National TB Elimination Programme in India aims to eliminate TB by 2025. TB remains a major public health problem in India, being one of the leading causes of death. In 2019, the estimated TB incidence was 26.4 lakh cases and estimated deaths were 4.45 lakh. There is a large gap between estimated cases and cases notified to the government. Private sector notification is very low. The government's targets are to reduce TB deaths by 90% and cut incidence rate by 80% by 2025 compared to 2015. This will require detecting all TB cases, ensuring treatment completion, preventive measures like contact screening, and building strong public-private partnerships.
this presentation is based on national health program in india in relation to tuberculosis and malaria as these are mostly occuring disease in india so national program are organised to irradicate the spread of vector borne disease by various methods like controlling the vector (mosquitos) from spreading
role of community pharmacist in educating and monitoring of patients for infection and counselling and educating them regarding the control of malaria and tb.
www.slideshare.ne www.slideshare.ne Tuberculosis (TB) is fatal
contagious disease that affects the lungs and other part of body which is a public health problem but curable and preventable disease .
Caused organism : bacteria (Mycobacterium tuberculosis
Human : Mycobacterium tuberculosis
Pulmonary TB
Extra pulmonary TB
Animals : Mycobacterium Bovis
Bovine tuberculosis (TB) is a chronic disease of animals caused by a bacteria called Mycobacterium bovis, (M.bovis) which is closely related to the bacteria that cause human
Presentation on GPDP_Dr Bharat Rout, MoPR (1).pptxAbhijit Dey
Article 243G of the Constitution of India acknowledges Panchayats as institutions of local self-government and mandates them to prepare plans for economic development and social justice.
Gram Panchayat Development Plans (GPDP) to be prepared for effective implementation of flagship schemes/ programmes
Panchayat Development Plans (PDP) must be comprehensive and based on participatory process, which inter alia involves the full convergence of the schemes of Central and State Governments related to 29 subjects
Intermediate/Block and District Panchayats are responsible for preparing Block Panchayat Development Plan (BPDP) and District Panchayat Development Plan (DPDP) at the respective levels.
As a result, Panchayats envisage for an efficient and robust planning process as part of GP’s core functioning
Overview of TB Mukt Panchayat initiative 30082023-Dr Mrigen.pptxAbhijit Dey
‘Healthy Villages’ has been articulated in achieving Sustainable Development Goals in Panchayat Raj Institutions.
Health functionaries at the village and Sub-Centre/HWC levels along with the support of Gram Panchayats, are making substantial progress towards elimination of TB.
The efforts made need to be measured and validated through a certification process so that panchayats can be declared TB Free.
The certification process will motivate and empower the Panchayats to prioritize and undertake the implementation of program activities.
this presentation is based on national health program in india in relation to tuberculosis and malaria as these are mostly occuring disease in india so national program are organised to irradicate the spread of vector borne disease by various methods like controlling the vector (mosquitos) from spreading
role of community pharmacist in educating and monitoring of patients for infection and counselling and educating them regarding the control of malaria and tb.
www.slideshare.ne www.slideshare.ne Tuberculosis (TB) is fatal
contagious disease that affects the lungs and other part of body which is a public health problem but curable and preventable disease .
Caused organism : bacteria (Mycobacterium tuberculosis
Human : Mycobacterium tuberculosis
Pulmonary TB
Extra pulmonary TB
Animals : Mycobacterium Bovis
Bovine tuberculosis (TB) is a chronic disease of animals caused by a bacteria called Mycobacterium bovis, (M.bovis) which is closely related to the bacteria that cause human
Presentation on GPDP_Dr Bharat Rout, MoPR (1).pptxAbhijit Dey
Article 243G of the Constitution of India acknowledges Panchayats as institutions of local self-government and mandates them to prepare plans for economic development and social justice.
Gram Panchayat Development Plans (GPDP) to be prepared for effective implementation of flagship schemes/ programmes
Panchayat Development Plans (PDP) must be comprehensive and based on participatory process, which inter alia involves the full convergence of the schemes of Central and State Governments related to 29 subjects
Intermediate/Block and District Panchayats are responsible for preparing Block Panchayat Development Plan (BPDP) and District Panchayat Development Plan (DPDP) at the respective levels.
