert the units.

  1. 196 pounds = _____ kg
  2. 157 pounds = _____ kg
  3. 61 kilograms = _____ lb

Pakistan Study BCQs/MCQs BScN

1. During khilafat movement an excited mob set fire to a police station at chauri chaura village where about 22 policemen burnt alive in:
a. February 1922
b. February 1923
c. February 1920
d. February 1921
e. February 1924
2. Who presented the resolution for the formation of All India Muslim League:
a. Nawab Salimullah Khan
b. M. Ali Johar
c. Waqar-ul-Mulk
d. Mohsin-ul-Mulk
e. Sir Agha Khan
3. Which of the following was commonly known as the ’Father of idea of Pakistan’?
a. Sir Muhammad Shafi
b. Choudhary Rehmat Ali
c. M A Jinnah
d. Allama Iqbal
4. When India cut off Pakistan’s water supply without notice?
a. June 1948
b. April 1949
c. May 1948
d. May 1949
e. April 1948
5. Mahmood Ghaznavi who ruled Ghani from 997-1030 A.D. raided India for:
a. 17 times
b. 15 times
c. 16 times
d. 19 times
e. 18 times
6. Historical wars of Paniput are very famous ; this battle field is located in Indian Punjab. How many major wars were fought in this field?
a. Five
b. Six
c. Four
d. Three
e. Two
7. The 3rd June plan was announced on 3rd June by:
a. Lord Mounbatten
b. Jawahar Lal Nehru
c. Loord Wavell
d. Moti Lal Nehru
e. M.A. Jinnah
8. Quaid-e-Azam inaugurated the State Bank of Pakistan on:
a. 14th August, 1948
b. 1st July, 1949
c. 14th July, 1948
d. 1st July, 1948
e. 1st June, 1948
9. Who was the chairman of two boundary commissions between India and Pakistan?
a. Sir Cyril Radcliff
b. Tej sinjh
c. Muhammad Muneer
d. Din Muhammad
e. Mehar Chand
10. Name the Viceroy of India who made an offer in August 1940, on the behalf of British Government to Indian people:
a. Lord Wavel
b. Lord Mount Batten
c. Lord Irwin
d. Lord Linlithgow
e. Lord Hardinge
11. Who was appointed as the caretaker prime minister of Pakistan after the first dismissal of Benazeer Bhutto:
a. Aftab Ahmed Sherpao
b. Muhammad Khan Junejo
c. Moen Qureshi
d. Meraj Khalid
e. Ghulam Mustafa Jatoi
12. The Muslims of Sub-continent launched the Khilafat movement in the year of:
a. 1918
b. 1919
c. 1916
d. 1917
e. 1920
13. Which of the following was the first Muslim of India who placed Two Nation Theory?
a. Sir Syed Ahmed Khan
b. Sir Agha Khan
c. M. Ali Jinnah
d. M. Ali Johar
e. Sir Muhammad Shafi
14. Quaid-e-Azam Muhammad Ali Jinnah joined All India Muslim League in the year of:
a. 1913
b. 1915
c. 1914
d. 1912
e. 1916
15. All India Muslim League was established in:
a. September 1905
b. December 1906
c. September 1906
d. December 1907
e. December 1905
16. The Mughal emperor who promulgated a new faith entitled Din-e-Elahi in 1581 A.D. was:
a. Akber
b. Jahangir
c. Humayun
d. Baber
e. Aurangzeb
17. Who was the first prime minister of Pakistan?
a. Kwaja Nazim-ud-din
b. M. Ali Jinnah
c. Liaquat Ali Khan
d. Muhammad Ali Bogra
e. Nur-ul-Amin
18. The Muslim Deputation met the Viceroy Minto in 1906 at:
a. Bombay
b. Delhi
c. Simla
d. Calcutta
e. Lahore
19. Who was the founder of Mughal dynasty?
a. Sher Shah
b. Humayun
c. Akber
d. Jahangir
e. Zaheer-ud-din Baber
20. In 712 A.D a Muslim expedition to conquer Sindh was sent by Hajjaj Bin Yousuf who was:
a. Governer of Iraq
b. Governer of Makran
c. Emperor of Egypt
d. King of Persia
e. Governer of Syria
21. The Simla Deputation led by Agha Khan was consisted of:
a. 25 members
b. 35 members
c. 30 members
d. 32 members
e. 40 members
22. When 3rd Martial law was imposed?
a. 5th July, 1980
b. 5th July, 1978
c. 5th July, 1976
d. 5th July, 1979
e. 5th July, 1977
23. Who coined the name Pakistan?
a. Maulana Muhammad Ali Johar
b. Choudhary Khaliq-uz-zama
c. M,A. Jinnah
d. Choudhary Rehmat Ali
e. Allama Iqbal
24. Select correct chronological order:
a. Akber, Shah Jahan, Humayun, Jahangir
b. Shah Jahan, Jahangir, Akber, Humayun
c. Akber, Humayun, Jahangir, Shah Jahan
d. Jahangir, Shah Jahan, Humayun, Akber
e. Humayun, Akber, Jahangir, Shah Jahan
25. On 23rd March, 1940, the famous resolution which came to be known as Pakistan Resolution was moved by:
a. Choudhary Khaliq-uz-zama
b. Moulvi Fazal-ul-Haq
c. Sardar Auranzeb
d. Moulana Zafar Ali Khan
e. M.Ali Johar
26. Sindh Provincial Muslim League Conference was held at Karachi and passed a resolution adopting Two-Nation Theory on:
a. 10th October, 1938
b. 10th October, 1941
c. 10th October, 1937
d. 10th October, 1939
e. 10th October, 1940
27. The British Government appointed Simon Commission for the recommendation for the new constitution in the year of:
a. 1928
b. 1926
c. 1927
d. 1930
e. 1929
28. The largest political forum of the Islamic countries in the world is:
a. NAM
b. Gulf Countries
c. OIC
d. ECO
e. Arab League
29. With the resignation of Congress Ministries, the Quaid-e-Azam appealed to the people to observe Day of Deliverance on:
a. 22 December, 1938
b. 22 January, 1940
c. 22 January, 1939
d. 22 December, 1939
e. 22 December, 1940
30. Under the Vidya Mandir scheme, the students were asked to pay respect and homage to Gandhi’s picture every day in their assemblies in the schools. The author of this scheme was.
a. Gandhi
b. Imam Ali
c. Zakir Hussain
d. Nehru
e. Dr. Abdul Kalam
31. Name the historians who visited India in 1001 A.D. gave earliest account of distinction between the Hindus and Muslims:
a. Mahmood Ghaznavi
b. Al-Beruni
c. Subuktigin
d. Shahabuddin
e. Alptigin
32. The Indian National Congress passed the ‘Quit India Resolution’ in Bombay on:
a. 30th August, 1942
b. 31st August, 1942
c. 28th August, 1942
d. 18th August, 1942
e. 8th August, 1942
33. Where Quaid-e-Azam taken to in the last months of his life:
a. Ziarat
b. Muree
c. Rawalpindi
d. Quetta
e. Lahore
34. India exploded five nuclear tests on 11th and 13th May 1998. Pakistan replied with atomic explosions on:
a. 27th May, 1998
b. 28th May, 1998
c. 26th May, 1998
d. 25th May, 1998
e. 24th May, 1998
35. The Quran and Sunnah declared as the supreme law of Pakistan in________ of constitution of 1973.
a. 9th amendment
b. 10th amendment
c. 7th amendment
d. 8th amendment
e. 11th amendment
36. Kashmir is located in the ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬________ of Pakistan.
a. East
b. North East
c. North
d. West
e. South
37. When East Pakistan separated from Pakistan?
a. 8th December, 1971
b. 18th December, 1971
c. 10th December, 1971
d. 16th December, 1971
e. 20th December, 1971
38. The famous Congress-League Scheme was signed in Lucknow in the year of:
a. 1916
b. 1912
c. 1914
d. 1919
e. 1918
39. Which significant step of Bhutto Government in 1974 was a great satisfaction for religious parties?
a. Qadianis were declared as non-Muslims
b. Friday was declared weekly holiday
c. Pakistan was declared Islamic state
d. Separate Electorate were announced

