Nursing professionals

1. Tuberculosis: A
Global Health
Challenge
MR. SAGAR MASNE
ASSISTANT PROFESSOR
GODAVARI CON, JALGAON

2. INTRO….
• Tuberculosis (TB) is a bacterial infection caused by Mycobacterium
tuberculosis.
• It primarily affects the lungs but can also affect other parts of the
body Including the meninges, kidney, bone, and lymph nodes.
• Initial infection usually occurs 2 to 10 week after exposure.
• Despite being preventable and curable, TB remains a significant
global health threat.

3. • TB is a worldwide public health concern that is closely associate with
poverty, malnutrition, overcrowding, substandard housing, inadequate health
care.

4. pathoplysiology
• Tb is transmitted when the person with active pulmonary disease expels the
organisam
• A susceptible person inhales the droplet and become infected .
• Bacteria are transmitted to the alveoli and multiply.
• An inflamatory reaction results in exudate in the alveoli and bronchopneumonia,
granulomas, and other fibrous tissue

5. Epidemiology
• TB is one of the top 10 causes of death worldwide.
• In 2020, an estimated 10 million people fell ill with TB, and 1.5
million died from the disease.
• It disproportionately affects low- and middle-income countries, with
the highest burden in Asia and Africa.

6. Transmission
• TB is spread through the air when an infected person coughs or sneezes.
• Close and prolonged contact with an infected individual increases the risk
of transmission.
• Factors such as overcrowding, poor ventilation, and compromised
immune systems contribute to its spread.
• Immunocompromised status(elderly, cancer, corticosteroid therapy and
HIV )
• Injection drug use alchoholism.

7. • People lacking adequate health care (e,g homeless, minorities, children, young
adults)
• Preexisting medical condition including Dm, CRF, Silocosis, Malnourishment
• Immigrants from countries with the high incidence of TB e,g Haiti, southest
Asea
• Institutionalization (long term care facilities, prisons)
• Occupation (health care worker, )

8. Symptoms
• Common symptoms include coughing, chest pain, fever, fatigue,
and weight loss.
• Nonproductive cough which may progress to mucopurulent sputum
with hemoptysis.
• In some cases, TB can remain latent for years without causing
symptoms.
• Without treatment, latent TB can progress to active TB disease.

9. D/E
• Diagnosis involves a combination of medical history, physical
examination, imaging tests (such as chest X-ray), and laboratory tests
(such as sputum smear microscopy and molecular tests).
• TB Skin test (Mantoux test)
• Acid fast bacillus smear
• Sputum culture.
• Rapid diagnostic tests have improved early detection and treatment
initiation.

10. Treatment
• TB is treated with a combination of antibiotics for at least six months.
• Directly Observed Therapy (DOT) ensures that patients take their medications regularly, reducing the risk of
drug resistance.
• Multi-drug resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) pose challenges to
treatment.
• First line antituberculosis medication
• Isonizid –peripheral neuropathy
• Rifampicin –orange coloured urine
• Pyarazinamide- gout
• Strptomycin- ototoxicty.
• Ethambutol- optic neuropathy

11. Prevention
• TB prevention strategies include vaccination (BCG vaccine),
infection control measures, early diagnosis, and treatment of latent
TB infection.
• Addressing social determinants of health, such as poverty and
access to healthcare, is crucial for TB control.

12. • Tuberculosis (TB) is a highly infectious disease caused by
Mycobacterium tuberculosis.
• Nursing plays a crucial role in the management of TB, including
prevention, diagnosis, treatment, and patient education.
• Nursing interventions focus on preventing the transmission of TB to
others.
• Educating patients about respiratory hygiene, such as covering their
mouth and nose when coughing or sneezing.
• Implementing infection control measures in healthcare settings to
minimize the risk of TB transmission.

13. • Nurses are often involved in TB screening activities, including
identifying high-risk populations and conducting TB tests.
• Collaborating with other healthcare professionals for accurate
diagnosis through sputum collection, chest X-rays, and other
diagnostic tests.
• Ensuring prompt initiation of treatment for those diagnosed with TB.

14. • Nurses play a crucial role in directly observed therapy (DOT),
ensuring that patients adhere to their treatment regimen.
• Monitoring patients for adverse drug reactions and providing
appropriate interventions.
• Educating patients about the importance of completing their
treatment to prevent drug resistance and relapse.

