Pulmonary Tuberculosis


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Pulmonary Tuberculosis

  1. 1. Pulmonary Tuberculosis
  2. 2. <ul><li>MÜKAM KARÔTI VACÁLAM </li></ul><ul><li>PANGUM LANGHAYATÄ GIRIM </li></ul><ul><li>YATKRIPÁ TAMAHAM VANDÄ </li></ul><ul><li>PARAMÁNANDA SÁGARAM </li></ul>PRAYER
  3. 3. <ul><li>Name of the disease & terminologies </li></ul><ul><li>Etiology </li></ul><ul><li>History, signs and symptoms </li></ul><ul><li>Physical examination </li></ul><ul><li>Investigation </li></ul><ul><li>Treatment according to allopathic medicine </li></ul><ul><li>Other therapies </li></ul><ul><li>Yoga practices </li></ul><ul><li>Books and journals for reference </li></ul>
  4. 4. INTRODUCTION <ul><li>A specific disease caused by the presence of Mycobacterium tuberculosis , which may affect almost any tissue or organ of the body, the most common seat of the disease being the lungs; the anatomical lesion is the tubercle, which can undergo caseation necrosis; local symptoms vary according to the part affected; general symptoms are those of sepsis: hectic fever, sweats, and emaciation; often progressive with high mortality if not treated. </li></ul>
  5. 5. <ul><li>Has in recent years proved to be an opportunistic infection of people with compromised immune systems, including those with AIDS. </li></ul><ul><li>There is also a high incidence among IV drug abusers. </li></ul><ul><li>Every year, tuberculosis (TB) – a life-threatening infection that primarily affects the lungs – kills nearly 2 million people worldwide. </li></ul><ul><li>Experts at the WHO predict these numbers will escalate in coming decades. </li></ul>
  6. 6. <ul><li>Approximately 2 billion people — one-third of the human population — are currently infected with TB, with one new infection occurring every second. </li></ul><ul><li>TB has plagued human beings for millennia. </li></ul><ul><li>Signs of tubercular damage have been found in Egyptian mummies and in bones dating back at least 5,000 years. </li></ul><ul><li>Today, despite advances in treatment, TB is a global pandemic, fueled by the spread of HIV/AIDS, poverty, a lack of health services and the emergence of drug-resistant strains of Mycobacterium tuberculosis, the bacterium that causes the disease. </li></ul>
  7. 7. <ul><li>TB spreads through airborne droplets when a person with the infection coughs, talks or sneezes. </li></ul><ul><li>In general, needs prolonged exposure to an infected person before becoming infected. </li></ul><ul><li>Even then, patient may not develop symptoms of the disease. </li></ul><ul><li>Although body harbors the TB bacteria, immune system often can prevent from becoming sick. </li></ul>
  8. 8. <ul><li>For that reason, make a distinction between: </li></ul><ul><li>If left untreated, active TB can be fatal. </li></ul><ul><li>With proper care, however, most cases of TB can be treated, even those resistant to the drugs commonly used against the disease. </li></ul><ul><li>Unfortunately, the world's poor — those most likely to have TB — are also the least likely to receive adequate medical care. </li></ul><ul><li>TB infection . This condition causes no symptoms and isn't contagious. </li></ul><ul><li>Active TB . This condition can spread to others. </li></ul>
  9. 9. SIGNS AND SYMPTOMS <ul><li>Immune system begins to attack TB bacteria two to eight weeks after infection. </li></ul><ul><li>Sometimes the bacteria die, and the infection clears completely. </li></ul><ul><li>In other cases, the bacteria remain in the body in an inactive state and cause no symptoms. </li></ul><ul><li>In still other cases, may develop active TB. </li></ul><ul><li>TB mainly affects the lungs (pulmonary tuberculosis). </li></ul>
  10. 10. Signs and symptoms of active pulmonary TB include: <ul><li>A cough lasting three or more weeks that may produce discolored or bloody sputum </li></ul><ul><li>Unintended weight loss </li></ul><ul><li>Fatigue </li></ul><ul><li>Slight fever </li></ul><ul><li>Night sweats </li></ul><ul><li>Chills </li></ul><ul><li>Loss of appetite </li></ul><ul><li>Pain with breathing or coughing (pleurisy) </li></ul>