Answer key:
1. A
2. A
3. B
4. E
5. A
6. D
7. A
8. D
9. A
10. D
11. E
12. B
13. A
14. A
15. B
16. A
17. C
18. C
19. E
20. A
21. B
22. E
23. D
24. E
25. B
26. A
27. C
28. C
29. D
30. C
31. B
32. E
33. A
34. B
35. A
36. C
37. D
38. A
39. A

Question and Answers about Monkeypox.

What is monkeypox?

The monkeypox virus causes the disease monkeypox. It is a zoonotic viral illness, which means it may pass from animals to people. It may also transmit from humans to humans and from people to the environment.

What are the symptoms of monkeypox?

Monkeypox can produce a variety of symptoms. While some individuals experience milder symptoms, others may develop more serious illnesses and need hospitalisation. Pregnant women, children, and anyone with impaired immune systems are at a greater risk.

During the 2022 epidemic, the most frequent symptoms of monkeypox were fever, headache, muscular pains, back pain, poor energy, and enlarged lymph nodes, followed or accompanied by the formation of a rash that might last two to three weeks. The rash might appear on the face, palms of hands, soles of feet, groyne, genital, and/or anal areas. It may also be discovered in the mouth, throat, anus, or vagina, as well as on the eyes. The number of sores might vary between one and thousands. Sores on the skin begin flat, then fill with fluids before crusting over, drying up, and falling off, leaving a new layer of skin behind.

There are continuing research to monitor and better understand symptoms during this new epidemic, such as which regions of the body may be impacted and how long symptoms may remain.

Anyone experiencing symptoms of monkeypox or who has had contact with someone who has monkeypox should contact or see a health care practitioner for help.

Symptoms normally resolve on their own or with supportive treatment, such as pain or fever medicine. People are contagious until all lesions have crusted over, scabs have dropped off, and a new layer of skin has developed underneath.

Can people get seriously ill or die from monkeypox?

Most people with monkeypox get better on their own after a few weeks. But for some people, an illness can cause health problems or even death. From what we know about past monkeypox cases, we know that newborn babies, children, and people with weakened immune systems may be more likely to have more severe symptoms or even die from monkeypox.

Monkeypox can lead to complications like secondary skin infections, asthma, confusion, and problems with the eyes. Some newer problems are proctitis, which is painful spots and growth inside the rectum, and pain or trouble peeing. People with monkeypox have died between 1% and 10% of the time in the past. It’s important to remember that death rates can be different in different places because of things like how easy it is to get health care. Because monitoring for monkeypox hasn’t been very good in the past, these numbers may be too high.


Some deaths have been reported in the new countries where the latest outbreak is taking place. This shows how important monkeypox is and how people should keep doing everything they can to protect themselves and others.

How is monkeypox transmitted from person to person?

Close contact with someone who has a monkeypox rash distributes the disease from person to person. Face-to-face contact (such as talking, breathing, or singing close to one another, which can generate droplets or short-range aerosols); skin-to-skin contact (such as touching or vaginal/anal sex); mouth-to-mouth contact (such as kissing); or mouth-to-skin contact (such as oral sex or kissing the skin) are all examples of close contact. The processes of monkeypox transmission via the air are not fully known, and research is being conducted to understand more.

