With
nursing
intervention,
patient is able to
perform ADLs with
minimal
assistance.
lesions all
over the
body
-loss of
sensation
on the skin
lesions
Dependent: With
nursing
intervention,
patient is able to
perform ADLs with
maximum
assistance.
Assessment:
Impaired
skin
integrity
related to
presence
of skin
lesions
Planning:
-Provide
clean
dressing
daily
-Monitor
for signs of
infection
-Teach
proper skin
care
Intervention:
-Cleansed
skin lesions
with normal
saline
This document summarizes the histopathology findings of a skin biopsy from a 54-year-old female patient with a clinical diagnosis of bullous pemphigoid. Microscopy showed a subepidermal blister filled with neutrophils. There was a dense neutrophilic infiltrate in the papillary dermis. The impression was consistent with dermatitis herpetiformis. Further evaluation with direct immunofluorescence was advised to identify granular IgA deposits in the dermal papillae, confirming the diagnosis. Differential diagnoses including linear IgA dermatosis and bullous systemic lupus erythematosus were discussed.
Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa. It is important to differentiate OLP from oral lichenoid reactions (OLR) as their management differs. The 2003 WHO diagnostic criteria for OLP require bilateral, reticular lesions along with characteristic histopathological features for a confirmed diagnosis of OLP. However, these strict criteria may exclude some true OLP cases. Clinicians should consider other clinical presentations of OLP and potential etiological factors rather than relying solely on the criteria to differentiate OLP from OLR.
Stevens Johnson syndrome (SJS) is a severe immune-mediated reaction involving the skin and mucous membranes. It is characterized by painful red or purplish flat blotches that develop into blisters and ulcers of the skin and mucous membranes. SJS can be caused by infections, certain medications, and some cancers. It affects the skin, eyes, mouth, lungs, and genitals. Treatment focuses on supportive care, withdrawing the triggering medication, and managing complications. The prognosis depends on the extent of organ involvement, with mortality rates reaching 35% in severe cases with over 30% body surface area affected.
Hansen's disease, also known as leprosy, is a chronic infection caused by Mycobacterium leprae. It primarily affects the skin, nerves, eyes, and mucous membranes. It is transmitted through droplets from the nose and mouth during close, repeated contact with untreated cases. Symptoms vary depending on the type of leprosy, which is classified by Ridley-Jopling scale ranging from tuberculoid to lepromatous forms. Diagnosis involves examination of skin lesions, sensory and motor impairment, and identification of acid-fast bacilli in smears. Differential diagnosis includes other causes of skin lesions and peripheral neuropathy.
Laboratory diagnosis of leprosy is primarily based on clinical signs and symptoms. Skin and nasal smears can be taken from lesions to look for acid-fast Mycobacterium leprae bacteria under microscopy. Biopsies of infected skin or nasal tissue can also be analyzed with acid-fast staining, culturing, or PCR to confirm the presence of M. leprae DNA. Classification of leprosy type is aided by the Lepromin skin test response and lymphocyte proliferation assays, which indicate level of cell-mediated immunity toward M. leprae.
This document discusses primary cutaneous lymphomas, specifically mycosis fungoides. It notes that mycosis fungoides accounts for about 50% of primary cutaneous lymphomas and presents as erythematous patches or plaques on the skin that can progress to tumors or generalized erythema. Diagnosis involves skin biopsy showing atypical lymphocytes in the epidermis and classification using the WHO-EORTC system. Prognosis depends on stage, with patch/plaque stage having the best survival and visceral involvement the worst. Treatment aims to control symptoms and involves skin-directed therapies like phototherapy or topical chemotherapy as well as systemic therapies for advanced disease.
This document summarizes the histopathology findings of a skin biopsy from a 54-year-old female patient with a clinical diagnosis of bullous pemphigoid. Microscopy showed a subepidermal blister filled with neutrophils. There was a dense neutrophilic infiltrate in the papillary dermis. The impression was consistent with dermatitis herpetiformis. Further evaluation with direct immunofluorescence was advised to identify granular IgA deposits in the dermal papillae, confirming the diagnosis. Differential diagnoses including linear IgA dermatosis and bullous systemic lupus erythematosus were discussed.
Oral lichen planus (OLP) is a chronic inflammatory disease that affects the oral mucosa. It is important to differentiate OLP from oral lichenoid reactions (OLR) as their management differs. The 2003 WHO diagnostic criteria for OLP require bilateral, reticular lesions along with characteristic histopathological features for a confirmed diagnosis of OLP. However, these strict criteria may exclude some true OLP cases. Clinicians should consider other clinical presentations of OLP and potential etiological factors rather than relying solely on the criteria to differentiate OLP from OLR.
Stevens Johnson syndrome (SJS) is a severe immune-mediated reaction involving the skin and mucous membranes. It is characterized by painful red or purplish flat blotches that develop into blisters and ulcers of the skin and mucous membranes. SJS can be caused by infections, certain medications, and some cancers. It affects the skin, eyes, mouth, lungs, and genitals. Treatment focuses on supportive care, withdrawing the triggering medication, and managing complications. The prognosis depends on the extent of organ involvement, with mortality rates reaching 35% in severe cases with over 30% body surface area affected.
Hansen's disease, also known as leprosy, is a chronic infection caused by Mycobacterium leprae. It primarily affects the skin, nerves, eyes, and mucous membranes. It is transmitted through droplets from the nose and mouth during close, repeated contact with untreated cases. Symptoms vary depending on the type of leprosy, which is classified by Ridley-Jopling scale ranging from tuberculoid to lepromatous forms. Diagnosis involves examination of skin lesions, sensory and motor impairment, and identification of acid-fast bacilli in smears. Differential diagnosis includes other causes of skin lesions and peripheral neuropathy.
Laboratory diagnosis of leprosy is primarily based on clinical signs and symptoms. Skin and nasal smears can be taken from lesions to look for acid-fast Mycobacterium leprae bacteria under microscopy. Biopsies of infected skin or nasal tissue can also be analyzed with acid-fast staining, culturing, or PCR to confirm the presence of M. leprae DNA. Classification of leprosy type is aided by the Lepromin skin test response and lymphocyte proliferation assays, which indicate level of cell-mediated immunity toward M. leprae.
This document discusses primary cutaneous lymphomas, specifically mycosis fungoides. It notes that mycosis fungoides accounts for about 50% of primary cutaneous lymphomas and presents as erythematous patches or plaques on the skin that can progress to tumors or generalized erythema. Diagnosis involves skin biopsy showing atypical lymphocytes in the epidermis and classification using the WHO-EORTC system. Prognosis depends on stage, with patch/plaque stage having the best survival and visceral involvement the worst. Treatment aims to control symptoms and involves skin-directed therapies like phototherapy or topical chemotherapy as well as systemic therapies for advanced disease.