As a result, Panchayats envisage for an efficient and robust planning process as part of GP’s core functioning
Overview of TB Mukt Panchayat initiative 30082023-Dr Mrigen.pptxAbhijit Dey
‘Healthy Villages’ has been articulated in achieving Sustainable Development Goals in Panchayat Raj Institutions.
Health functionaries at the village and Sub-Centre/HWC levels along with the support of Gram Panchayats, are making substantial progress towards elimination of TB.
The efforts made need to be measured and validated through a certification process so that panchayats can be declared TB Free.
The certification process will motivate and empower the Panchayats to prioritize and undertake the implementation of program activities.
Small PPT on How to measure QT & How to calculate corrected QT.
To get value of cube root of RR(in second) please use google online calculator (search bar) or a scientific calculator
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
3. TB BURDEN – COMPARISON WITH OTHER
DISEASES
Tuberculosis is (India)-
• Leading cause of death among communicable diseases- as a single
infectious agent
• 5th leading cause of death among all diseases
Diarrheal
diseases
Tuberculosis
Typhoid
and
paratyphoid
Encephalitis
HIV/AIDS
Maternal
disorders
Meningitis
Malaria
0
200
400
600
800
1000
1200
1400
1600
1800
DALY
per
100000
Deaths attributed to disease
Source: IHME, Global disease burden
4. Comparison of annual mortality of Infectious Diseases in India:
1.Malaria (2020), 2. Dengue (2019), 3. HIV (2020) , 4. COVID (2021) & 5.TB (2020)
Data Sources:
1. NVBDCP Report: Countrywide
Epidemiological Situation (1995 –
2020)
2. NVBDCP report: Dengue Cases
and Deaths in the Country since
2015
3. NACO INDIA HIV ESTIMATES
2020
4. India Coronavirus COVID-19
Deaths
(https://tradingeconomics.com/indi
a/coronavirus-deaths)
5. WHO Global TB Report 2021
Malaria, 93
Dengue, 166
HIV,51000
COVID, 332000
TB, 504000
5. TB Epidemiology –India 2019-2021
Source: WHO Global TB Report 2016, 2020, 2021 & 2022
Parameters 2015 2019 2020 2021
Estimated TB incidence 28,40,000 26,40,000
25,90,0
00
29,50,00
0
Incidence per 100 000
population 217 193 188 210
Total TB Deaths 4,19,000 4,45,000
5,04,00
0 5,05,000
TB case fatality ratio
(estimated
mortality/estimated
incidence) 15% 17% 20% 17%
Total cases notified 17,40,000 23,91,022
18,12,6
43
21,16,97
6
11 lakhs
6. GAP BETWEEN ESTIMATES AND NOTIFICATION-
INDIA (NUMBERS IN LAKHS)
28.40 27.90 27.4026.90
26.40 25.9
29.5
16.67 17.64 17.87
19.94
23.90
18.1
21.2
24.3
10.00
15.00
20.00
25.00
30.00
35.00
2015 2016 2017 2018 2019 2020 2021 2022
WHO estimated incident TB cases
GAP
Two significant
causes of the
GAP—
Case presented
with symptom
but remain
undiagnosed
Diagnosed but
NOT notified
Gap has increased in huge proportion due to COVID in 2020
7. PROPORTION OF DRUG SALES IN PRIVATE AND CONSUMPTION IN NTEP-
VS
PROPORTION OF PRIVATE NOTIFICATION
1 1 1 1 1 1
0.8
0.9
0.7
0.5
0.4
0.5
0.02
0.06
0.12
0.18
0.30 0.28
0
0.2
0.4
0.6
0.8
1
1.2
2015 2016 2017 2018 2019 2020
Public Drug Consumption Private Drug Sale Private Notification
IQVIA data- Calculated from Drug sales in private and consumption in NTEP. Notification
We are still missing Notifications from
Private
9. Few Public-health targets set by WHO
Eradication (zero transmission at global level)
• Polio
• Dracunculiasis (Guinea worm disease)
• Yaws
Elimination (interruption of active transmission at country level)
• Onchocerciasis
• Human African trypanosomiasis (g)
Elimination as a public-health problem (elimination of morbidity, mortality and/or reduction of transmission)
• Tuberculosis
• Human African trypanosomiasis (r)
• Chagas disease
• Lymphatic filariasis