We are still learning how long people with monkeypox are infectious, but they are generally considered infectious until all of their sores have crusted over, the scabs have fallen off and a new layer of skin has formed beneath, and all sores on the eyes and in the body (in the mouth, throat, eyes, vagina, and anus) have healed as well.

When an infected individual touches clothes, bedding, towels, items, devices, or surfaces, the environment might become contaminated with the monkeypox virus. If anybody else touches these goods and has any scrapes or abrasions, or if they accidently contact their eyes, nose, mouth, or other mucous membranes, they may get infected. This is referred to as fomite transmission. Cleaning your hands after contacting potentially infected things may help avoid this form of transfer. Infection may also occur via inhaling skin flakes or viruses from clothes, beds, or towels. Experts are still attempting to figure out if this mechanism of transmission is important in the current epidemic.

The virus may also be transmitted to the foetus during pregnancy, during or after delivery by skin-to-skin contact, or from a parent infected with monkeypox to an infant or kid through intimate contact.

Although asymptomatic infection has been documented, it is unclear if persons who are asymptomatic may transmit the illness or whether the disease can spread via other body fluids. Although a live monkeypox virus has been isolated from sperm, it is unknown if infection may transmit through sperm, vaginal fluids, prenatal fluids, lactation, or blood. More research is being conducted to determine whether or not persons may transmit monkeypox via the sharing of these fluids during and after symptomatic illness.


How is monkeypox transmitted from animals to humans?

Monkeypox can be transmitted to humans through physical contact with an infected animal, such as a non-human primate, terrestrial rodent, antelope, gazelle, or tree squirrel, such as through bites or scratches, or through activities such as hunting, skinning, trapping, cooking, or playing with carcasses. The virus may also be acquired by consuming contaminated animals that have not been completely cooked. Avoiding unprotected contact with wild animals, particularly those that are ill or dead (including their flesh and blood), may lower the chance of contracting monkeypox from them. Any items including animal parts or meat should be fully prepared before consuming in regions where animals spread monkeypox.

Can monkeypox spread from humans to animals?

Monkeypox transmission from people to pets (dogs) is now being explored. Together with our One Health partners, the Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health (WOAH), we are actively watching these developments and considering how to alter our outbreak response and advice if necessary.

Because many animal species are known to be vulnerable to the monkeypox virus, there is the possibility of viral spillover from humans to susceptible animal species in diverse situations, potentially leading to the establishment of new animal reservoirs.

People with monkeypox should avoid close physical contact with animals, including pets (such as cats, dogs, hamsters, gerbils, and so on), livestock, and wildlife.


Who is at risk of catching monkeypox?

People who live with or have close relationships (including sexual contact) with someone infected with monkeypox are the most vulnerable. Anyone who lives with someone who has monkeypox should take precautions to avoid being infected. A person with monkeypox should be evaluated by a health care practitioner to see whether they are healthy enough to be cared for at home and if isolation can be handled safely at home. To protect oneself when caring for monkeypox patients, health staff should practise infection prevention and control methods. Newborn newborns, young children, and persons with underlying immune weaknesses are at a greater risk of developing more severe symptoms, and in rare circumstances, dying from monkeypox. Pregnancy may also raise one’s chances of having a miscarriage or stillbirth.

People who were immunised against smallpox may be immune to monkeypox. Younger individuals, on the other hand, are unlikely to have had smallpox vaccine since the illness was eliminated in most settings worldwide in 1980. People who have received a smallpox vaccination should continue to take steps to protect themselves and others.

What can I do to protect myself and others against monkeypox?

In places where monkeypox is present, avoid unprotected contact with wild animals, particularly those that are ill or dead (including their flesh and blood). Any items containing animal parts or meat should be fully prepared before consumption.

Limit your contact with persons who have suspected or confirmed monkeypox to reduce your chance of contracting it from them. Maintain awareness of monkeypox in your community or social group, and have open dialogues with individuals with whom you have close contact (particularly sexual contact) about any symptoms you or they may be experiencing. Hands should be washed often with soap and water or an alcohol-based hand massage.

Clean and disinfect frequently touched surfaces in locations that might have been contaminated with the virus from an infected person.  The monkeypox virus may be killed with common home disinfectants or bleach solutions.

If you suspect you have monkeypox, get medical attention and isolate yourself from others until you have been assessed and tested. If you have monkeypox, you should separate yourself from people until all of your wounds have crusted over, the scabs have come off and a new layer of skin has grown underneath, and all of your internal sores have healed. This will prevent you from spreading the infection to others. Consult your health care provider about whether you should isolate at home or at a health institution. Use condoms as a precaution when having sexual contact for 12 weeks after you have recovered until more is known regarding transmission via sexual fluids.


Can I get monkeypox from touching things and surfaces in public?

Previous monkeypox outbreaks have shown that getting monkeypox after contacting infected materials is possible. If an infected person touches an object, surface, or fabric, it might get contaminated with the monkeypox virus. In some settings, the virus has been discovered to live on various surfaces for some time. However, in this epidemic, researchers are currently investigating whether humans may get monkeypox through contacting surfaces and objects.  Currently, practically all instances are connected to close contact, such as touching or intercourse.

To destroy the monkeypox virus, clean objects and surfaces with soap and water, basic home disinfectants, or a bleach product.

What should I do if I have signs of monkeypox or have been around someone who has it?

If you have had close contact with someone who has monkeypox or have been in an area that may have been contaminated with the virus, keep a watchful eye out for signs and symptoms for 21 days following your last exposure. Limit your close contact with other people as much as possible, and let your contacts know if it is unavoidable that you have been exposed to monkeypox.