15. • TB diagnosis and treatment can have a significant psychosocial
impact on patients.
• Nurses provide emotional support, address patient concerns, and
promote coping strategies.
• Collaborating with social workers and other support services to
address social determinants of health that may affect TB
management.

16. • Nurses educate patients about TB transmission, symptoms,
treatment, and prevention.
• Emphasizing the importance of medication adherence, follow-up
appointments, and infection control measures.
• Providing information about resources available for TB patients,
such as support groups and financial assistance programs.

17. • Nurses coordinate follow-up care for TB patients, including
monitoring treatment response and assessing for treatment
completion.
• Facilitating communication between patients and healthcare
providers to address any concerns or complications.
• Ensuring continuity of care and support for TB patients beyond the
acute phase of treatment.

18. • DOTS therapy, also known as Directly Observed Treatment, Short-
Course, is the internationally recommended strategy for TB control.
• It is endorsed by the World Health Organization (WHO) as the most
effective approach for TB treatment.

19. COMPONENTS OF DOTS
1.DOTS therapy consists of five key components: Political commitment for
TB control.
2.Case detection through quality-assured bacteriology.
3.Standardized treatment regimen directly observed by a healthcare worker
or trained community volunteer.
4.A regular, uninterrupted supply of high-quality anti-TB drugs.
5.A standardized recording and reporting system to monitor treatment
outcomes.

20. Importance of DOTS
• DOTS therapy ensures that patients receive the correct treatment
regimen under supervision, reducing the risk of drug resistance.
• It improves treatment adherence and completion rates, leading to
better patient outcomes and reduced transmission of TB within
communities.
• DOTS has been credited with saving millions of lives and is a
cornerstone of global TB control efforts.

21. Understanding Mumps: Causes,
Symptoms, Treatment, and Prevention

22. DEFINITION
• Mumps is a contagious viral infection that affects the salivary
glands.
• Children between 5 to 15 years of age

23. OVERVIEW
• Mumps is caused by the mumps virus, a member of the
paramyxovirus family.
• It is characterized by swelling of the salivary glands, which typically
occurs in childhood but can affect individuals of any age.
• Mumps is preventable through vaccination, but outbreaks can still
occur in unvaccinated populations.

24. CAUSES
• Mumps is caused by the mumps virus, which is transmitted through
respiratory droplets from coughing, sneezing, or close contact with
an infected person.
• The virus enters the body through the mouth and nose, then
replicates in the upper respiratory tract and spreads to the salivary
glands.

25. • The most common symptom of mumps is swelling and tenderness
of the parotid glands, which are located on the sides of the face,
near the ears.
• Other symptoms may include fever, headache, muscle aches,
fatigue, loss of appetite, and swelling of the testicles (orchitis) in
males or ovaries (oophoritis) in females.

26. Complications of Mumps
• While most cases of mumps resolve without complications, some
individuals may experience complications such as meningitis
(inflammation of the brain and spinal cord membranes),
encephalitis (inflammation of the brain), pancreatitis, or deafness.

27. • Miscarriage. Getting mumps during the first 12 weeks of
pregnancy may increase the risk that a pregnancy will end, called
miscarriage.
• Hearing loss. This complication can happen suddenly or over time.
Hearing usually gets better after the illness.
• Pancreatitis. Mumps can cause damage to the pancreas, called
pancreatitis, from swelling. Symptoms may include pain or
tenderness near the stomach, upset stomach, vomiting and fever.

28. • Swollen testicles. This complication, also called orchitis, causes severe
pain. It's more common with a mumps infection after puberty. A swollen
testicle may lead to a decrease in the size of the testicle and a decline in
fertility.
• Swollen ovaries. This complication, also caused oophoritis, causes pain,
upset stomach, vomiting and fever. This complication is more likely after
puberty. The condition doesn't seem to affect fertility.
• Encephalitis. Encephalitis is swelling, called inflammation, in the brain
that may damage tissues. This complication can cause changes in
consciousness, seizures and loss of muscle control.

29. Diagnosis of Mumps
• Mumps is diagnosed based on clinical symptoms, particularly swelling of the
parotid glands, and confirmed through laboratory tests such as viral culture or
polymerase chain reaction (PCR) testing.
• Physical exam
• Swab/saliva test
• RT-PCR test
• IgM test
• Ig G test
• CSF analysis

30. Treatment for mumps
• There is no specific treatment for mumps. Treatment usually
focuses on relieving symptoms through rest, hydration, pain
relievers such as acetaminophen or ibuprofen, and warm or cold
compresses to reduce swelling.
• Infected individuals should be isolated to prevent the spread of the
virus to others.