• Rabies
Control (reduction of morbidity)
• All the others
• Trachoma
• Visceral leishmaniasis
• Schistosomiasis
• Soil-transmitted
helminthiases
• Leprosy
• Malaria
10. Where to go: India’s Commitment to End TB
Vision: India free of TB
TARGETS (for
Reduction)
INDIA (NSP) SDG WHO
End TB
2025 2030 2035
Reduction in number of TB deaths
Compared with 2015 (32 deaths per 1 lakh )
90%
(3 per lakh)
90% 95%
Reduction in TB incidence rate
Compared with 2015 (217 cases per 1 lakh)
80%
(44 per lakh)
80% 90%
Family affected with catastrophic costs
due to TB
100%
(0)
100% 100%
11. THE STATE STRATEGIC PLAN FOR TUBERCULOSIS ELIMINATION
2020 – 2025
Treat
Prevent
Build
Detect
Find all TB cases
through quality
assured Diagnostics
with an emphasis on
reaching every TB
patient in the private
sector
Treat all TB cases with
high quality anti TB
drugs
Prevent the emergence
of TB in susceptible
populations and stop
catastrophic
expenditure due to TB
Build & strengthen
supportive systems
including enabling
policies, empowered
institutions & human
resources
12. 100% Notification from the entire Private
Sector
Registration in TB Surveillance
portal(Nikshay)
Notificationcan be done in 3 ways—
A) Using registered ID inNikshaydirectly
B) Through Patient Provider Support
Agencies
C) Inform District TB officer in
prescribed format
Use Molecular Diagnostic Technology.
Establish Microbiological confirmation
All TB cases has to undergo Drug
Susceptibility testing
Nikshayrecords all events of a TB patient,
hence has to be updated real time
regularly)
Scale up of
Technology
Govt
Sector- WB
2021
Microscopy 1029
Rapid
Molecular Test
276
Culture lab
(for drug resistance
test)
5
GAP--
Quantum of TB
Diagnostic modalities
present in Private is
Unknown. Urgent need
to line list ALL PRIVATE
HEALTH FACILITIES
along with the
D
E
T
E
C
T
13. When we suspect TB?
Presumptive TB : Sign & symptoms of Pulmonary TB in adult
1. Cough for 2 weeks or more
2. Any Chest X-ray abnormality
3. Fever for 2 weeks or more
4. Significant weight loss (>5% wt. loss in last 3 month)
5. Blood in sputum
6. Abnormal night sweat
Any one of the above qualify for TB testing
Presumptive TB : Sign & symptoms of TB in Children (<15
years)
1. H/o Cough or fever for 14 days or abnormal chest X-ray or hemoptysis or weight loss or no
weight gain
2. H/o contact with active TB within two years in case of under six years
• For extra-pulmonary TB- symptoms depend on organ affected
• Socially and clinically vulnerable populations needs to be screened for TB at
regular intervals
• In case of PLHIV , cough for any duration qualify for TB testing
In a Health
Facility
around 3-5%
of total OPD
footfall is
referred for
TB testing
14.
15. ANTIBIOTICS TO AVOID IN PATIENT HAVING ANY
SIGN/SYMPTOM OF TB , TILL TB STATUS IS KNOWN
Fluoroquinolones Macrolides Rifamycins Aminoglycosides
Ciprofloxacin Azithromycin Rifampicin Streptomycin
Ofloxacin Clarithromycin Rifabutin Amikacin
Levofloxacin Erythromycin Kanamycin
Moxifloxacin Roxithromycin
17. PUBLIC VS PRIVATE- KEY INDICATORS: PASCHIM MEDINIPUR (2022)
Indicators
Norms /Target
/National Average Public (%) Private (%)
% Pediatric Cases 6-8% 1.6 3.5
% Female Cases 35-40% 24.6 34.5
Drug Susceptibility testing offered 90% 72.4 37.3
Microbiological confirmation 80% 71.3 36.1
% DRTB detected 6% 2.3 0.3
Proportion of Treatment Days
monitored/reported adherence 50% 33 20
HIV status known 100% 97.9 95.4
Treatment Success Rate (2020) 90% 87.2 86.2
Better surveillance indicator for women & child
Public health action? Status of Treatment Adherence?
Are we missing DRTB Patients from the Private Sector?
18. WHY NOTIFICATION?
PUBLIC HEALTH ACTIONS FOR THE NOTIFIED TB PATIENTS !