If you suspect you have monkeypox, contact your healthcare professional for guidance, testing, and medical treatment. Isolate yourself from people as much as possible until you get your test results. Hands should be cleaned on a regular basis.

If you test positive for monkeypox, your doctor will tell you whether you should isolate at home or in a hospital, as well as what kind of treatment you need.

If I have monkeypox, what should I do to protect other people from getting infected?

If you have monkeypox, your doctor will tell you whether you should be treated in a hospital or at home. This will depend on the severity of your symptoms, whether you have risk factors that put you at risk for more severe symptoms, and if you can reduce your chances of infecting everyone you live with.

You should not go out if it is recommended that you isolate at home. Protect those with whom you live as much as possible by:

  • Inviting friends and relatives to assist you by providing items you need
  • Isolating yourself in a different room
  • Having a separate loo or washing after each use
  • Using soap and water and a home disinfectant, clean and disinfect regularly touched surfaces.
  • Avoid cleaning or vacuuming (this may dislodge virus particles and infect others).
  • Before sharing, use separate utensils, items, and devices, or thoroughly clean with soap and water/disinfectant.
  • There will be no sharing of towels, beds, or clothing.
  • Doing your own laundry (carefully lifting bedding, shirts, and towels without shaking them, placing them in a plastic bag before transporting them to the washing machine, and washing them in hot water > 60 degrees)
  • Ventilation may be improved by opening windows.
  • Encourage everyone in the family to wash their hands with soap and water or an alcohol-based hand sanitizer on a frequent basis.


If you can’t avoid being in the same room as someone else or having close contact with another person while isolating yourself at home, try to decrease their danger by:

  • Avoiding physical contact
  • Hands should be washed often with soap and water or an alcohol-based hand sanitizer.
  • Covering your rash with clothes or bandages (until you can isolate again – your rash heals quickest when left alone)
  • Leaving windows open around the house
  • Ensure that you and everyone else in the room are wearing properly fitted medical masks.
  • Keeping at least one metre apart from others
  • If you are unable to wash your own laundry and require someone to assist you, they should wear a well-fitting medical mask, disposable gloves, and follow the laundry procedures specified above.

Is there a vaccine against monkeypox?

Yes. There are three vaccinations available to protect against monkeypox. Despite the fact that supplies are now limited, get vaccinated if provided since they provide a vital degree of protection against the illness. After being vaccinated, continue to take precautions to avoid catching and spreading monkeypox; this is because immunity takes several weeks to develop after vaccination, and we don’t yet know how well the vaccines protect you or prevent you from infecting others, as efficacy data in this outbreak setting is needed.

Vaccination is recommended in several nations for those who are at risk. Many years of study have resulted in the creation of improved and safer vaccinations for smallpox, which may also be effective for monkeypox. Two of them (MVA-BN and LC16) have been licenced for monkeypox prophylaxis. Only those who are at risk (for example, someone who has had intimate contact with someone who has monkeypox) should be vaccinated. At this time, mass immunisation is not advised.

While the smallpox vaccination has previously been found to be protective against monkeypox, current evidence on the efficacy of newer smallpox/monkeypox vaccines in the prevention of monkeypox in clinical practise and in field settings is sparse. The study of the usage of monkeypox vaccinations wherever they are used will allow for the quick collection of more information on the efficiency of these vaccines in various circumstances.

How should someone take care of themselves if they have monkeypox? What care do they need?

The care someone need will be determined by their symptoms and their risk of developing a more serious condition. People who have monkeypox should listen to their doctor’s recommendations.  Symptoms often last two to three weeks and resolve on their own or with supportive treatment, such as pain or fever medication (such as analgesics and antipyretics).

It is critical for anybody suffering with monkeypox to remain hydrated, eat properly, and get enough sleep. People who are self-isolating should take care of their mental health by doing things they find relaxing and enjoyable, staying connected to loved ones through technology, exercising if they feel well enough and can do so while isolating, and seeking mental health support if necessary.

People suffering from monkeypox should avoid scratching their skin and take care of their rash by washing their hands before and after touching sores and keeping their skin dry and uncovered (unless they are forced to share a room with someone else, in which case they should cover it with clothing or a bandage until they can isolate again). The rash may be cleaned with sterile water or an antiseptic. Saltwater rinses may aid with mouth sores, while warm baths with baking soda and Epsom salts can help with body sores. If necessary, paracetamol may be given to assist control the discomfort produced by sores. A health expert should be consulted if greater pain medication is required.

Many years of study on smallpox therapies have resulted in the discovery of medications that may also be beneficial for treating monkeypox.  The European Medicines Agency authorised tecovirimat, an antiviral intended to treat smallpox, for the treatment of monkeypox in exceptional circumstances in January 2022. There has been little experience with these therapies in the setting of a monkeypox epidemic. As a result, their usage is often accompanied by enrollment in a clinical trial or extended access protocol, as well as the gathering of data that will increase understanding on how to effectively utilise them in the future.

Where in the world is there currently a risk of monkeypox?

A multi-country monkeypox epidemic is presently happening throughout Europe, the Americas, Africa, the Western Pacific, Eastern Mediterranean nations, and South East Asia, where the virus has not before been identified. More cases than usual have been documented in 2022 in previously reported areas of Africa, including Nigeria, the Democratic Republic of the Congo, and the Central African Republic. WHO is collaborating with all impacted countries to improve monitoring and give guidelines on how to contain the outbreak and care for patients.

Monkeypox has been documented in various African nations prior to the pandemic. Cameroon, Central African Republic, Republic of the Congo, Côte d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, and Sierra Leone are among them. Some of these nations experienced just a few instances, while others had continuous or recurring epidemics. Travel from Nigeria has been related to a few instances in other countries. The current epidemic, which is hitting many nations at the same time, is unlike earlier outbreaks.