Scleroderma is a multisystem collagen vascular disease characterized by fibrosis of the skin and involvement of internal organs. It can be classified as diffuse or localized systemic sclerosis. Common manifestations include pulmonary fibrosis, esophageal dysmotility causing reflux, delayed gastric emptying, and small bowel involvement seen as "hidebound sign". Skeletal involvement causes acro-osteolysis, joint space narrowing, and flexion deformities of the hands.
Etiology of Leprosy:
A chronic infection caused by Mycobacterium leprae
Acid-fast, rod shaped
Main route of infection:
nasal droplets,
Eating armadillos (south america)
Not very contagious, but close relatives are at high risk of infection
This document summarizes the histopathogenesis of Hansen's disease (leprosy) through descriptions of key pathological features and microscopic images. It discusses how Mycobacterium leprae has an affinity for Schwann cells in peripheral nerves. The types of leprosy (tuberculoid, borderline, lepromatous) are characterized based on the composition and appearance of granulomas in tissue samples. Immunological reactions and rare conditions like Lucio's phenomenon and histoid leprosy are also outlined.
Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium leprae. It primarily affects the skin and nerves. There are approximately 600,000 new cases detected worldwide each year. It is endemic in many developing countries. The disease presentation exists on a spectrum from tuberculoid leprosy to lepromatous leprosy depending on the immune response. Left untreated, leprosy can cause permanent nerve damage and deformities. Standard treatment involves multidrug therapy with dapsone, rifampin, and clofazimine over the course of months or years.
Lichenoid Dermatoses, Characteristics of Lichenoid Dermatoses, What are the Major Lichenoid Dermatoses, Lichen planus (LP), Introduction of LP, Epidemiology of LP, Etiology of LP, Pathogenesis of LP, Clinical Features & Clinical variants of LP, Histopathology of LP, Immunohistochemistry of LP, Differential Diagnosis of LP, Treatment of LP
This document summarizes key information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae bacteria and primarily affects the skin, nerves, respiratory tract and testes.
- There is a spectrum of clinical forms from tuberculoid (high resistance) to lepromatous (low resistance).
- Complications include reactions, nerve damage leading to deformities, and secondary infections.
- Treatment involves multidrug therapy but nerve damage may be permanent without rehabilitation. Advocacy groups continue working to eliminate stigma and provide care.
This document provides information on the diagnosis of leprosy. It begins by describing leprosy as a chronic infectious disease caused by Mycobacterium leprae. Key points include that M. leprae was discovered in 1873 and has an affinity for Schwann cells in nerves and macrophages in the skin. Transmission occurs through inhalation of droplets or skin-to-skin contact. Diagnosis involves clinical examination looking for hypo-pigmented skin lesions with sensory deficits or nerve involvement, as well as visualization of acid-fast bacilli in slit skin smears or histopathology. Classification systems include paucibacillary and multibacillary forms based on bacterial load.
Cutaneous leprosy, also known as Hansen's disease, is a chronic infection caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Animals like armadillos and chimpanzees can also be infected. The disease progresses slowly and symptoms may not appear for years. Initial lesions often appear as pale patches on the skin in cooler areas of the body. A definitive diagnosis is made based on skin lesions, nerve thickening, and loss of sensation. Leprosy is classified based on clinical features and response to treatment involves multidrug therapy administered for 6-12 months depending on a patient's classification.
This document discusses the structure and pathology of the oral cavity and esophagus. It begins by describing the general four-layer structure of the esophagus which includes the mucosa, submucosa, muscularis and serosa layers. It then provides more details on the histology and functions of each layer. The document goes on to describe common oral pathologies like aphthous ulcers, oral candidiasis, leukoplakia and erythroplakia. It also discusses salivary gland structures, diseases like Sjogren's syndrome, mucoceles, ranulas, sialolithiasis and various benign and malignant salivary gland tumors.
The document discusses erythema and summarizes key information about several types of annular erythemas. It describes how erythema is a change in skin color due to dilation of blood vessels that can range from pink to dark red. It then provides brief summaries of erythema marginatum, erythema chronicum migrans (Lyme disease), and erythema gyratum repens, noting their associations with rheumatic fever, Borrelia burgdorferi infection, and underlying malignancies respectively.
Leprosy is caused by Mycobacterium leprae and transmitted through inhalation or prolonged skin contact with infected individuals. It has an incubation period of 2-20 years. Leprosy is classified based on bacillary load and immune response into paucibacillary (no bacilli) and multibacillary forms. Clinical manifestations range from hypopigmented skin lesions with sensory loss to disfiguring nodules. Complications include sensory loss, nerve damage, muscle weakness and deformities of hands, feet and face. Diagnosis involves clinical findings and visualization of acid-fast bacilli in skin smears or biopsies.
Leprosy, also known as Hansen's disease, is caused by the slow-growing bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves, potentially causing disabling deformities. M. leprae proliferates best at temperatures between 32-34°C and infects Schwann cells in the cooler areas of the body like the skin and nerves. This can lead to either paucibacillary tuberculoid leprosy characterized by a strong immune response and few bacteria, or multibacillary lepromatous leprosy with a weak response and high bacterial loads, spreading widely. Untreated, leprosy can cause permanent damage to skin, nerves,
Tb lymphnode, tuberculoid and lepromatous leprosySowmya Srinivas
The document discusses the lymphatic system and lymph nodes. It explains that lymph is fluid that passes through lymphatic vessels after leaving capillaries and collects in lymph nodes before returning to circulation via the thoracic duct. Lymph nodes filter bacteria and other particles from lymph and add lymphocytes. The document then discusses specific conditions like tuberculosis and leprosy that can affect lymph nodes, describing their characteristic presentations microscopically, including formation of granulomas and caseation necrosis in tuberculosis.
This document summarizes information about leprosy presented by Dr. Alteib Yousif. It discusses the history, classification, signs and symptoms, complications, diagnosis, and treatment of leprosy. Key points include that leprosy is caused by Mycobacterium leprae, has various clinical types defined by skin and nerve involvement, and is treated with multidrug therapy regimens recommended by the WHO to cure the disease. Prevention involves avoiding contact with untreated patients.
The document discusses various types of ichthyoses and ichthyosiform syndromes. It describes ichthyosis vulgaris, X-linked ichthyosis, lamellar ichthyosis, epidermolytic hyperkeratosis, harlequin fetus, bullous ichthyosiform erythroderma, ichthyosis linearis circumflexa, Netherton syndrome, Refsum syndrome, KID syndrome, and CHILD syndrome. It also discusses acquired ichthyosis due to vitamin deficiencies, infections, medications, and systemic diseases.