31. Prevention of Mumps
• The most effective way to prevent mumps is through vaccination
with the measles, mumps, and rubella (MMR) vaccine, which is
typically given in two doses during childhood.
• Vaccination not only protects individuals from mumps but also
helps prevent outbreaks in communities.
• Maintaining good hygiene practices, such as frequent handwashing
and covering coughs and sneezes, can also help prevent the
spread of mumps.

32. conclusion
• In conclusion, mumps is a contagious viral infection that primarily
affects the salivary glands.
• While there is no specific treatment for mumps, it can be prevented
through vaccination and good hygiene practices.
• If you suspect you or someone you know has mumps, it's important
to seek medical attention for proper diagnosis and management

33. DEFINITION
• Smallpox is a highly contagious and sometimes fatal disease
caused by the variola virus.

34. Transmission of Smallpox
• Smallpox is transmitted through respiratory droplets or by direct
contact with the skin lesions of an infected person.
• The virus enters the body through the respiratory tract or breaks in
the skin, then spreads to the lymph nodes and eventually to other
organs.

35. Symptoms of Smallpox
• The symptoms of smallpox typically begin with fever, headache,
and body aches, followed by a rash that progresses from macules
to papules, then vesicles, and finally pustules.
• The rash is most prominent on the face, arms, and legs, and
lesions often appear in the mouth and throat.

36. Complications of Smallpox
• Smallpox can lead to severe complications, including blindness,
pneumonia, encephalitis (inflammation of the brain), and death.
• Survivors of smallpox may be left with permanent scars, both
physical and emotional.

37. Eradication Efforts
• The World Health Organization (WHO) launched a global
vaccination campaign in the mid-20th century to eradicate
smallpox.
• Through mass vaccination programs and intensive surveillance,
smallpox was declared eradicated in 1980, making it the first and
only human disease to be eradicated through vaccination.

38. DEFINITION
• Measles is a highly contagious viral infection caused by the
measles virus.
• Rubeola, also known as measles

39. OVERVIEW
• Measles is a significant public health concern, particularly in areas
with low vaccination coverage.
• The virus spreads through respiratory droplets and can lead to
serious complications, especially in young children and
immunocompromised individuals.

40. Causes of Measles
• Measles is caused by the measles virus, which belongs to the
paramyxovirus family.
• It spreads through the air when an infected person coughs or
sneezes, and can also be transmitted by direct contact with nasal
or throat secretions of infected individuals.

41. Symptoms of Measles
• The symptoms of measles typically appear 10 to 14 days after exposure
to the virus.
• Early symptoms include fever, cough, runny nose, and red, watery eyes.
A characteristic rash usually appears a few days later, starting on the face
and spreading to the rest of the body.
• Koplik's spots seen inside the mouth are diagnostic for measles, but are
temporary and therefore rarely seen. Koplik spots are small white spots
that are commonly seen on the inside of the cheeks opposite the
molars.They appear as "grains of salt on a reddish
background." Recognizing these spots before a person reaches their
maximum infectiousness can help reduce the spread of the disease

43. complications
• Measles can lead to serious complications, particularly in vulnerable populations
such as young children, pregnant women, and individuals with weakened immune
systems.
• Complications may include pneumonia, encephalitis (inflammation of the brain), and
death.
• Diarrhea.
• Ear infections.
• Pneumonia.
• Encephalitis.
• Pregnancy complications like low birth weight or preterm birth (in people who have
measles during pregnancy)

44. Diagnosis of Measles
• Measles is diagnosed based on clinical symptoms, particularly the
presence of the characteristic rash, along with a history of exposure
to the virus.
• Laboratory tests, such as blood tests or throat swabs, may also be
used to confirm the diagnosis.

45. Treatment of Measles
• There is no specific antiviral treatment for measles. Treatment
usually focuses on relieving symptoms and preventing
complications.
• Rest, hydration, and over-the-counter medications to reduce fever
and relieve discomfort may be recommended.