Is there a risk of this becoming the next pandemic?

Monkeypox is not as infectious as other viruses because it needs intimate contact (e.g., face-to-face, skin-to-skin, mouth-to-skin, or mouth-to-mouth), a contaminated environment, or an infected animal to spread. We have a window of opportunity to stem the spread of this epidemic by collaborating closely with communities and groups at greater risk. It is critical that everyone work together immediately to limit the spread by understanding their risk and taking measures to reduce it. In July, the Director General of WHO declared the monkeypox epidemic a public health emergency of worldwide concern and issued Temporary Recommendations to assist nations in combating and controlling the outbreak.

To prevent future spread, WHO is reacting to this epidemic as a top priority. WHO is focused on learning more about how the virus is spreading during this epidemic and preventing additional individuals from being sick. Raising awareness about this new condition will aid in the prevention of future spread.

What do we know about monkeypox and sex?

Monkeypox may be transmitted by any kind of intimate contact, including kissing, touching, oral and penetrative vaginal or anal intercourse with an infected person.  People who have sex with several or new partners are more vulnerable. Although the monkeypox virus has been discovered in sperm, it is still unknown if monkeypox may be transmitted by sperm or vaginal secretions.

If you are having sex, check yourself for symptoms on a frequent basis and advise your partners to do the same. Anyone who develops new or unusual rashes or sores should avoid having sex or other close contact with other people until they have been tested for sexually transmitted diseases (STIs) and monkeypox. Remember that the rash may appear in regions that are difficult to view within the body, such as the mouth, throat, genitals, vagina, and anus/anal area.

Consider decreasing your number of sexual partners to lower your chance of monkeypox. You could wait a while before having sex with new people, or you could stop having sex until the outbreak is under control or until you can get vaccinated (and even then, it’s best to limit your number of partners because no vaccine provides 100% protection and you could still pass the virus on to others). Keep in mind that immunisations take many weeks to work.

If you’re having sex, have open, nonjudgmental talks with your partner or partners and exchange contact information so you may notify each other if you develop symptoms, even if you don’t intend to see each other again.

Wearing a condom will not completely prevent you from monkeypox, but it will minimise your risk or level of exposure and will also protect you and others from a variety of other STIs. People with monkeypox are recommended to wear condoms for 12 weeks following recovery until more is known about virus levels and possible infectivity in sperm during this time.

The virus spreads not just via sexual intercourse, but also through any sort of intimate contact with an infected person. Persons living in the same home are more vulnerable. Anyone experiencing signs of monkeypox should seek medical attention right once.

Are men who have sex with men at higher risk of catching monkeypox?

The danger of monkeypox is not confined to sexually active persons or men who have sex with males. Anyone in close touch with someone suffering from symptoms is at danger. However, the majority of the cases reported in the current epidemic have been detected in males who have intercourse with men.  Given that the virus is now spreading from person to person in these social networks, males who have sex with men may be more vulnerable to infection if they have intercourse or other intimate contact with someone who is contagious. People who have several or new sexual partners are the most vulnerable right now.

Monkeypox cases have been detected in sexual health clinics. One reason we’re getting more reports of monkeypox cases among communities of guys who have sex with males is that this demographic group is more health-conscious. Monkeypox rashes may mimic those of sexually transmitted illnesses such as herpes and syphilis, which may explain why these cases are being reported to sexual health clinics. We may find additional examples in the larger community as we learn more. Monkeypox has been discovered in some mothers and children.

Raising awareness among homosexual, bisexual, and other men who have sex with men is critical to protecting those most vulnerable. If you have intercourse with other males, be aware of your risk and take precautions to protect yourself and others. Anyone experiencing symptoms suggestive of monkeypox should seek medical attention promptly to be diagnosed and treated.

What is WHO’s response to stigma and discrimination related to monkeypox?

We’ve witnessed prejudice and messages stigmatising specific categories of individuals in the aftermath of the monkeypox epidemic. We want to make it quite clear that this is not acceptable. This epidemic response should be carried out in accordance with long-standing ideals of human rights, inclusivity, and the dignity of all persons and communities.

Anyone who comes into close personal contact with someone who has monkeypox, regardless of who they are, what they do, who they have sex with, or any other circumstance, is at danger. It is wrong to stigmatise somebody because of a sickness or condition. Stigma is simply going to make things worse and prevent us from stopping this pandemic as soon as possible. We must all work together to support anybody who has been infected or who is assisting in the care of those who are ill. We understand how to halt the spread of this illness and how we can all safeguard ourselves and others. Stigma and prejudice are never acceptable, and they are more so in the context of this epidemic. We’re in this together.

Is my risk of becoming infected, developing serious symptoms or dying from monkeypox higher if I am living with HIV?

Anyone who comes into touch with someone who has monkeypox is at danger of getting it.

HIV may impair your immune system if left untreated. There is some evidence that being immunocompromised may raise your chances of being infected and developing severe disease or dying from monkeypox if you are exposed. More evidence, however, is required to properly comprehend this.

People with preexisting immunological weaknesses may be more vulnerable to monkeypox. People living with HIV who are aware of their status, have access to, and utilise, medication, may achieve viral suppression. This implies that their immune systems are less susceptible to other illnesses than they would be if they were not receiving therapy. Many persons with monkeypox in the present epidemic also had HIV, but there have been very few severe instances of monkeypox, most likely because their HIV infection was well-controlled in the majority of cases. Studies are being conducted to have a better understanding of these issues.