SCLERODERMA: Searching for the Cause and the Cure
Maureen D. Mayes, MD, MPH Professor of Medicine Director of the Scleroderma Program Division of Rheumatology University of Texas - Houston
Presented at the Scleroderma Patient Education Conference, Saturday, October 19, 2013 at Northwestern Memorial Hospital.
Hosted by the Scleroderma Foundation, Greater Chicago Chapter and the Northwestern Scleroderma Program.
Systemic sclerosis is a connective tissue disease characterized by fibrosis of the skin and internal organs. It can be classified as localized scleroderma, which only affects the skin, or systemic scleroderma, which affects multiple internal organs in addition to the skin. The skin manifestations of systemic sclerosis include Raynaud's phenomenon, skin thickening, ulceration, dyspigmentation, calcinosis, and telangiectases. Currently there is no cure for systemic sclerosis, and treatment focuses on controlling organ-specific complications.
The patient is a 33-year-old female who was admitted to the hospital for blurry vision and headaches associated with pre-eclampsia. She has experienced nausea, vomiting, and lethargy since admission. The patient requires assistance with activities of daily living and has an altered nutrition status due to being on a low-sodium, low-fat diet. Her hospitalization has impacted her views on health and lifestyle. The patient interacts well with her family and healthcare providers.
Este documento proporciona recursos para ayuda con las tareas, investigación de documentos, tutoría en línea y sitios web de tutoría freelance. También incluye una lista de palabras en inglés con sus traducciones al español.
Scleroderma is a multisystem collagen vascular disease characterized by fibrosis of the skin and involvement of internal organs. It can be classified as diffuse or localized systemic sclerosis. Common manifestations include pulmonary fibrosis, esophageal dysmotility causing reflux, delayed gastric emptying, and small bowel involvement seen as "hidebound sign". Skeletal involvement causes acro-osteolysis, joint space narrowing, and flexion deformities of the hands.
Etiology of Leprosy:
A chronic infection caused by Mycobacterium leprae
Acid-fast, rod shaped
Main route of infection:
nasal droplets,
Eating armadillos (south america)
Not very contagious, but close relatives are at high risk of infection
This document summarizes the histopathogenesis of Hansen's disease (leprosy) through descriptions of key pathological features and microscopic images. It discusses how Mycobacterium leprae has an affinity for Schwann cells in peripheral nerves. The types of leprosy (tuberculoid, borderline, lepromatous) are characterized based on the composition and appearance of granulomas in tissue samples. Immunological reactions and rare conditions like Lucio's phenomenon and histoid leprosy are also outlined.
Leprosy, also known as Hansen's disease, is a chronic bacterial infection caused by Mycobacterium leprae. It primarily affects the skin and nerves. There are approximately 600,000 new cases detected worldwide each year. It is endemic in many developing countries. The disease presentation exists on a spectrum from tuberculoid leprosy to lepromatous leprosy depending on the immune response. Left untreated, leprosy can cause permanent nerve damage and deformities. Standard treatment involves multidrug therapy with dapsone, rifampin, and clofazimine over the course of months or years.
Lichenoid Dermatoses, Characteristics of Lichenoid Dermatoses, What are the Major Lichenoid Dermatoses, Lichen planus (LP), Introduction of LP, Epidemiology of LP, Etiology of LP, Pathogenesis of LP, Clinical Features & Clinical variants of LP, Histopathology of LP, Immunohistochemistry of LP, Differential Diagnosis of LP, Treatment of LP
This document summarizes key information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae bacteria and primarily affects the skin, nerves, respiratory tract and testes.
- There is a spectrum of clinical forms from tuberculoid (high resistance) to lepromatous (low resistance).
- Complications include reactions, nerve damage leading to deformities, and secondary infections.
- Treatment involves multidrug therapy but nerve damage may be permanent without rehabilitation. Advocacy groups continue working to eliminate stigma and provide care.
This document provides information on the diagnosis of leprosy. It begins by describing leprosy as a chronic infectious disease caused by Mycobacterium leprae. Key points include that M. leprae was discovered in 1873 and has an affinity for Schwann cells in nerves and macrophages in the skin. Transmission occurs through inhalation of droplets or skin-to-skin contact. Diagnosis involves clinical examination looking for hypo-pigmented skin lesions with sensory deficits or nerve involvement, as well as visualization of acid-fast bacilli in slit skin smears or histopathology. Classification systems include paucibacillary and multibacillary forms based on bacterial load.
Cutaneous leprosy, also known as Hansen's disease, is a chronic infection caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Animals like armadillos and chimpanzees can also be infected. The disease progresses slowly and symptoms may not appear for years. Initial lesions often appear as pale patches on the skin in cooler areas of the body. A definitive diagnosis is made based on skin lesions, nerve thickening, and loss of sensation. Leprosy is classified based on clinical features and response to treatment involves multidrug therapy administered for 6-12 months depending on a patient's classification.
This document discusses the structure and pathology of the oral cavity and esophagus. It begins by describing the general four-layer structure of the esophagus which includes the mucosa, submucosa, muscularis and serosa layers. It then provides more details on the histology and functions of each layer. The document goes on to describe common oral pathologies like aphthous ulcers, oral candidiasis, leukoplakia and erythroplakia. It also discusses salivary gland structures, diseases like Sjogren's syndrome, mucoceles, ranulas, sialolithiasis and various benign and malignant salivary gland tumors.
The document discusses erythema and summarizes key information about several types of annular erythemas. It describes how erythema is a change in skin color due to dilation of blood vessels that can range from pink to dark red. It then provides brief summaries of erythema marginatum, erythema chronicum migrans (Lyme disease), and erythema gyratum repens, noting their associations with rheumatic fever, Borrelia burgdorferi infection, and underlying malignancies respectively.
Leprosy is caused by Mycobacterium leprae and transmitted through inhalation or prolonged skin contact with infected individuals. It has an incubation period of 2-20 years. Leprosy is classified based on bacillary load and immune response into paucibacillary (no bacilli) and multibacillary forms. Clinical manifestations range from hypopigmented skin lesions with sensory loss to disfiguring nodules. Complications include sensory loss, nerve damage, muscle weakness and deformities of hands, feet and face. Diagnosis involves clinical findings and visualization of acid-fast bacilli in skin smears or biopsies.