46. Prevention of Measles
• The most effective way to prevent measles is through vaccination
with the measles, mumps, and rubella (MMR) vaccine.
• The MMR vaccine is typically given in two doses, with the first dose
administered at 12 to 15 months of age and the second dose at 4
to 6 years of age.
• High vaccination coverage is essential to achieve herd immunity
and prevent outbreaks.

47. DEFINITION
• Influenza, commonly known as the flu, is a contagious respiratory
illness caused by influenza viruses.

48. Overview
• Influenza is a significant global health concern, causing seasonal
epidemics and occasional pandemics.
• The virus spreads easily from person to person, primarily through
respiratory droplets when an infected person coughs, sneezes, or
talks.

49. Types of Influenza Viruses
• Influenza viruses are classified into three types: Influenza A,
Influenza B, and Influenza C.
• Influenza A viruses are further divided into subtypes based on the
proteins on the surface of the virus, such as H1N1 and H3N2.

50. Symptoms of Influenza
• Symptoms of influenza typically include fever, cough, sore throat, runny or stuffy nose, body
aches, headaches, fatigue, and sometimes vomiting and diarrhea, especially in children.
• Other symptoms include:
• Headache.
• Dry, persistent cough.
• Shortness of breath.
• Tiredness and weakness.
• Runny or stuffy nose.
• Sore throat.
• Eye pain.

51. Complications of Influenza
• Influenza can lead to severe complications, particularly in high-risk
groups such as young children, elderly individuals, pregnant
women, and individuals with underlying health conditions.
• Complications may include pneumonia, exacerbation of chronic
medical conditions, and even death.

52. Diagnosis of Influenza
• Influenza is diagnosed based on clinical symptoms and may be
confirmed through laboratory testing, such as rapid influenza
diagnostic tests (RIDTs) or molecular assays.
• Rapid testing allows for quick detection of influenza viruses and
helps guide treatment decisions.

53. Treatment of Influenza
• Antiviral medications such as oseltamivir (Tamiflu) and zanamivir
(Relenza) are available for the treatment of influenza.
• These medications can help reduce the severity and duration of
symptoms if started within 48 hours of symptom onset, particularly
in high-risk individuals.

54. emergency symptoms can include:
• Difficulty breathing or shortness of breath.
• Chest pain.
• Ongoing dizziness.
• Seizures.
• Worsening of existing medical conditions.
• Severe weakness or muscle pain.

55. Prevention of Influenza
• The most effective way to prevent influenza is through annual
vaccination with the seasonal influenza vaccine.
• The influenza vaccine is recommended for everyone aged six
months and older, with particular emphasis on high-risk groups.
• In addition to vaccination, practicing good hygiene, such as
handwashing, covering coughs and sneezes, and staying home
when sick, can help prevent the spread of influenza.

56. Pentavalent vaccine.
• Pentavalent vaccine provides protection to a child from 5 life-threatening diseases
– Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib. DPT

58. DEFINITION
• Meningitis is an inflammation of the protective membranes covering
the brain and spinal cord known as the meninges.
• This inflammation is usually caused by an infection, which can be
bacterial, viral, or fungal in nature.
• It can lead to serious complications such as brain damage, hearing
loss, and even death if not treated promptly.

59. Types of Meningitis
1. Bacterial Meningitis:
1. Caused by bacteria such as Neisseria meningitidis, Streptococcus pneumoniae, or Haemophilus influenzae.
2. Can be severe and life-threatening if not treated promptly with antibiotics.
2. Viral Meningitis:
1. Most common form of meningitis.
2. Caused by various viruses, including enteroviruses, herpes simplex virus, and HIV.
3. Typically less severe than bacterial meningitis and often resolves on its own.
3. Fungal Meningitis:
1. Caused by fungal infections such as Cryptococcus.
2. Less common but can be serious, especially in people with weakened immune systems.

60. Parasitic meningitis
• This type of meningitis is less common than viral or bacterial
meningitis, and it’s caused by parasites that are found in dirt, feces,
and on some animals and food, like snails, raw fish, poultry, or
produce.
• Angiostrongylus cantonensis
• Baylisascaris procyonis
• Gnathostoma spinigerum

61. Tuberculous meningitis
Tuberculous meningitis is a severe form of bacterial meningitis caused
by Mycobacterium tuberculosis, which also causes tuberculosis (TB).1
The disease affects the central nervous system after starting elsewhere in
the body.
It is often characterized by inflamed membranes around the brain and
spinal cord.
Symptoms begin with headaches and changes in the way you act.
A fever, stiff neck, and vomiting may follow. More severe symptoms can
make you feel confused or drowsy, leading to a coma. Without treatment,
this disease can threaten your life.