People who have multiple sexual partners, including those living with HIV, are encouraged to take precautions to reduce their risk of exposure to monkeypox by avoiding close contact with anyone who has symptoms and avoiding high-risk situations where multiple contacts may occur, even with people who are unaware they have monkeypox. Having fewer sexual partners may lessen your risk.


Can children get monkeypox?

Children may get monkeypox if they come into touch with someone who is ill.  According to data from previously impacted nations, children are more susceptible to serious sickness than adolescents and adults.  There have been a few cases of monkeypox among youngsters in the current epidemic. Some children have been exposed to the virus at home via close contact with parents, carers, or other family members. Other children are teens who have had sexual relations with someone infected with monkeypox.

What should I do if a child in my care has symptoms that could be monkeypox?

At first glance, the monkeypox rash resembles other common children diseases such as chickenpox and other viral infections. Consult a healthcare practitioner if a kid you are caring for exhibits signs of monkeypox. They will assist them in getting tested and receiving the necessary treatment.

Children may be more vulnerable to severe monkeypox than adults. They should be constantly watched until they have healed in case they need further treatment. A health professional in charge of the kid may recommend that they be cared for at a health institution. In this case, a healthy parent or carer who is at low risk of monkeypox will be permitted to isolate with them.

What are the risks of monkeypox during pregnancy?

More study is required to better understand the hazards of monkeypox during pregnancy, as well as how the virus may be transmitted to the foetus in the womb, the baby during or after delivery, or during nursing. According to available evidence, acquiring monkeypox during pregnancy may be harmful to the foetus.

Avoid close contact with somebody who has monkeypox if you are pregnant. Anyone who comes into touch with an infected person, regardless of age, may get monkeypox.

Contact your healthcare practitioner if you believe you have been exposed to or are experiencing symptoms of monkeypox. They will assist you in getting tested and receiving the necessary treatment.


Can I continue to breastfeed if I have been diagnosed with monkeypox?

If you have confirmed or suspected monkeypox and are nursing, get guidance from your healthcare professional. They will analyse the danger of spreading monkeypox as well as the risk of depriving your child of nursing. If you can continue to breastfeed and have close contact, they will advise you on how to limit the risk by taking precautions such as covering your sores and wearing a mask to reduce the danger of viral transmission. The danger of infection must be carefully evaluated against the possible damage and suffering caused by discontinuing nursing and close parental-child interaction. It is unknown if the monkeypox virus may be passed from parent to kid via breastfeeding; additional research is needed in this area.

Why is this disease called ‘monkeypox’?

The illness is known as monkeypox because it was discovered in 1958 in study colonies of monkeys. It was only in 1970 that it was discovered in humans. Experts are being consulted on whether the illness should be renamed.

Can the monkeypox virus be spread through a blood transfusion?

You should never give blood if you are sick. If you have a blood donation appointment, examine your health and monitor any signs of monkeypox, and postpone if you don’t feel well.

When individuals may donate blood, severe processes are in place. The potential donor is questioned about their present state of health and any symptoms they are experiencing. This is done to limit the possibility of someone with an infectious illness donating blood.

There have been no cases of monkeypox being transmitted via blood transfusions.

Does past exposure to chickenpox provide any protection against monkeypox?

A separate virus (the varicella virus) causes chickenpox. Past chickenpox exposure does not protect against monkeypox (produced by the monkeypox virus, an orthopoxvirus).

Is there a test to check whether I have had monkeypox in the past?

There are tests available to determine if you have antibodies to orthopoxviruses (the viral family to which monkeypox belongs). These tests may assist determine if you had previously been immunised against smallpox or monkeypox or exposed to an orthopoxvirus. However, the tests cannot tell you if you were exposed to a vaccination, the monkeypox virus, or another orthopoxvirus in the past. As a result, antibody tests are seldom utilised to screen for prior monkeypox exposure or to diagnose a suspected new disease.

I’ve had monkeypox in the past. Can I catch it again?

Our knowledge of how long immunity lasts after monkeypox infection is still limited. We don’t know if a past monkeypox infection provides protection against subsequent infections, and if so, for how long. There have been rare reports of second infections. Even if you have previously had monkeypox, you should take every precaution to prevent being infected again.

If you have had monkeypox in the past and someone in your home now has it, you may protect others by being the designated carer, since you are more likely to be immune than others. You should, however, take all care to prevent being infected.

Are people who are immunosuppressed at higher risk of developing severe mpox?

Immunocompromised patients, notably those with untreated HIV and advanced HIV illness, seem to be at a greater risk of getting severe mpox and dying. Larger, more extensive lesions (particularly in the mouth, eyes, and genitals), secondary bacterial infections of the skin or blood, and lung infections are all symptoms of severe mpox. The statistics reveal that persons with significant immunosuppression (CD4 count fewer than 200 cells/mm3) had the worst symptoms.

People living with HIV who achieve viral suppression by antiretroviral therapy have no increased risk of severe mpox. In the event of infection, effective HIV therapy lowers the likelihood of developing severe mpox symptoms. People who are sexually active and do not know their HIV status should be tested for HIV if it is accessible. HIV-positive people who are receiving effective treatment have the same life expectancy as HIV-negative people. More information may be obtained from your health care provider.

Severe mpox instances in certain countries underscore the critical need to expand equitable access to mpox vaccinations and medicines, as well as HIV prevention, testing, and treatment. Most impacted groups will be left without the tools they need to preserve their sexual health and well-being if this does not happen.

If you have mpox symptoms or believe you may have been exposed, contact your health care provider to get tested for mpox and obtain the information you need to lower your risk of developing more severe symptoms.

