The document discusses schizophrenia, antibiotic resistance, and provides two case studies. It summarizes schizophrenia symptoms and treatments. It describes how overuse of antibiotics can lead to resistance and increased deaths from bacterial infections worldwide. A case study describes a 20-year-old man exhibiting symptoms of schizophrenia including delusions, hallucinations, and paranoia. A second case study outlines a woman's experience with undiagnosed schizophrenia and subsequent treatment.

1. Case study on overcoming resistance & understanding
schizophrenia

2. Contents
• Schizophrenia
• case study 1
• case study2
• Antibiotics resistance
• Cause of resistance
• Case study

3. Schizophrenia
• Schizophrenia is a serious disorder which affects how a person
thinks, feels and acts. Someone with schizophrenia may have
difficulty distinguishing between what is real and what is
imaginary; may be unresponsive or withdrawn; and may have
difficulty expressing normal emotions in social situations.

4. Causes
• Genetic inheritance
• Chemical imbalance in the brain
• Family relationships
• Drug induced schizophrenia
• Environmental factors

5. Symptoms
• Positive symptoms
• Negative symptoms
• Cognitive symptoms
• Emotional symptoms
• Other symptoms:
• Delusions
• Hallucinations
• Lack of motivation
• Social withdrawal
• Unawareness of illness

6. Diagnosis
• Blood tests - in cases where drug use may be a
factor a blood test may be ordered. Blood tests are
also done to exclude physical causes of illness.
• Imaging studies - to rule out tumors and problems
in the structure of the brain.
• Psychological evaluation - a specialist will assess
the patient's mental state by asking about thoughts,
moods, hallucinations, suicidal traits, violent
tendencies, or potential for violence, as well as
observing their demeanor and appearance.

7. Treatment
• The most common schizophrenia medications are:
• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Maytiapine (Seroquel)
• Ziprasidone (Geodon)
• Clozapine (Clozaril)
• Haloperidol

8. Treatment
• The primary schizophrenia treatment is medication. Sadly, compliance
(following the medication regimen) is a major problem. People with
schizophrenia often come off their medication for long periods during
their lives, at huge personal costs to themselves and often to those
around them.
• The patient must continue taking the medication even when symptoms
are gone. Otherwise they will come back.
• The first time a person experiences schizophrenia symptoms, it can be
very unpleasant. They may take a long time to recover, and that
recovery can be a lonely experience. It is crucial that a person living
with schizophrenia receives the full support of their family, friends, and
community services.

9. Case Study
• Name :- Myles
• Age:- 20 years man

10. Case Study
• He was brought to the emergency room by the campus police
of the college from which he had been suspended several
months ago. A professor had called and reported that Myles
had walked into his classroom, accused him of taking his
tuition money and refused to leave.
• Although Myles had much academic success as a teenager, his
behaviour had become increasingly odd during the past year.

11. Case Study
Symptoms:-
• Quit seeing his friends
• No longer seemed to care about his appearance or social
pursuits
• Began wearing the same clothes each day and seldom bathed
• He lived with several family members but rarely spoke to any
of them.

12. Case Study
• Told his family he had found clues that his college was just a
front for an organized crime operation.
• His sister said that she had often seen him mumbling quietly
to himself
• At times he seemed to be talking to people who were not there.
• He would emerge from his room and ask his family to be quiet
even when they were not making any noise.

13. Case Study
• Myles began talking about organized crime so often that his
father and sister brought him to the emergency room.
• On exam there, Myles was found to be a poorly groomed
young man who seemed inattentive and preoccupied.
• His family said that they had never known him to use drugs or
alcohol, and his drug screening results were negative.
• He did not want to eat the meal offered by the hospital staff
and voiced concern that they might be trying to hide drugs in
his food.

14. Case Study
• His father and sister told the staff that Myles’ great-
grandmother had had a serious illness and had lived for 30
years in a state hospital, which they believed was a mental
hospital. Myles’ mother left the family when Myles was very
young. She has been out of touch with them.
• Myles agreed to sign himself into the psychiatric unit for
treatment.

15. Conclusion
• His story reflects a common case, in which a high-functioning
young adult goes through a major decline in day-to-day skills.
Although family and friends may feel this is a loss of the
person they knew, the illness can be treated.
• In the case of Myles, he was having persecurtory delusions,
auditory hallucinations and negative symptoms that had lasted
for at least one year.
• It is key for the treating doctor to quickly rule out other causes
of the problem, such as substance use, a head injury or a
medical illness.

16. Case study no. 2
Patient profile
Name:- Tanara
AGE:- 31
Sex:- Female

17. Starting symptoms
• Paranoid feeling
• Hearing voices
• Understand problem
Case study

18. • July of 2009, she was hospitalized
• doctors thought she had a mood disorder doctor started
number of medications.
• But once she got out of the hospital She stopped taking
medicine. Because symptoms were gone.
• she was feeling well enough to get a job doing work
like painting.
• In April 2010, when the symptoms returned and she
began feeling paranoid again.
Case study

19. • They started new medication but when she was
discharged four months later.
• she noticed that she was having side effects, like
twitching. So she stopped taking medicines again.
• She got into that altercation with neighbor and was sent to
jail. she’s symptoms were acting up and she felt so angry.
Case study
• The doctors still thought she had a mood disorder
because she didn’t tell them about paranoia or about
suddenly hearing voices in my head.