Leprosy, also known as Hansen's disease, is caused by the slow-growing bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves, potentially causing disabling deformities. M. leprae proliferates best at temperatures between 32-34°C and infects Schwann cells in the cooler areas of the body like the skin and nerves. This can lead to either paucibacillary tuberculoid leprosy characterized by a strong immune response and few bacteria, or multibacillary lepromatous leprosy with a weak response and high bacterial loads, spreading widely. Untreated, leprosy can cause permanent damage to skin, nerves,
Tb lymphnode, tuberculoid and lepromatous leprosySowmya Srinivas
The document discusses the lymphatic system and lymph nodes. It explains that lymph is fluid that passes through lymphatic vessels after leaving capillaries and collects in lymph nodes before returning to circulation via the thoracic duct. Lymph nodes filter bacteria and other particles from lymph and add lymphocytes. The document then discusses specific conditions like tuberculosis and leprosy that can affect lymph nodes, describing their characteristic presentations microscopically, including formation of granulomas and caseation necrosis in tuberculosis.
This document summarizes information about leprosy presented by Dr. Alteib Yousif. It discusses the history, classification, signs and symptoms, complications, diagnosis, and treatment of leprosy. Key points include that leprosy is caused by Mycobacterium leprae, has various clinical types defined by skin and nerve involvement, and is treated with multidrug therapy regimens recommended by the WHO to cure the disease. Prevention involves avoiding contact with untreated patients.
The document discusses various types of ichthyoses and ichthyosiform syndromes. It describes ichthyosis vulgaris, X-linked ichthyosis, lamellar ichthyosis, epidermolytic hyperkeratosis, harlequin fetus, bullous ichthyosiform erythroderma, ichthyosis linearis circumflexa, Netherton syndrome, Refsum syndrome, KID syndrome, and CHILD syndrome. It also discusses acquired ichthyosis due to vitamin deficiencies, infections, medications, and systemic diseases.
SCLERODERMA: Searching for the Cause and the Cure
Maureen D. Mayes, MD, MPH Professor of Medicine Director of the Scleroderma Program Division of Rheumatology University of Texas - Houston
Presented at the Scleroderma Patient Education Conference, Saturday, October 19, 2013 at Northwestern Memorial Hospital.
Hosted by the Scleroderma Foundation, Greater Chicago Chapter and the Northwestern Scleroderma Program.
Systemic sclerosis is a connective tissue disease characterized by fibrosis of the skin and internal organs. It can be classified as localized scleroderma, which only affects the skin, or systemic scleroderma, which affects multiple internal organs in addition to the skin. The skin manifestations of systemic sclerosis include Raynaud's phenomenon, skin thickening, ulceration, dyspigmentation, calcinosis, and telangiectases. Currently there is no cure for systemic sclerosis, and treatment focuses on controlling organ-specific complications.
The patient is a 33-year-old female who was admitted to the hospital for blurry vision and headaches associated with pre-eclampsia. She has experienced nausea, vomiting, and lethargy since admission. The patient requires assistance with activities of daily living and has an altered nutrition status due to being on a low-sodium, low-fat diet. Her hospitalization has impacted her views on health and lifestyle. The patient interacts well with her family and healthcare providers.
Este documento proporciona recursos para ayuda con las tareas, investigación de documentos, tutoría en línea y sitios web de tutoría freelance. También incluye una lista de palabras en inglés con sus traducciones al español.
The document provides information about Enviroform Solutions' open day event promoting their internal wall insulation (IWI) and external wall insulation (EWI) systems and products for addressing thermal bridging issues. It discusses various IWI and EWI system options, highlights potential risks of traditional approaches, and introduces Enviroform's patented products that provide thin, robust insulation solutions for walls, floors, reveals, pipes, and other areas prone to thermal bridging. These innovative aerogel-based products help create continuous insulation and vapor barriers while minimizing the impact on building dimensions.
This document discusses the role of banks, credit, and consumer credit in the Bangladesh economy. It provides background on commercial banks and their role in lending money and processing transactions. It describes how banks in Bangladesh, like Dhaka Bank, provide various types of consumer credit to help develop people's living standards. The document outlines the history of banking in Bangladesh and the role of specialized financial institutions. It also discusses issues with credit administration in the past, as well as the success of the Grameen Bank in providing loans to the poor.
This document provides a summary of valuation concepts in the Central Excise Act of Pakistan. It discusses the definitions of value, wholesale cash price, and retail price as used in the Act for determining excise duty. It outlines how the definitions have evolved through amendments over time. It also summarizes some key Central Excise general orders and rules regarding valuation, such as those relating to printing of retail price and submission of packaging samples. The document aims to explain the various valuation concepts and principles used in Central Excise case law in Pakistan.
This document summarizes a Supreme Court of the Philippines case involving the conviction of Erland Sabadlab y Bayquel for forcible abduction with rape. The Regional Trial Court and Court of Appeals both found Sabadlab guilty based on the testimony of the 16-year-old victim AAA, which was consistent with her physical injuries. Sabadlab appeals, arguing AAA's testimony was inconsistent and implausible. The Supreme Court affirms the conviction, finding no clear reasons to overturn the lower courts' assessment of AAA as a credible witness.
This document summarizes a court case between Paz P. Arrieta and the National Rice and Corn Corporation (NARIC) regarding a breach of contract for the sale and delivery of rice. Key details:
- Arrieta won a bid to supply NARIC with 20,000 metric tons of Burmese rice for $203 per ton under a contract requiring NARIC to immediately open an irrevocable letter of credit.
- NARIC did not apply for the letter of credit until a month later, and was unable to meet the bank's requirement to deposit 50% of the letter amount, delaying the opening of the credit until over two months later.
- This
This document provides summaries of and links to several articles about outsourcing. It discusses transformational outsourcing which involves outsourcing core business activities to accelerate growth. Strategic and tactical benefits of outsourcing beyond cost savings are outlined. Guidelines for offshore outsourcing address risks, models, and delivering benefits. Banking, financial services, insurance and healthcare industries are discussed in the context of outsourcing. Softorix is introduced as a provider of outsourcing services including IT, business processes and domain expertise for these industries.
This document provides information about credit cards, including:
- A credit card allows the holder to buy goods and services with the promise to pay the issuer later. Most are issued by banks and are made of plastic.
- Credit cards originated in the 1920s and became widely used starting in the 1950s and 1960s with the creation of Diners Club and other general purpose cards.
- Credit cards work by verifying funds during purchase and sending the customer a monthly statement to pay. Interest is charged if the full balance isn't paid. Customers receive rewards while merchants pay fees for each transaction.
Cloud computing is a technology that uses internet-connected remote servers rather than local hardware or software to maintain data and applications. This allows users to access files and applications from any device with an internet connection. Key benefits include reduced costs, increased storage, automatic updates, flexibility, and mobility. However, users relinquish direct control and responsibility of their data to the cloud provider.
The document is a Supreme Court of India case from 1999 regarding the validity of the Bar Council of India Training Rules. It discusses the arguments from both petitioners challenging the rules and the Bar Council of India defending the rules. The petitioners argued the rules exceeded the Bar Council's powers and violated rights to practice law. The Bar Council argued it had the authority to make the rules under the Advocates Act. The court had to determine if the rules were valid exercises of rule-making power or if they violated fundamental rights.