  11. 11. <ul><li>Tuberculosis also can target almost any part of the body, including joints, bones, urinary tract, central nervous system, muscles, bone marrow and lymphatic system. </li></ul><ul><li>When TB occurs outside lungs, signs and symptoms vary, depending on the organs involved. </li></ul><ul><li>For example, TB of the spine may result in back pain, and TB that affects kidneys might cause blood in urine. </li></ul><ul><li>Tuberculosis can also spread through entire body, simultaneously attacking many organ systems. </li></ul>
  12. 12. Tuberculosis in infants <ul><li>Women who have active TB can transmit the disease to their babies either before or during birth. </li></ul><ul><li>About half the babies born to women with active TB develop signs and symptoms during the first year of life. </li></ul><ul><li>These may include: </li></ul><ul><li>Fever </li></ul><ul><li>Poor feeding </li></ul><ul><li>Failure to thrive </li></ul><ul><li>Difficulty breathing </li></ul><ul><li>Swollen liver and spleen </li></ul>
  13. 14. CAUSES <ul><li>The bacteria that cause TB spread in microscopic droplets that are released into the air when someone with the untreated, active form of the disease coughs, speaks, laughs or sneezes. </li></ul><ul><li>Although TB is contagious, it's not an especially easy disease to catch. </li></ul><ul><li>In general, needs long-term contact with an infected person – as much as eight hours a day for up to six months – to become infection. </li></ul>
  14. 15. <ul><li>Patients are much more likely to contract TB from a family member or close co-worker than from a stranger on a bus or in a restaurant, although there have been a number of cases of transmission on plane flights. </li></ul><ul><li>A person with active TB who's been effectively treated for at least two weeks is no longer contagious and can't spread the bacteria to others. </li></ul><ul><li>Although TB can affect other organs and tissues, it primarily attacks the lungs. </li></ul><ul><li>Approximately two to eight weeks after lungs are infected with M. tuberculosis, immune system springs into action. </li></ul>
  15. 16. <ul><li>Macrophages — specialized white blood cells that ingest harmful organisms — begin to surround and &quot;wall off&quot; the tuberculosis bacteria in the lungs, much like a scab forming over a wound. </li></ul><ul><li>If the macrophages are successful, the bacteria may remain within these walls for years — alive, but in a dormant state. </li></ul><ul><li>In that case, patient is considered to have TB infection, but won't feel sick or have symptoms, and can't transmit the disease to others. </li></ul><ul><li>The only way to know infection with TB is through a positive skin test. </li></ul>
  16. 17. <ul><li>But sometimes immune defenses fail, even if patient is otherwise healthy and don't have a compromised immune system. </li></ul><ul><li>In that case, TB bacteria actually begin to exploit macrophages for their own survival, causing the white blood cells to form into tightly packed groups called granulomas. </li></ul><ul><li>The bacteria multiply inside the granulomas, which eventually may enlarge into tumor-like nodules. </li></ul><ul><li>The centers of these nodules have the consistency of soft, crumbly cheese. </li></ul>
  17. 18. <ul><li>Over time, the centers can liquefy and break through the granulomatous wall surrounding them, spilling bacteria into the lungs' airways and causing large air spaces (cavities) to form (active TB). </li></ul><ul><li>Filled with oxygen, the air spaces make an ideal breeding ground for the bacteria, which multiply in enormous numbers. </li></ul><ul><li>The bacteria may then spread from the cavities to the rest of the lungs as well as to other parts of the body. </li></ul>
  18. 19. Additional contributing factors <ul><li>Crowded living conditions. </li></ul><ul><li>Increased poverty and lack of access to medical care. </li></ul><ul><li>Increase in drug-resistant strains of TB. </li></ul>
  19. 20. Becomes infected with TB when inhales TB bacteria into the lungs. But even though we are infected, the immune system may prevent from developing symptoms of the disease.