Monkeypox (Mpox)

Key facts

  • Mpox, also called “monkeypox,” is a disease caused by a virus called the monkeypox virus, which is a species of the genus Orthopoxvirus. There are two different clades: clade I and clade II.
  • Common symptoms of Monkeypox include a skin rash or mucosal lesions that can last 2–4 weeks, along with fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes.
  • Monkeypox can be passed to humans through direct contact with an infected person, contaminated materials, or infected animals.
  • PCR tests of skin lesions can be used to prove Monkeypox in the lab.
  • Supportive care is used to treat mumps. Some vaccines and treatments for smallpox that have been cleared for use in some countries can also be used for Monkeypox.
  • In 2022–2023, a type called clade IIb spread Monkeypox all over the world.
  • You can avoid getting Monkeypox by staying away from people who have it. Vaccinations can help keep people who are at risk from getting sick.


Mpox, also called “monkeypox,” is a condition spread by the monkeypox virus. It may cause you a fever, a painful rash, and swollen lymph nodes. The majority of people get better, but some get very sick.

Anyone can get Monkeypox. It spreads through touch with people who have it:

  • Individuals, through touch, kissing, or sex;
  • Animals, when shooting, skinning, or cooking them;
  • Materials, such as dirty sheets, clothes, or needles;
  • Pregnant individuals, who may pass the virus on to their developing child.

If you have Monkeypox:

  • Tell anyone you’ve been close to recently
  • Stay at home until all the scabs fall off and a new layer of skin forms
  • Cover the sores and wear a mask when you’re around other people.
  • Don’t touch anyone.

The monkeypox virus, also known as MPXV, is what causes Monkeypox, which used to be called monkeypox. MPXV is an enveloped double-stranded DNA virus of the Orthopoxvirus genus in the Poxviridae family. Other viruses in this family include variola, cowpox, vaccinia, and others. Clades I and II are the two groups of genes that make up the virus.

The monkeypox virus was first found in 1958 in monkeys kept for study in Denmark. In 1970, a nine-month-old boy in the Democratic Republic of the Congo (DRC) was the first person to be diagnosed with monkeypox. Mumps can be passed from person to person and sometimes from animals to people. After smallpox was wiped out in 1980 and vaccinations against it were stopped everywhere, Monkeypox slowly spread through central, east, and west Africa. In 2022 and 2023, there was a worldwide spread. No one knows where the virus comes from in nature, but small animals like squirrels and monkeys can get it.


Person-to-person transmission of Monkeypox can happen through direct contact with infected skin or other lesions, like those in the mouth or genitals. This includes

  • face-to-face contact (talking or breathing),
  • skin-to-skin contact (touching or vaginal/anal sex),
  • mouth-to-mouth contact (kissing), and
  • mouth-to-skin contact (oral sex or kissing the skin).
  • breathing drops or short-range fumes from close touch for a long time

The virus then gets into the body through broken skin, mucous areas (like the mouth, throat, eyes, genitalia, and urethra), or the breathing system. Mumps can spread to other people in the same house and to people who have sex. People who have more than one sexual partner are more likely to get sick.

People can get Monkeypox from animals when they bite or scratch them, or when they hunt, skin, trap, cook, play with dead animals, or eat them. We don’t know everything about how viruses spread through animal groups, and more research is being done.

People can get Monkeypox from infected items like clothes or sheets, from sharps injuries in health care, or in public places like tattoo parlours.

Signs and symptoms

Monkeypox causes signs and symptoms that usually start within a week, but can start anywhere from 1 to 21 days after contact. Symptoms usually last between two and four weeks, but someone with a weak immune system may have them for longer.

Common symptoms of Monkeypox are:

  • rash
  • fever
  • sore throat
  • headache
  • muscle aches
  • back pain
  • low energy
  • swollen lymph nodes.

For some people, the first sign of Monkeypox is a rash. For others, the first sign may be something else.

The rash starts out as a flat sore that turns into a blister filled with fluid. The blister may itch or hurt. As the rash gets better, the sores dry out, harden, and fall off.

Some people have one or two skin blemishes, while others have hundreds or even thousands. These can appear anywhere on the body such as the:

  • palms of hands and soles of feet
  • face, mouth and throat
  • groin and genital areas
  • anus.

Some people also have painful swelling of their rectum, or they have pain and trouble going to the toilet.

People with monkeypox are contagious and can give the disease to others until all the sores have healed and a new layer of skin has grown.

People with weak immune systems, children, and pregnant women are more likely to get sick from monkeypox.

Most of the time, heat, aches in the muscles, and a sore throat are the first signs of monkeypox. The rash of monkeypox starts on the face and moves to the rest of the body, including the palms and soles of the feet and hands. It happens in stages over 2 to 4 weeks: macules, papules, vesicles, and pustules. Lesions have a depression in the middle before they crust over. Then, the scabs fall off. Monkeypox often causes lymphadenopathy, which means that the lymph nodes swell up. Some people can be sick but not show any signs of illness.

In the setting of the worldwide spread of monkeypox that started in 2022 and was mostly caused by the Clade IIb virus, some people get sick in different ways. A rash can show up before or at the same time as other symptoms in just over half of cases, and it doesn’t always spread all over the body. The first spot can be in or around the mouth, in the groyne, or in the anus.

When someone has monkeypox, they can get very sick. For example, germs can get into the skin and cause sores or major damage to the skin. Other complications include pneumonia, an infection of the cornea that causes blindness, pain or trouble swallowing, vomiting and diarrhoea that cause severe dehydration or malnutrition, sepsis, inflammation of the brain (encephalitis), heart (myocarditis), rectum (proctitis), genital organs (balanitis), or urinary passages (urethritis), or death. Monkeypox is more likely to cause major illness or death in people whose immune systems are weak because of medicine or a medical condition. People whose HIV is not well controlled or handled are more likely to get very sick.