20. • she got out of the hospital and off the treatments I was taking
there, I try a new treatment for schizophrenia. After weighing
the risks and benefits, we both agreed the treatment, given
through monthly injections, might help control my symptoms.
Case study
• When she got out of jail the judge said you should go to
a psychiatric hospital. she tell about what she was
experiencing the voices the paranoia. doctor said, “You
are battling schizophrenia.”

21. She started a day rehabilitation program and also started the new
medication the monthly injections. she was working hard to
achieve goals by following treatment plan. Her schizophrenia
symptoms were under control, and she started feeling better.
Conclusion

22. INTRODUCTION
Bacteria are small (microscopic size) organisms that can be
found in most environments, for example in soil, water and on
and inside the human body
There are around 50 million bacteria in every gram of surface
soil
Examples of bacterial infections:
• Pneumonia
• Blood stream infections
• Urinary tract infections
• Wound infections
Antibiotics are medicines for bacterial infections
Examples of antibiotics:
Penicillin and Ciprofloxacin

23. ANTIBIOTIC RESISTANCE
The ability of bacteria to protect themselves against the effects of an
antibiotic
Bacteria are experts at surviving in changing environments.
Antibiotic resistant bacteria each year cause:
• More than 38,000 deaths in Thailand
• More than 23,000 deaths in the USA
• 25,000 deaths in the European Union
In South Asia (India, Pakistan, Afghanistan, Nepal, Bangladesh) one
newborn child dies every 5 minutes from blood stream infections
(sepsis) because the antibiotics given are not effective due to bacterial
resistance

24. CAUSE OF RESISTANCE
• Rational use of antibiotics
• Antibiotics do not work against viruses
• Examples of viral infections:
Common cold
Flu (influenza)
• Mechanism of antibiotic resistance :
1. The drug does not reach its target
2. The drug is inactivated
3. The target site is altered

26. Is antibiotic resistance a problem?
• Antibiotic resistance leads to treatment failures
• Antibiotic resistance threatens our ability to perform modern
medical procedures
• Antibiotic resistance imposes a major economic burden on society
• Antibiotic resistant bacteria already cause many deaths around the
world

27. CASE STUDY
• The discovery of antibiotics in the 20th century helped humans to fight
deadly diseases like syphilis and gangrene, but the more we use them, the
greater the pressure becomes for bacteria to evolve. Any genetic mutation
that helps a bacterium beat a drug very quickly gets ‘selected’ and spreads
throughout the bacterial population as the cells without the mutation die
off.
• Doctors are then left with fewer treatment options, meaning that patients
take longer to recover or are less likely to survive. Inappropriate use of
antibiotics – including doctors prescribing the drugs unnecessarily and
patients failing to completely eliminate infections by not finishing
antibiotic courses – is making the problem worse by giving bacteria a
chance to develop resistance.
• To keep up with bacteria, drug companies need to develop entirely new
classes of antibiotics. But the drug discovery and approval process is
lengthy, and there are few incentives to develop antibiotics because they
start becoming ineffective within a couple of years.

28. CASE STUDY
• Tuberculosis (TB) is an infectious disease caused by Mycobacterium
tuberculosis bacteria. It is curable with a combination of antibiotics over a
six-month course, though there are complications. Among curable
infectious diseases, it is the top killer.
• In 2012 about 450,000 people developed multidrug-resistant TB, and
170,000 people died from it.
• The World Health Organization has outlined a target of treating 80 per cent
of all multidrug-resistant (MDR) cases by 2015, but right now less than 3
per cent receive proper treatment. Treatment usually lasts for at least 2
years and involves daily injections.
• Five per cent of all cases of MDR-TB are considered extensively drug-
resistant (XDR), meaning patients do not respond to first-line and some
second-line drugs. Many labs are unable to even detect and diagnose this
form of the disease.
• India and China : These countries account for over half of all MDR-TB
cases.

29. CASE STUDY
• A 20-year old woman with no previous history of UTI, complains of burning on
urination, frequent urination of a small amount, and bladder pain. She has no fever
or CVA tenderness. A clean-catch midstream urine sample shows Gram-negative
rods on Gram stain. A culture and sensitivity test is, although this is somewhat
antibiotic class-specific.
• Bactrimordered .Based on these findings, woman is presumed to have a lower UTI
1. TREATMENT :
• The duration of therapy for UTI’s has been shortened considerably. The traditional
7 to 14 day course of antibiotic therapy now is considered excessive for most
patients with uncomplicated infections.
• A 3 day antibiotic treatment regimen is just as effective as a 10 day regimen in
eradicating urinary tract organisms, Augmentin, and the fluoroquinolones are
recommended as the preferred agents for 3 day treatment regimens.
• Nitrofurantoin, sulfoanamides other than Bactrim, and tetracyclines are more
appropriately reserved for longer treatment failure following regimens of shorter
duration.
• The choice of a specific agent should be based on geographic sensitivities as well as
patient allergies and the relative cost of the agents.

30. Thank
you