62. Non-infectious meningitis
• Non-infectious meningitis is not an infection. Instead, it is a type of
meningitis that’s caused by other medical conditions or treatments. These
include:
• lupus
• a head injury
• brain surgery
• cancer
• certain medications

63. Symptoms of Meningitis
• Symptoms can vary depending on the cause of meningitis, but common
symptoms include:Sudden onset of fever
• Severe headache
• Stiff neck
• Nausea and vomiting
• Sensitivity to light
• Confusion or altered mental status
• Seizures

64. • Kernig's Sign:
• Kernig's sign is a test used to evaluate for meningeal irritation,
particularly in cases of meningitis.
• To perform the Kernig's sign test, the patient is lying on their back
with their hip and knee flexed at 90-degree angles. The examiner
then attempts to extend the patient's knee. If the patient
experiences pain or resistance when the knee is extended, it's
considered a positive Kernig's sign.

65. Brudzinski's sign
• To perform Brudzinski's sign, the patient is lying on their back with
their legs fully extended. The examiner then flexes the patient's
neck towards the chest.
• A positive Brudzinski's sign occurs when involuntary flexion of the
patient's hips and knees is observed as a result of neck flexion.
This involuntary movement indicates irritation of the meninges.

67. Diagnosis
• Diagnosis of meningitis typically involves:Physical examination to
assess symptoms such as neck stiffness and neurological function.
• Lumbar puncture (spinal tap) to collect cerebrospinal fluid for
analysis.
• Blood tests to check for signs of infection.
• Imaging tests such as CT scan or MRI to look for signs of
inflammation or swelling in the brain.

68. Treatment for meningitis
• Treatment for meningitis depends on the cause:
• Bacterial Meningitis: Requires prompt treatment with antibiotics in a
hospital setting. The choice of antibiotic depends on the suspected or
identified bacteria and may include antibiotics such as ceftriaxone,
cefotaxime, or penicillin G.
• Viral Meningitis: Treatment is supportive, focusing on relieving symptoms.
• Antiviral Medications: In some cases, antiviral medications may be
considered for specific viral causes of meningitis, such as acyclovir for
herpes simplex virus (HSV) or ganciclovir for cytomegalovirus (CMV)
meningitis.Fungal Meningitis: Requires antifungal medications, often
administered intravenously.

69. • Antifungal Therapy: Fungal meningitis requires treatment with
antifungal medications. The choice of antifungal agent depends on
the specific fungus causing the infection and may include drugs
such as amphotericin B, fluconazole, or voriconazole.

70. • Corticosteroids: In some cases, corticosteroids such as
dexamethasone may be administered to reduce inflammation and
the risk of complications, particularly in cases of bacterial
meningitis caused by certain bacteria like Streptococcus
pneumoniae.

71. • Assessment and Monitoring:
• Conduct thorough neurological assessments, including level of
consciousness, pupil size and reaction, motor strength, and sensation.
• Monitor vital signs frequently, including temperature, heart rate, blood
pressure, and respiratory rate.
• Assess for signs of increased intracranial pressure (ICP), such as
changes in mental status, headache, vomiting, and papilledema.
• Perform regular assessments for signs of meningeal irritation, such as
Kernig's sign and Brudzinski's sign.

72. • Infection Control:
• Implement standard precautions to prevent the spread of infection,
including hand hygiene, wearing appropriate personal protective
equipment (PPE), and proper disposal of contaminated items.
• Use isolation precautions as necessary based on the suspected or
confirmed cause of meningitis (e.g., droplet precautions for
bacterial meningitis).

73. • Medication Management:
• Administer prescribed medications promptly and accurately,
including antibiotics, antivirals, antifungals, corticosteroids, and
analgesics.
• Monitor for adverse reactions to medications and report any
concerns to the healthcare provider.
• Educate patients and families about the importance of completing
the full course of antibiotics or antifungal medications as
prescribed.

74. • Fluid and Electrolyte Management:
• Monitor fluid intake and output closely to prevent dehydration and
maintain hydration status.
• Administer intravenous fluids as prescribed to maintain fluid and
electrolyte balance.
• Monitor electrolyte levels, particularly sodium levels, which can be
affected by meningitis and its treatment.