Monkeypox can be hard to spot because it looks like other illnesses and diseases. It is important to tell the difference between monkeypox and chickenpox, measles, bacterial skin infections, lice, herpes, syphilis, and other sexually transmitted diseases, as well as allergies caused by medications. Someone with monkeypox might also have an illness that can be spread sexually, like herpes. On the other hand, a child who might have monkeypox could also have chickenpox. Because of these things, testing is important so that people can get care as soon as possible and the disease doesn’t spread further.

The best lab test for Monkeypox is polymerase chain reaction (PCR), which looks for virus DNA. The best diagnostic samples come from the rash itself—skin, fluid, or crusts—and are taken by swabbing it hard. If there are no skin sores, tests can be done with swabs from the oropharynx, the anus, or the pelvic area. It is not a good idea to test blood. Methods for finding antibodies may not be useful because they can’t tell the difference between different orthopoxviruses.

Treatment and vaccination

The goal of treating monkeypox is to get rid of the rash, ease the pain, and keep other problems from happening. It’s important to get care early and in a helpful way to help handle symptoms and keep problems from getting worse.

Getting a vaccine against monkeypox can help keep you from getting sick. The vaccine should be given within 4 days of coming into touch with someone who has monkeypox, or within 14 days if there are no signs.

People who are at a high risk of getting Monkeypox should get vaccine, especially when there is an outbreak. This includes:

  • health workers at risk of exposure
  • men who have sex with men
  • people with multiple sex partners
  • sex workers.

People who have monkeypox should be cared for away from other people.

Tecovirimat and other antivirals that were made to treat smallpox have been used to treat monkeypox, and more research is being done. There is more information about monkeypox vaccinations and how to treat cases.

Self-care and prevention

Most people get better in 2–4 weeks after getting monkeypox. Things you can do to ease the symptoms and keep from spreading the illness:


  • If you can, stay home and in your own room.
  • Wash your hands often with soap and water or hand sanitizer, especially before or after touching sores.
  • Wear a mask and cover sores when you’re around other people until your rash heals.
  • Keep skin dry and covered (unless you’re in a room with someone else);
  • Don’t touch things in shared spaces and clean them often;
  • Rinse mouth sores with saltwater;
  • Soothe body sores with sitz baths, warm baths with baking soda or Epsom salts;
  • Take painkillers like paracetamol (acetaminophen) or ibuprofen.

Do not

  • pop blisters or scratch sores, which can slow healing, spread the rash to other parts of the body, and cause sores to get sick; or
  • shave areas with sores until scabs have healed and new skin is showing (this can spread the rash to other parts of the body).

To prevent Monkeypox from spreading to other people, those who have it should stay at home or, if necessary, in the hospital for as long as they are contagious (from the start of symptoms until sores have healed and scabs fall off). Covering the sores and wearing a medical mask when around other people may help stop the disease from spreading. Using a condom when you have sex will lower your chance of getting monkeypox, but it won’t stop the virus from spreading through skin-to-skin or mouth-to-skin contact.

Source: WHO

Population, Exposure, and Outcome

All participants in a research study are referred to as the study population, regardless of whether they are exposed, treated, experience the desired result, or leave the study early. The suggested research question determines the study’s exposure and results. Any trait that could explain or predict the existence of a research result is referred to as the exposure. The projected feature is referred to as the result.

Whether neonatal hyperbilirubinemia increases the likelihood that children may have linguistic delays in the future is the subject of a research. 100 newborns with neonatal hyperbilirubinemia are identified by researchers, along with a control group of 100 infants. The rates of language delay after three years are then calculated.

  1. What are the study population, exposure, and outcome of this study?
  • study investigates elements that can affect high school students’ usage of the nutritional supplement creatine. 1200 students from 5 metropolitan high schools are interviewed by researchers to learn about their usage of creatine, food preferences, physical activity, and smoking. From the stated dietary information, the researchers extrapolate calorie consumption. The research discovers that among males but not among girls, increased caloric consumption is linked to a higher risk of creatine usage.
  1. What are the study population, exposure, and outcome of this study?
  • A study examines whether surgical experience affects the likelihood of bile leakage during laparoscopic cholecystectomy. An extensive healthcare system’s 800 general surgeons are identified by researchers. They determine the quantity of prior laparoscopic cholecystectomy operations and the quantity of bile leakage for each surgeon using the medical information system. According to the research, surgeons who conduct more laparoscopic cholecystectomies tend to have lower postoperative bile leak rates.
  1. Which of the following exclusion criteria would be least suitable for the study of the laparoscopic cholecystectomy described above?
  • Patients having a history of bile leaks are excluded
  • Patients having a prior history of bile duct disease should be excluded because they run a higher risk of developing a postoperative bile leak.
  • Eliminating doctors whose prior laparoscopic cholecystectomy operations have missing data.
  • The exclusion of surgeons who have only carried out 20 or fewer prior laparoscopic cholecystectomies
  1. Which of the following would promote internal validity of the study of laparo- scopic cholecystectomy described above?
  • assessing the relationship between surgical experience and postoperative mortality
  • including information from additional healthcare organisations from other geographical locations
  • Evaluating the results of further laparoscopic surgical operations
  • Examining medical records to see if postoperative bile leaks that occurred during the research were present.
  1. Which of the following would promote external validity of the study of laparoscopic cholecystectomy described above?
  • Not include individuals with a history of bile leaks
  • Incorporating information from several healthcare organisations worldwide
  • Using person-time data to determine incidence rates of postoperative bile leaks.
  • Examining medical records to see if postoperative bile leaks that occurred during the research were present.