Leprosy Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
The document discusses leprosy (Hansen's disease), caused by Mycobacterium leprae bacteria. It covers the disease's incidence, risk factors, modes of transmission, immunology, pathogenesis, classification, signs and symptoms, complications, diagnosis, and treatment. Leprosy mainly affects the skin and nerves and can cause disabilities if left untreated. It remains prevalent in tropical countries and India accounts for over half of all new cases globally each year. Treatment involves multidrug therapy with dapsone, rifampicin and clofazimine for 6-12 months depending on classification.
Leprosy, also known as Hansen's disease, is caused by the bacteria Mycobacterium leprae. It primarily affects the nerves, skin, and mucous membranes of the body. Leprosy is curable with multidrug therapy. While leprosy is moderately contagious, about 95% of people have natural immunity. Left untreated, leprosy can cause permanent damage to the skin, nerves, limbs, and eyes. Clinical signs include pale skin lesions with loss of sensation. Diagnosis involves skin smears and biopsy to detect bacteria. Treatment depends on the classification of leprosy into paucibacillary or multibacillary forms.
The document provides information about the integumentary system, specifically the skin. It discusses the functions of skin including protection, homeostasis, vitamin D synthesis, and cosmesis. It describes the layers of the skin - epidermis, dermis, and hypodermis. It outlines the various skin appendages like hair, nails, sebaceous glands, and sweat glands. It also discusses the different sensory nerve endings and cutaneous nerves in the skin. The document provides details about the pathways for sensory conduction and characteristics of different skin types.
This document provides information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae and primarily affects the skin, nerves, and mucosa.
- There are several classification systems including paucibacillary, multibacillary, lepromatous, tuberculoid, and borderline. Classification depends on immune response and bacterial load.
- It remains a major public health problem with millions of cases worldwide, especially in India, Brazil, and African countries. Treatment involves multidrug therapy to prevent disability.
1. Dermatophytes are fungi that infect the dead keratin of skin, hair, and nails. They can spread from person to person, animals to people, or soil to people. Common sites of infection include the scalp, beard, body, groin, hands, feet, and nails.
2. Candidiasis is a fungal infection caused by Candida yeasts, most commonly Candida albicans. It can cause infections in warm, moist areas of the body like the mouth, throat, genitals, under breasts, and between fingers. Risk factors include diabetes, obesity, pregnancy, steroid use, and weakened immunity.
3. Both dermatophyte and Candida infections
The information about Leprosy is a basic content intended to share Students of Graduate and postgraduate in Life Sciences.
The up loader has no Commercial interests
The document discusses the general diagnosis of skin diseases. It emphasizes the importance of a thorough history, physical examination of the entire body under good lighting, and use of diagnostic tools like microscopy and biopsy. The physical examination involves assessing various characteristics of lesions including distribution, evolution, color, texture and involvement of other areas like hair and nails. Further laboratory investigations and imaging may be needed to confirm diagnoses.
Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Leprosy remains a public health problem in many tropical and subtropical countries. It is classified based on clinical, bacteriological, immunological and histopathological features. Complications can include reactions, peripheral nerve damage leading to numbness and deformities, and eye and bone complications. Treatment involves multidrug therapy to cure the disease and prevent further disability.
"A Study of Clinical Profile of Leprosy in Post Leprosy Elimination Era"iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It is characterized by lesions of the peripheral nerves, skin, and nasal mucosa. There are different clinical classifications of leprosy based on immune response and bacterial load, ranging from tuberculoid leprosy with few bacteria and strong immune response to lepromatous leprosy with many bacteria and weak immune response. Without treatment, leprosy can cause permanent damage, especially to the hands, feet, and face.
Psoriasis is a chronic inflammatory skin condition characterized by well-defined erythematous plaques bearing thick silvery scales. It affects 1-3% of the population and has an unpredictable chronic course with exacerbations and remissions. Common triggers include trauma, infection, and stress. Histopathology shows parakeratosis, epidermal thickening, and dermal inflammatory infiltrate. The most common form is stable plaque psoriasis presenting as salmon-pink plaques on the elbows and knees. Treatment includes topical corticosteroids and vitamin D analogues, phototherapy, and systemic medications for severe cases.
Children's skin problems span nearly two decades from birth through adolescence. Several common pediatric skin conditions will be discussed including: diaper dermatitis, atopic dermatitis, warts, and acne.
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- Leprosy, also known as Hansen's disease, is caused by the bacterium Mycobacterium leprae. It affects the skin and peripheral nerves.
- There are different types of leprosy including tuberculoid, lepromatous, borderline, and indeterminate. Symptoms vary depending on type but may include skin lesions and nerve damage.
- Leprosy is treated with multidrug therapy which includes dapsone, rifampicin, and clofazimine. Treatment duration depends on whether a patient has paucibacillary or multibacillary leprosy. Nursing care focuses on monitoring for side effects, educating patients, and preventing
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
The document provides information on various bacterial, viral, and fungal infections that can affect humans. It discusses specific infections such as actinomycosis, syphilis, tuberculosis, candidiasis, herpes simplex virus, and more. For each infection, it describes the causative agent, transmission, clinical features, histological features, and in some cases treatment. The document is an informative reference for various microbial infections.
This presentation provides an overview of leprosy (Hansen's disease), including its causes, symptoms, diagnosis, treatment, and status in Pakistan. It is caused by the bacterium Mycobacterium leprae, which primarily affects the skin and nerves. Symptoms include disfiguring skin sores and lesions, as well as nerve damage leading to numbness and muscle weakness. Leprosy is diagnosed based on skin signs and presence of acid-fast bacilli. Treatment involves multidrug therapy regimens administered by the WHO. While leprosy rates are declining in Pakistan due to elimination programs, it remains a concern in other parts of Asia and Africa.
This document provides an overview of the business process outsourcing (BPO) industry. It discusses the growth of the global BPO market, with India emerging as a major hub due to its large English-speaking workforce and lower costs compared to countries like the US. The document outlines the advantages that have made India and other countries like the Philippines competitive locations for BPO. It also notes some of the challenges that countries face in attracting BPO work, such as China's smaller English-speaking population.
This case study examines the success of IKEA's expansion into the American market. Key factors in IKEA's success include its Scandinavian designs, cost efficiency through flat packaging and customer assembly, and structured product strategy using a pricing matrix. While shopping at IKEA has downsides like durability issues and assembly requirements, the company aims to build partnerships with customers. IKEA plans to open 50 stores in the US by 2013, which some see as optimistic but achievable given their value proposition. Minor adjustments to the pricing matrix and additional product styles and price points could support IKEA's continued growth goals. Expanding into smaller "IKEA Lite" stores is also proposed to increase accessibility and impulse purchases.