75. • Comfort and Symptom Management:
• Provide comfort measures to relieve symptoms such as headache,
fever, and nausea.
• Use cooling measures, such as tepid sponge baths or cooling
blankets, to reduce fever.
• Position the patient comfortably to minimize discomfort and
promote respiratory function.

76. • Neurological Support:
• Implement measures to reduce the risk of complications associated
with increased ICP, such as elevating the head of the bed,
maintaining adequate oxygenation, and avoiding activities that
increase ICP (e.g., straining, coughing). DOC mannitol- osmotic
diuretic
• Monitor for changes in neurological status and report any
deterioration promptly to the healthcare provider.

77. 1.Patient and Family Education:
1.Provide education to patients and families about meningitis, its causes,
symptoms, and treatment.
2.Teach signs and symptoms of complications to watch for and when to seek
medical attention.
3.Emphasize the importance of completing the full course of treatment and
attending follow-up appointments.
•

78. Prevention
• Vaccination:
• Vaccines are available to prevent certain types of bacterial meningitis, such as
meningococcal meningitis and pneumococcal meningitis.
• Vaccination is the most effective way to prevent meningitis.
• Practice Good Hygiene:
• Wash hands frequently.
• Avoid sharing utensils, drinking glasses, or other personal items.
• Avoid Close Contact with Sick Individuals:
• Especially important during outbreaks of viral meningitis.

79. Intro
• Gas Gangrene: A potentially life-threatening condition caused by
bacterial infection.
• Also known as Clostridial myonecrosis or Clostridial gas gangrene.
• Characterized by rapid tissue destruction and gas formation within
the affected tissues.

80. • as gangrene (also known as clostridial myonecrosis[1]) is
a bacterial infection that produces tissue gas in gangrene. This
deadly form of gangrene usually is caused by Clostridium
perfringens bacteria. About 1,000 cases of gas gangrene are
reported yearly in the United States.[2]
• Myonecrosis is a condition of necrotic damage, specific to muscle
tissue. It is often seen in infections with C. perfringens or any of
myriad soil-borne anaerobic bacteria.

81. • Gas gangrene can cause myonecrosis (muscle tissue death), gas
production, and sepsis. Progression to toxemia and shock is often
very rapid. It can easily be noticed by the large, blackened sores
that form, as well as a degree of loud and
distinctive crepitus caused by gas escaping the necrotic tissue.

82. Causes
• Caused primarily by Clostridium bacteria, especially Clostridium
perfringens.
• Bacteria commonly found in soil, dust, and the gastrointestinal tract
of animals and humans.
• Entry into the body through wounds, cuts, or surgical incisions,
especially in deep wounds with limited oxygen supply.
• Production of toxins and enzymes that destroy tissue and cause
gas formation.

83. Risk Factors
• Trauma or injury leading to open wounds.
• Surgical wounds, especially those involving bowel surgery.
• Poor blood supply to the affected area (ischemia).
• Diabetes mellitus or other conditions causing impaired blood flow or
weakened immune system.
• Intravenous drug use.
• Chronic alcoholism.
• Malnutrition.

84. • diabetes
• arterial disease -
• colon cancer
• frostbite
• open fractures
• used a contaminated needle to inject substances into your muscles

85. Symptoms
• Severe pain at the site of infection, often disproportionate to the injury.
• Swelling and redness around the wound.
• Formation of gas bubbles under the skin, giving it a crackling sensation
(crepitus).
• Bluish or blackish discoloration of the skin.
• Fever and chills.
• Rapid heart rate (tachycardia) and low blood pressure (hypotension).
• Symptoms may progress rapidly, leading to tissue death and systemic
toxicity.

86. • Pain near your injury.
• Sweating.
• Anxiety.
• Yellow skin (jaundice).
• Light-headedness.
• Low blood pressure (hypotension).

87. Dignosis
• Clinical examination: Assessment of symptoms and signs.
• Imaging studies: X-rays, CT scans, or MRI to detect gas within
tissues.
• Laboratory tests: Blood tests to identify markers of infection and
tissue damage.
• Wound culture: Sampling the infected tissue to identify the
causative bacteria.