  20. 21. RISK FACTORS <ul><li>Anyone of any age, race or nationality can contract TB, but certain factors increase the risk of the disease. </li></ul><ul><li>These factors include: </li></ul><ul><li>Lowered immunity. </li></ul><ul><li>Close contact with someone with infectious TB. </li></ul><ul><li>Nationality. </li></ul><ul><li>Sex. </li></ul><ul><li>Race. </li></ul>
  21. 22. <ul><li>Age. </li></ul><ul><li>Substance abuse. </li></ul><ul><li>Malnutrition. </li></ul><ul><li>Lack of medical care. </li></ul><ul><li>Living or working in a residential care facility. </li></ul><ul><li>Living in a refugee camp or shelter. </li></ul><ul><li>Health care work. </li></ul><ul><li>International travel. </li></ul>
  22. 23. People infected with M. tuberculosis within the past two years Older adults People with other medical conditions that appear to increase the risk of TB, such as diabetes and silicosis People born in areas of the world where TB is common, such as Asia, Africa or Latin America People with HIV infection or an otherwise compromised immune system Close contacts of people with infectious TB People at higher risk of active TB disease People at higher risk of TB infection
  23. 24. Other people who may be exposed to TB on the job, such some health care professionals People who live or work in residential facilities, such as nursing homes or correctional facilities People who inject illicit drugs or abuse alcohol People who inject illicit drugs People with chest X-ray findings that show previous TB disease People with poor access to health care, including homeless people People at higher risk of active TB disease People at higher risk of TB infection
  24. 25. Risk factors in children <ul><li>Children rarely get TB from other children. Instead, they're much more likely to acquire the disease from an adult. </li></ul><ul><li>For that reason, children who live in a household with an adult who has active TB or who is at risk of TB are at high risk themselves. </li></ul><ul><li>Also at risk are children who: </li></ul><ul><li>Have HIV or another illness that weakens their immune system </li></ul><ul><li>Were born in a country where TB is prevalent </li></ul><ul><li>Don't have access to regular medical care </li></ul><ul><li>Are homeless </li></ul>
  25. 26. WHEN TO SEEK MEDICAL ADVICE <ul><li>Fever, </li></ul><ul><li>Unexplained weight loss, </li></ul><ul><li>Night sweats and </li></ul><ul><li>Persistent cough. </li></ul><ul><li>These are often signs of TB, but they can also result from other medical problems. </li></ul>
  26. 27. TB tests are advised: <ul><li>In HIV patients . </li></ul><ul><li>Contact with contagious TB. </li></ul><ul><li>Nurses, doctors, health workers in sanatoriums. </li></ul>
  27. 28. SCREENING AND DIAGNOSIS <ul><li>The first step in diagnosing TB is a simple skin test. </li></ul><ul><li>Although there are two methods, doctors consider the Mantoux test the most accurate. </li></ul><ul><li>For the test, a small amount of a substance called PPD tuberculin is injected just beneath the skin of the inside forearm. </li></ul><ul><li>Should feel only a slight needle prick. </li></ul><ul><li>Within 48 to 72 hours, a health care professional will check the arm for a local reaction to the injected material. </li></ul>
  28. 29. <ul><li>Depending on the response, the test is diagnosed as positive or negative. </li></ul><ul><li>A positive response — usually shown by a hard, raised bump at the injection site — means TB infection. </li></ul><ul><li>In that case, further tests to help determine whether it is active TB disease: Chest X-ray, culture tests, etc. </li></ul>
  29. 31. Diagnosing TB in children <ul><li>It's harder to diagnose TB in children than in adults — they're far less likely than adults to have signs and symptoms of the disease, even when they're quite sick. </li></ul><ul><li>Children also may swallow sputum, rather than coughing it out, making it harder to take culture samples. </li></ul><ul><li>And infants and young children may not react to the skin test. </li></ul><ul><li>For these reasons, tests from an adult who is likely to have been the cause of the infection may be used to help diagnose TB in a child. </li></ul>
  30. 32. Diagnosing TB in people with HIV/AIDS <ul><li>Diagnosing TB in HIV-positive people can be challenging, in part because signs and symptoms of HIV/AIDS are often similar to those of TB. </li></ul><ul><li>What's more, people with HIV may not react to a standard TB skin test, and X-rays, sputum tests and other exams may fail to show evidence of early TB infection. </li></ul>
  31. 33. COMPLICATIONS <ul><li>Pulmonary TB can cause permanent lung damage when it's not diagnosed and treated early. </li></ul><ul><li>Untreated active disease can also spread to other parts of the body where it can lead to serious or life-threatening complications. </li></ul><ul><li>TB that infects the bone, for example, can cause severe pain, abscesses and joint destruction. </li></ul>