- Judge Adoracion Angeles charged lawyer Thomas Uy with violating his fiduciary duties by failing to promptly return 16,500 pesos paid to him in trust for his client, Primitiva Del Rosario. During a court hearing, Del Rosario said she did not receive the money from Uy. Uy was then ordered to return the money but failed to do so.
- In his comment, Uy explained that the money was paid to his office by Norma Trajano on December 14, 1998 to settle the civil aspect of a criminal case. He claims Primitiva Del Rosario asked for the money to be kept in his office until further payments were made. However, during a February 10,
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Jemison, MacLaughlin, and Majumder "Broadening Pathways for Editors and Authors"
103317354 1st caselepro-1docx
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XI. INTRODUCTION
A. Background of the Study
Leprosy has been a Public problem in the Philippines for several decades. The
disease unequally distributed throughout the country. In 1987, in the provinces of
Ilocos Norte and Ilocos Sur, Abra, Sulu, Palawan Cebu and La Union, Pangasinan and
Metro Manila, the prevalence rate changed from 0.40 to 3.01 per thousand
populations. In other provinces. The prevalence rate is lower than 0.40/1000
population. The National Prevalence Rate as of 1998 was 0.65/1000. (Community
Health Nursing Services in The Philippines. 9th Edition, page 215)
The Nationwide implementation of Multi-drug Therapy (MDT) SINCE 1988 has
resulted in the decrease In the prevalence rate of leprosy. The prevalence rate of the
disease declined from 7.2/10,000 population in 1986 to 1.2/10,000 population in
1997. Since then, the treatment of leprosy has shifted from institutional care to that
home treatment.
Leprosy (Hansen’s Disease; Hansenosis; Lepra; Leontiasis) is a chronic disease
with an insidious onset, transmitted from man to man, affecting the skin, mucous
membranes and nervous tissue and eventually producing deformities. This chronic,
mildly, infectious disease is caused by rod-shaped bacilli, Mycobacterium Leprae pr
Leprosy bacilli or Hansen’s Bacillus.
B. Rationale for Choosing the Case
Most of our patient assignments are Non-hansen patient. Meaning they are not
affected with the Mycobacterium Leprae. Since my focus is Patient care
management and we are in a Leprosarium, I choose the case of Hansen patient or
2. patient affected with the Mycobacterium Leprae because it would help us to have
focus study regarding this case- more nursing care would be given.
XII. PATIENT PROFILE
A. General Data
Name: Patient X
Age: 25 years old
Birth date: January 24, 1979
Birth Place: Cebu
Sex: Female
Nationality: Roman Catholic
Civil Status: Single
Address: Caloocan City
Ward/Accommodation/Service: Female Ward/Charity/Medicine
Patient Category: Non regular Hansen
Date Admitted: June 16, 2012
Time Admitted: 3:00pm
XIII. PHYSICAL ASSESSTMENT
BODY PARTS NORMS ACTUAL
FINDINGS
INTERPRETATION
AND ANALYSIS
Skin Varies from light to
deep brown; from
ruddy pink; from
yellow overtones
to olive (pg. 538
Fundamentals of
Nursing by Kozier,
7th Edition)
Skin lesions all
over the body.
Loss of sensation
on the skin
lesions.
Not normal. The
cardinal signs of
leprosy are the ff:
--Loss of sensation
on the skin lesions
--Enlargements of
peripheral nerves
--Presence OF
leprosy bacilli in the
skin smear. Loss of
sensation can cause
further damage to
skin.
XIV. Anatomy and Physiology
3. The skin is the body’s largest organ, covering the entire body. In addition to
serving as a protective shield against heat, light, injury and infection, the skin also:
a. Regulates body temperature
b. Stores sensory organ
c. Prevents water loss
d. Prevents entry of bacteria
Throughout the body, the skin’s characteristics (thickness, color, texture)
vary. For instance, the head contains more hair follicles than anywhere else,
while the soles of the feet contain none. In addition, the soles of the feet and the
palms of the hand are much thicker. The skin is made up of the following layers,
with each layer performing specific functions:
a. Epidermis
b. Dermis
c. Subcutaneous fat layer
Epidermis The epidermis is the thin outer layer of the skin and
consists of three parts:
a. Stratum corneum (horny layer)
-this layer consists of fully mature
keratinocytes which contain fibrous proteins
(keratins) The outermost layer is continuously
shed. The stratum corneum prevents the
entry of most foreign substances as well as
the loss fluid from the body.
b. keratinocytes (squamous cells)
-This layer just beneath the stratum corneum
contains living keratinocytes, which mature
and forms stratum corneum.
c. Basal layer
-the basal layer is the deepest layer of the
epidermis containing basal cells. Basal cells
continually divide, forming new keratinocytes
that replace the cells that are shed from the
skin’s surfaces. The epidermis also contain
melanocytes, which are cells that produces
melanin (skin pigment)
4. Dermis The Dermis is the middle layer of the skin. The dermis
contains the following.
d. Blood vessels
e. Lymph vessels
f. Hair follicles
g. Sweat glands
h. Collagen bundles
i. Fibroblasts
j. Nerves
The dermis is held together by a protein called
collagen, made fibroblasts. This layer also contains
pain and touch receptors.
Subcutaneous Fat
Layer
The subcutis is the deepest layer of the skin. The
subcutis, consisting of network of collagen and fat
cells, helps conserve the body’s heat and protects the
body from injury by acting as shock absorber.
XV. Patophysiology/Schematic diagram of the disease
a. A chronic intracellular infectious disease unique to man usually it is not fatal. The
manifestations of the disease depend on the resistance of the host.
Types:
1. Tuberculoid- host is highly resistant, clinical abnormalities limited yo a few
peripheral nerves and adjacent skin areas, tuberculoid granuloma
2. Lepromatous- host lacks resistance, all tissues affected from cell granuloma
3. Borderline- between tuberculoid and lepromatous
The earliest clinically detectable lesions of leprosy involve the skin and show
histologic association with sebaceous glands and hair follicles. From the
onset, small cutaneous nerve fibers are involved. With bacillary
multiplication, contiguous skin areas including autonomic nerve fibers,
dermal appendages, and blood vessels are invaded.
Lymphohemategenous dissemination of bacilli is probably an early
phenomenon. An infection spreads along sensory nerves motor fibers within
5. parent nerve trunks are damaged. Leprosy bacilli are unable to penetrate
directly into the nervous system proximal to the dorsal root ganglions:
central nervous systeminfection does not occur.