Components—
1. Patient home visit as per convenience of patient
2. Counselling of patient and family members
3. Treatment adherence and follow up support to ensure treatment
completion
4. Contact tracing -- Symptoms screening -- Evaluation of TB
symptomatics
5. Offering TB preventive treatment to all contacts after ruling out TB
6. Offering HIV counselling and testing
7. Offering Diabetes testing
8. Offering drug susceptibility testing
9. Linking with available social welfare schemes and Nikshay Poshan
Yojana
19. INCENTIVE TO PRIVATE PROVIDERS & TREATMENT
SUPPORTERS
Health Establishment are expected to utilise these incentives in
recordkeeping, facilitating notification, for storing NTEP drugs,
dispensing them to patients as per norms, counselling, ensuring
adherence, timely follow up, recordkeeping, updating Nikshay
portal and liasoning with Govt
Patients Private Providers
Beneficiary All TB patients (Private, Public,
DS, DR)
All types of Private providers.
Private provider who notifies
the earliest
Benefits
Rs 500/- per treatment month.
Travel allowance for DRTB
patient. Locally managed
additional nutrition, Social
support scheme etc
500 for notifying, 500 for
declaring outcome
Mode Payment is made through direct bank transfer
20. GAZETTE ON TB NOTIFICATION
Mandatory Notification and Public Health Actions of TB patients
Private Clinics---Hospitals---Laboratories--- Chemists
Latest version of the Gazette dated 19th
March 2018 has the following provision—
Failure to take the mandated steps may attract
the provisions of Sections 269 and 270 of
the Indian Penal Code (IPC)
21. Follow STANDARDISED Treatment
Protocol for Drug Sensitive and
Drug Resistant TB cases
Use 2ndline Anti TB Drugs like
Linezolid, Kanamycin only for
Microbiologically confirmed Drug
Resistant TB cases
Use injection free regimens with
latest Anti TB drugs
Store NTEP drugs in Private
Pharmacies for periodic
dispensation to private TB patients
Use IT based adherence technology
to monitor compliance
Sustain treatment success rate of
95% and more
T
R
E
A
T
STOP
empirical
treatmen
t/ Trial
ATD
24. Regimen class Intensive phase
Continuation
phase
H mono/poly DR TB (R resistance not detected and H resistance)
All oral H mono-poly
DR TB regimen
(6) Lfx R E Z
MDR/RR TB
Shorter Oral MDR TB
regimen
(4-6) BDQ(6) Lxf Eto Cfz Z Hh E (5) Lxf Cfz Z E
All oral longer MDR TB
regimen
(18-20) Bdq(6) Lfx Lzd# Cfz Cs
Treatment regimens for DRTB
25. DOSAGE DISPARITY
Daily dosage according to Standards of TB
Care in NTEP are—
FDCs are prepared in such a way that they
can cater to all age groups. Even
paediatric formulations are present.
Weight
band
Number of tablets
Intensive phase Continuation
phase
HRZE HRE
75/150/400/275
mg
75/150/275 mg
25-39
kg
2 2
40-54
kg
3 3
55-69
kg
4 4
≥70 5 5
26. Sustain COVID
appropriate behavior
Contact Tracing
&amp; TB Preventive
Treatment for all contacts
of TB patients–GAME
CHANGER
TB preventive
treatment after testing
for TB infection among
clinically vulnerable
Airborne Infection
Control in Health
Facilities
Contact tracing and
screening of all
household contacts and
TB Preventive Treatment
P
R
E
V
E
N
T
Clinical risk groups-
Patients on anti-TNF treatment
Receiving dialysis
Preparing for organ or hematological
transplantation
Those with silicosis
On immune suppressants
Patients with cancer
Having HIV infection
Cross
27. Display Information material on TB in
Hospital premise
Strengthening workforce in the
hospital for TB awareness and
counselling among staff and patients,
Notification techniques
Formation of Private Hospitals
Consortium for TB
elimination.Member of State TB Forum
Apply for NTEP certification for TB
diagnosis and Drug susceptibility
testing. Join IPAQT labs
Establish dedicated DR-TB, Pediatric
TB wards/ ICU
Avail Partnership Options Or
apply CSR
Mobilize Brand Ambassador for TB,
Organize High Visibility Event,
Support Mass Media Activity, Social
Media Campaign, Community
B
U
I
L
D
Plenty of
Partnership
options available
Invest to Eliminate TB
Make India TB Free by
2025
#TBHaregaDeshJeetega