C1198203

 According to the UK Health Security Agency (UKHSA) guidelines, a 6-year-old child with acute lymphoblastic leukaemia (ALL), who is varicella-zoster virus (VZV) antibody negative and has been exposed to chickenpox within the last 48 hours, should receive post-exposure prophylaxis (PEP) with oral aciclovir.

Key Points:

• Eligibility for PEP: Immunosuppressed individuals, such as children undergoing treatment for ALL, are at increased risk of severe varicella infection. PEP is recommended for those who have had significant exposure to chickenpox and are VZV antibody negative. (GOV.UK)

• Timing of Antiviral Therapy: Oral aciclovir should be initiated from day 7 to day 14 after exposure. If the child presents after day 7 of exposure, a 7-day course of antivirals can be started as soon as possible, up to day 14 post-exposure. (GOV.UK)

• Dosage: The recommended dosage of oral aciclovir for children aged 2 to 12 years is 20 mg/kg (maximum 800 mg) four times daily for 7 days. Dosage should be adjusted based on renal function and under specialist guidance.

• Alternative to VZIG: Varicella zoster immunoglobulin (VZIG) is no longer routinely available in the UK for most groups. It is reserved for neonates exposed within one week of delivery or individuals for whom oral antivirals are contraindicated. (GOV.UK, Patient)

• Monitoring: Despite prophylaxis, the child may still develop chickenpox. Caregivers should be advised to monitor for symptoms and seek medical attention if signs of infection appear.

For detailed guidance, please refer to the UKHSA's Guidelines on post-exposure prophylaxis for varicella or shingles.(GOV.UK)

It is essential to consult with the child's healthcare provider to initiate appropriate prophylactic treatment and ensure close monitoring during the incubation period.

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Knowing Iswara, jiva and the universe to be Brahman means that Brahman is the

adhishtanam and since Iswara, jiva and the universe are products of Maya (i.e.

mithya), they are not different entities. Swetasvatara 1.7 says that the three are

supported by Parabrahman.

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the effulgent Sakshi as the all pervading Brahman, who, in the form of

Iswara, is the creator of the universe, becomes free from punya papa, becomes

taintless and attains total identity with Brahman.‖ Mundaka Upanishad II.i.10 –

―He who knows this supremely immortal Brahman as existing in the heart

destroys, here, the knot of ignorance.‖ Brhadaranyaka Upanishad IV.iii.21

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I ever will be non-different.

• Even if I want to go away from Paramatma, its not possible because what is all

pervading I can’t ever get away from.

• Aham Brahma Asmi is my realisation, I have attained the Goal of Moksha, promised by

the scriptures.

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SMT 

Stem:

The popular conception of the stem or trunk of a tree is fairly clear, until we come down to the lowly herbs, in which

case it may appear very root-like, as in the example of the potato. The stem of a Calladium, which is an under growing

stem, like a potato, is called a corm. The onion is an underground stem, and is termed a bulb. The creeping underground

stem, covered with scales, such as that of a fern or a canna is called a rhizome. The stem of a palm is known as a

caudex. The Euphorbias (often erroneously referred to as Cactuses) and true Cactuses develop thick fleshy (succulent)

stems to act as reservoirs to tide them over the dry conditions under which they live. Terms similar to those used to

describe the shape of the roots are used to describe the shape of the stems.

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Evergreen forest: Such forests are composed of trees which do not shed their leaves all at once, so that only bare

trunks and branches are left. Evergreen trees shed their leaves slowly, at the same time producing new ones—there is

no marked change in the condition of the foliage of such trees. Under this heading are also classed the evergreens of the

temperate forests—some botanists are at variance on this point, but we shall leave them to settle their disputes. In India

the evergreen forests are more or less restricted to the areas of high rainfall. The dense forests of Kanara, South India,

Assam and Burma, for example, all fall into this category. Such forests are termed tropical rain forests.

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