When there is dense proliferation of leprosy bacilli, as a lepromatous leprosy,
bacteremia is virtually continues, and bacilli are easily demonstrable in many
organs. Yet there is little systematic reaction, and tissue destruction occurs
mainly in cool superficial locations; the skin (except folds); peripheral nerves
in subcutaneous loci; oral and naso pharyngeal mucous membranes (not
enteric or vaginal) ; the testes (not the ovaries) and the anterior third of the
eye.
The clinical manifestations are the indeterminate (1) lesion, which may be
the initial manifestation, shows as ordinary-looking skin changes, such as
pale oval or rounded macules, papulonodules, wheals or circinate patches.
They may be found in the malar area, extremities’ or buttocks. There may be
only one or few lesions which may appear and disappear, undergo
spontaneous healing or gradually progress through the borderline (BB) form
towards the tuberculoid (BT) or lepromatous (BL) forms. The lesions are
usually anesthetic but this may be later manifestations. They maybe
depigmented or erythomatous. Sensory disturbances as paresthesias,
numbness and formication may also be found. There may also be thickening
or superficial nerve trunks. Especially the ulnar, as well as lymphadenophaty
anhindrosi, ichtyosis and limb weakness. The foregoing manifestations may
be seen in nay of the clinical forms particularly in the tuberculoid (TT) which
is also characterized by adefinite tendency towards healing. Damage in the
following nerves is associated with characteristic impairments in leprosy;
®ulnar and median- clawed hand
®posterior tibila- plantar insensitivity and clawed toes
®common peroneal- foot drop
Radial cutaneous, facial and greater auricular nerves infiltration by
bacteria may lead to destruction of nasal cartilage (lepromatous form) ocular
movement and diffuse thickening of the skin. Advanced cases involve the loss
of eyebrows and lashes but these deformities are less common.
XVI. Laboratory and Diagnostic Examination
6. Diagnostic Exam Norms Actual Results Interpretation and
Analysis
Urinalysis Reference Values
Color: light straw to
dark amber
Appearance: clear
Odor: aromatic
Ph: 4.5-8.0
Specific gravity:
1.005-1.030
Protein: 2-8
Mg/dl: Negative
reagent strip test
Trace Glucose:
negative
Ketones: negative
(Handbook of
Laborator and
Diagnostic Test)
Actual findings Color:
Yellow
Appearance: Clear
Odor: aromatic
pH: Acidic
Specific gravity:1.030
Protein: Negative
Glucose: negative
Microscopic
Examination:
RBC: 0-1/hpf
Pus: 0-3/hpf
Epithelial Cells:
positive
Urates: postive
Interpretation: The
urine color, Ph,
specific gravity and
microscopic
examination
(epithelial cells and
urates) are not normal
while the appearance
protein, glucose are
normal.
Analysis: Color of the
urine changes can
results from diet.
Drugs and much
disease. (pg. 395,
Diagnostic Test) When
water loose from the
body exceeds water
intake, the kidneys
need to consume
water making the
urination more
concentrated with
waste products and
subsequently dark in
color. Yellow colored
urine is possible of
pyuria, and infection.
(Medical Surgical
Nursing by Bare and
Smeltzer pg. 1263) A
normal pH is 7. A pH <
7 indicates alkaline
urine. Acid urine pH is
associate with renal
tubercolosis, pyrexia,
phenylketonuria,
alkaptonuria and
acidosis. (Diagnostic
Tests. A prescriber’s
Guide to Selection and
7. Interpretation by
Lippincott Williams
and Wilkins, p. 395)
due to carbohydrate
malabsorption, fat
malabsorption and
disaccharides
deficiency. (A manual
of Laboratory and
Diagnostic Tests, 7th
Edition by Lippincott
Williamand Wilkins,
p.279) Normally,
freshly voided urine
has a faint odor owing
to the presence of
volatile acids. It is not
generally offensive.
Fresh urine from most
persons has a
characteristics
aromatic odor (pg. 396
Diagnostic Test)
Specific gravity is an
indication of the
relative proportions of
dissolved solid
components to the
total volume of the
specimen and reflects
the relative degree of
concentration or
dilution of the
specimen.
(www.intensive
caring.com) In a
healthy renal and
urinary tract system,
urine contains no
protein or only trace
amount (pg. 191, A
Manual Laboratory
and Diagnostic Test)
Sugar, usually absent
8. from the urine may
appear under normal
conditions (pg.329
Handbook of
Diagnostic Test 3rd
Edition) A high
number of white
blood cells in the urine
is usually a symptom
of urinary tract
infection. A large
number of cells from
tissue lining (epithelial
cells) indicate damage
to the small tubes that
carry material into out
of the kidneys.
(www.healthatoz.com)
Hematology Reference Values:
WBC: 5-10x 10’ g/dl
Neutrophils:0.40-0.60
Lymphocytes: 0.20-
0.40 (Diagnostic
Testing and Nursing
Implications, 4th
edition)
Actual findings:
WBC: 12.6
Neutrophils: 0.71
Interpretation: Not
normal.
Analysis: increased
Leukocytosis, an
increase in circulating
leukocytosis in all
types occur, if it is
usually a result of hem
concentration (A
Manual of Laboratory
and Diagnostic Tests,
7th Edition By
Lippincott Williamand
Wilkins p.49)
Increase in
neutrophils: severe
bacterila disease,
diabetic acidosis,
infarctions, increase in
acute, severe
inflammation
malignancies
(Diagnostic Testing
and Implications 4th
edition)
9. XVII. DRUG STUDY
Generic/Trade
Name/Drug
Class
Mode of
Action
Dosage/Route
Frequency
Indications Contraindications Side Effects Nursing
Consideration
Rifampin
Rifadin,
Rimactane,
Rofact (CAN)
Antibiotic
Antituberculotic
(First line)
Inhibits
DNA-
dependent
RNA
polymerase
activity in
susceptible
bacterial
cells.
Adults:
10mg/kg/day;
no to exceed
600mg in a
single daily
dose PO or IV
Treatment of
Pulmonary TB in
conjunction with
atleast one other
effective
antituberculotic.
Neisseria
Meningitidis
carriers, for
asymptomatic
carriers to
eliminate
meningococcemia
from naso
pharynx; not for
treatment of
meningitis
Contraindicated
with allergy to
any rifamycin,
acute hepatic
disease,
lactation.
Use cautiously
with pregnancy
Headache,
Drowsiness,
Fatigue,dizzy-
ness, Rash,
urticuria,
flushing,
epigastric
distress,
nausea,
vomiting gas,
cramps,
diarrhea,
Administer to
an empty
stomach, 1hr
before or 2 hr
after meals.
Administer in
a single dose
only
Consult
pharmacist
for rifampin
supension.
Report fevers,
chills, muscle
and bone
pain.