  32. 34. <ul><li>Meningeal TB, which infects the brain and central nervous system, and miliary TB, which occurs when TB bacteria spread throughout the entire body, are particularly dangerous forms of the disease. </li></ul><ul><li>Children are especially susceptible to both meningeal TB and miliary TB, which makes early diagnosis in infants and children imperative. </li></ul><ul><li>The most serious complication is the recurrence of TB after the initial infection and the development of drug-resistant strains of the disease. </li></ul>
  33. 35. TREATMENT <ul><li>Until the mid-20th century, people with TB were routinely cared for in sanitariums — often for years — where the clear, cold air, abundant food and enforced rest were believed to heal the lungs and halt the wasting that's characteristic of the disease. </li></ul><ul><li>Often, the treatment not only helped cure TB, but prevented its spread. </li></ul><ul><li>Today, medications are the cornerstone of TB treatment, but the therapy is still lengthy. </li></ul>
  34. 36. <ul><li>Normally, taking antibiotics for six to 12 months to completely destroy the bacteria. </li></ul><ul><li>The exact drugs and length of treatment depends on age, overall health, the results of susceptibility tests, and whether it is TB infection or active TB. </li></ul>
  35. 37. Allopathic Antitubercular Medications <ul><li>Bacille Calmette Guerin [BCG] </li></ul><ul><li>capreomycin </li></ul><ul><li>cycloserine </li></ul><ul><li>ethambutol </li></ul><ul><li>ethionamide </li></ul><ul><li>isoniazid </li></ul><ul><li>pyrazinamide </li></ul><ul><li>rifampin </li></ul><ul><li>rifampin and isoniazid </li></ul><ul><li>rifampin, isoniazid and pyrazinamide </li></ul>
  36. 38. PREVENTION <ul><li>In general, TB is a preventable disease. From a public health standpoint, the best way to control TB is to diagnose and treat people with TB infection before they develop active disease and to take careful precautions with hospitalized TB patients. </li></ul><ul><li>But there are also other measures : </li></ul><ul><li>Get tested regularly. </li></ul><ul><li>Consider preventive therapy. </li></ul><ul><li>Finish entire course of medication. </li></ul><ul><li>BCG vaccination in newborn. </li></ul>
  37. 39. COPING SKILLS <ul><li>Undergoing treatment for TB can be complicated, yet sticking with therapy is the only way to cure the disease. </li></ul><ul><li>Medication administered by a nurse or other health care professional is helpful. </li></ul><ul><li>In addition, try to maintain the normal activities and hobbies and stay connected with family and friends. </li></ul>
  38. 40. <ul><li>Keep in mind that physical health can directly impact mental health. </li></ul><ul><li>Denial, anger and frustration are not uncommon when patient learn life has dealt – something painful and unexpected. </li></ul><ul><li>At times, may need more tools to deal with these or other emotions. </li></ul><ul><li>Professionals, such as therapists or behavioral psychologists, may help put things in perspective. </li></ul>
  39. 41. YOGA PRACTICES <ul><li>YOGA IS BALANCE (SAMATVAM) </li></ul><ul><li>I A Y T CORRECTS IMBALANCES </li></ul><ul><li>AIMS : </li></ul><ul><li>STRESS REDUCTION </li></ul><ul><li>RELIEF OF PAIN </li></ul><ul><li>MEDICATION REDUCTION </li></ul>
  40. 42. Ánandamaya Kôùa Vijòanánmaya Kôùa PERFECT HEALTH Manômaya Kôùa Annamaya Kosa Pranamaya Kosa ÁDHIJA VYÁDHIS YOGA Panchakosa concept
  41. 43. INTEGRATED YOGA MODULE FOR PULMONARY TUBERCULOSIS <ul><li>Breathing practices </li></ul><ul><li>Hands in and out breathing </li></ul><ul><li>Ankle stretch breathing </li></ul><ul><li>Tiger breathing </li></ul><ul><li>Rabbit breathing </li></ul><ul><li>Dog breathing (eyes closed) </li></ul><ul><li>Straight leg raise breathing </li></ul><ul><li>Back stretch </li></ul><ul><li>Tiger stretch </li></ul><ul><li>Yoga chair breathing </li></ul><ul><li>Sithilikarana Vyayama (loosening exercises) </li></ul><ul><li>Pavanamuktasana kriya </li></ul><ul><li>Suryanamaskar </li></ul>
  42. 44. <ul><li>Yogasanas </li></ul><ul><li>Ardhakati cakrasana </li></ul><ul><li>Padahastasana </li></ul><ul><li>Ardha cakrasana </li></ul><ul><li>Vakrasana/ Ardha-Matsyendrasana </li></ul><ul><li>Bhujangasana </li></ul><ul><li>Salabhasana </li></ul><ul><li>Sarvangasana </li></ul><ul><li>Matsyasana </li></ul><ul><li>Deep relaxation technique (DRT) </li></ul>
  43. 45. <ul><li>Pranayama </li></ul><ul><li>Kapalabhati </li></ul><ul><li>Vibhaga pranayama (Sectional breathing) </li></ul><ul><li>Surya Anuloma </li></ul><ul><li>Nadi suddhi </li></ul><ul><li>Bhramari </li></ul><ul><li>Meditation (Dhyana Dharana) </li></ul><ul><li>Nadanusandhana </li></ul><ul><li>OM meditation </li></ul><ul><li>Kriyas </li></ul><ul><li>Jala Neti </li></ul><ul><li>Sutra Neti </li></ul><ul><li>Vaman Dhouti </li></ul>
  44. 46. SPECIFIC PRACTICES <ul><li>Jalaneti </li></ul><ul><li>Sarvangasana </li></ul><ul><li>Matsyasana </li></ul><ul><li>Vajrasana </li></ul><ul><li>Supta Vajrasana </li></ul>