Generic/Trade
Name/Drug Class
Mode of
Action
Dosage/Route
Frequency
Indications Contraindications Side
Effects
Nursing
Considerations
Dapsone
Aczone Gel
Lerostatic
Treatment of
Hansen’s disease
Treatment of
herpetiformis
Topical
drugs
Contraindicated
with allergy to
these drugs, open
wounds or
abrasions.
Local
irritation,
stinging,
burning,
dermatitis,
toxic effects if
absorbed
systematically.
Apply
sparingly to
the affected
area as
directed. Do
not use with
open wounds
or broken skin.
Avoid contact
with eyes.
Report any
local irritation,
allergic
reaction,
worsening of
condition
10. XVIII. NURSING CARE PLAN PRIORITIZATION
A.
RATE Nursing Problems
Identified
Justification
1 Ineffective airway
breathing pattern related
to excessive mucus
secretion
According to Abraham
Maslow of Hierarchy of
needs, physiologic needs
come in priority. This is an
actual problem that
requires immediate
attention. It is the chief
complaint of the patient
and the other nursing
problems occur in relation
to the presence of this
problem
2 Impaired skin integrity
related to presence of skin
lesion.
Fur2ther damage to skin
may cause other
infections. This is an actual
problem which is an effect
of the prioritized problem
above interventions are
available and possible for
this problem.
3 Anxiety (Mild) related to
changes in health status
Sudden in her way of
living
B. NURSING CARE PLAN.
ASSESSTME
NT DIAGNOS
IS
PLANNING
INTERVENTIO
N
RATIONALE EVALUATIO
N
Subjective
: “Hindi
naman na
Impaire
d skin
integrit
Independent: After
nursing intervention
with collaborative
Goal
met.
being treated.
11. masakit
itong mga
sugat ko,
matagal
na rin
naman na
itong mga
sugat ko”
Objective:
-presence
of skin
lesion all
over the
body
-black
color
lesions
y
realted
to
presenc
e of
skin
lesions
all over
the
body
nursing intervention,
the client will be able
to have improved
skin integrity as
evidenced by:
a. Exhibited no
further skin
breakdown
b. Healed skin
lesions
Objectives: After 8
hours shift the client
will be able to:
1. Exhibit
evidence of
skin
breakdown
a. Inspect
patient’s
skin every
shift,
describe
and
document
skin
condition
and report
changes.
b.Perform
and teach
patient
prescribed
treatment
regimen
for skin
condition
involved
and
monitor
progress.
Report
response
a. This
provides
evidence of
effectivene
ss of skin
regimen.
(Nursing
Diagnosis
CARD 9TH
Edition by
Taylor and
Sparks card
158)
b. to
maintain or
modify
current
therapy.
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
12. 2. Communicate
understanding
, verbalizes
intent to use
skin
protection
measures,
demonstrates
skin
inspection
technique and
performs skin
care continue
to
treatment
regimen.
c.warm the
patient
against
tampering
with
wound.
d.explain
therapy to
patient.
a.instruct
patient in
skin care
regimen
b.supervise
patient in
skin care
c.to avoid
spread of
infection
and
decreased
chance of
further skin
damage
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
d. to aid
compliance
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
a.to
encourage
compliance
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
b.to
improve
skill of the
patient
(Nursing
Diagnosis
13. 3. Communicate
feelings about
change in the
body image
manageme
nt
a.allow
patient to
express
feelings
regarding
skin
problem
b.refer
patient to
psychiatric
liaison
nurse,
social
services or
other
support
groups.
card 9th
edition by
Taylor and
Sparks,
Card 158)
a.this helps
allay
anxiety and
develop
coping
skills
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
b.this
provide
additional
support for
patient
(Nursing
Diagnosis
card 9th
edition by
Taylor and
Sparks,
Card 158)
XIX. DISCHARGE PLANNING
MEDICATION
● Multi-drug Therapy (Dapsone, Rifampicin and Clofazimine)
14. EXERCISE
●The client should have a daily routine exercises
●Encourage client to have regular exercise such as performing range of motions
exercises
●Encourage the client to follow an exercise to follow a appropriate exercise
program. Exercise is also a useful way to lose weight, ease stress and maintain a
feeling of well-being. It is also good for wound healing.
TREATMENT
●Medications as prescribed by the physician
●Educating both patient and family
●Provides and arranges for provisions of nursing care of patients at home
HEALTH TEACHINGS
●Control measures such as immunizations
●Practice personal hygiene
●Health education of patients, families, and the community on the nature of the
disease, symptomatology and its transmission
●Advocates healthful living through proper nutrition, adequate rest, sleep, exercise
and good environment.
●Health teaching to prevents secondary injury
●Teach the client that she/he should not fail to complete treatment within the
prescribed duration.
●The Nurse should give health teachings like information about how to prevent and
protect his skin from wounds and lesions. If there’s such, teach how will be the
proper way of addressing the wound and taking good care of it.
OUT PATIENT FOLLOW UP
●Refers patient to other health and allied workers
●refers patient to other persons/agencies who can help inhis/her physical, mental
and social rehabilitation.
15. ●Monthly outpatient follow up is recommended during treatment, although weekly
visits may be necessary if the patient experience leprosy reaction.
DIET
●Diet as tolerated
SPIRITUAL TEACHINGS
●Mental and emotional support by encouraging self-confidence and self reliance.
●Providing counseling and guidance
References:
Fundamentals of Nursing by Kozier, 7th Edition
Handbook of Laboratory and Diagnostic Test)
www.intensive caring.com
Nursing Diagnosis card 9th edition by Taylor and Sparks
Diagnostic Testing and Nursing Implications, 4th edition)
Diagnostic Tests. A prescriber’s Guide to Selection and Interpretation by Lippincott Williams and
Wilkins
Medical Surgical Nursing by Bare and Smeltzer
Handbook of Diagnostic Test 3rd Editon
www.healthoz.com
16. TABLE OF CONTENTS
I. INTRODUCTION
A. Back ground of the Study
B. Rationale for Choosing the Case
II. PATIENTPROFILE
A. General Data
III. PHYSICAL ASSESSTMENT
IV. ANATOMY AND PHYSIOLOGY
V. PATHOPHYSIOLOGY/SCHEMATIC DIAGRAM OF THEDISEASE
VI. LABORATORYAND DIAGNOSTIC EXAMINATION
VII. DRUG STUDY
VIII. NURSING CAREPLA PRIORITIZATION
A. NURSING CAREPLAN
IX. DISCHARGEPLAN
17. X. REFERRENCE
CENTRAL LUZON COLLEGE OF SCIENCE & TECHNOLOGY
College of Nursing
A CASE STUDY ON
LEPROSY
In Partial Fulfillment for
Related Learning Experience
Presented by:
Adelina Pinero
BSNIII
18. Presented to:
Mrs. Ma. Rowena Dimapilis RN, Man
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