88. Treatment
• Immediate medical attention is crucial.
• Surgical debridement: Removal of dead or infected tissue to prevent further
spread.
• Antibiotics: Broad-spectrum antibiotics to target Clostridium bacteria and other
potential pathogens.
• Hyperbaric oxygen therapy: High-pressure oxygen to inhibit bacterial growth and
promote tissue healing.
• Supportive care: Intravenous fluids, pain management, and treatment of
complications such as organ failure.
• Amputation: In severe cases where the infection is extensive and life-threatening.

89. Prevention
• Prompt wound care: Clean and dress wounds properly to prevent
infection.
• Antibiotics: Prophylactic antibiotics may be given before surgery in
high-risk individuals.
• Vaccination: Tetanus vaccination to prevent Clostridium tetani
infection.
• Avoiding risk factors: Proper management of underlying conditions
like diabetes and alcoholism.

90. DIPTHERIA

91. • Diphtheria is a potentially serious bacterial infection caused by
Corynebacterium diphtheriae, which primarily affects the mucous
membranes of the throat and nose.
• Corynebacterium diphtheriae: Gram-positive bacterium.

92. types
• Classical respiratory diphtheria: The most common type of
diphtheria, classical respiratory diphtheria may affect
your nose, throat, tonsils or larynx (voice box).
• Cutaneous diphtheria: The rarest type of diphtheria, cutaneous
diphtheria is characterized by skin rash, sores or blisters, which can
appear anywhere on your body. Cutaneous diphtheria is more
common in tropical climates or crowded places where people live in
unhealthy conditions.

94. How do you get diphtheria
• You can catch diphtheria through airborne droplets that contain
bacteria (spread by sneezing, coughing and spitting) or by touching
something that has bacteria on it.

95. • Common diphtheria symptoms include:
• Throat pain.
• Weakness or fatigue.
• Fever.
• Swollen neck glands.
• Problems breathing due to tissues obstructing your nose and throat.
• Difficulty swallowing (dysphagia).
• Nerve, kidney or heart problems (if the bacteria enters your bloodstream).

96. Clinical Presentation
• Symptoms: Sore throat, fever, difficulty swallowing, and a
characteristic grayish membrane in the throat.
• Complications: Myocarditis, neurological complications, and airway
obstruction.

97. Diagnosis
• Clinical Evaluation: Based on symptoms and physical examination.
• Laboratory Tests: Culture of throat swab specimens and
polymerase chain reaction (PCR).

98. Treatment
• Antitoxin Therapy: Administration of diphtheria antitoxin to
neutralize circulating toxin.
• Antibiotics: Penicillin or erythromycin to eradicate the bacterium.
• Supportive Care: Airway management and monitoring for
complications.

99. PERTUSIS
• Whooping cough also known as pertussis or the 100-day cough,
is a highly contagious, vaccine-preventable bacterial disease. Initial
symptoms are usually similar to those of the common cold with
a runny nose, fever, and mild cough, but these are followed by two
or three months of severe coughing fits. Following a fit of coughing,
a high-pitched whoop sound or gasp may occur as the person
breathes in. The violent coughing may last for 10 or more weeks,
hence the phrase "100-day cough“. The cough may be so hard
that it causes vomiting, rib fractures, and fatigue.

100. DEFINITION
• Pertussis, commonly known as whooping cough, is a highly
contagious respiratory disease caused by the bacterium Bordetella
pertussis.
• Bordetella pertussis: Gram-negative bacterium.
• it's marked by a severe hacking cough followed by a high-pitched
intake of breath that sounds like "whoop."

101. SPREAD
• Spread: Inhalation of respiratory droplets from infected individuals.
• Contagiousness: Highly contagious, especially during the early
stages of illness.
• The time between exposure and the development of symptoms is
on average 7–14 days (range 6–20 days), rarely as long as 42
days.

102. CLINICAL FEATURES
• The classic symptoms of pertussis are a paroxysmal cough,
inspiratory whoop, and fainting, or vomiting after coughing.[19] The
cough from pertussis has been documented to
cause subconjunctival hemorrhages, rib fractures, urinary
incontinence, hernias, and vertebral artery dissection.[19] Violent
coughing can cause the pleura to rupture, leading to
a pneumothorax.
• Red or blue face

103. DIAGNOSIS
• Clinical Evaluation: Based on symptoms and physical examination.
• Laboratory Tests: Nasopharyngeal swab culture, polymerase chain reaction
(PCR)
• The polymerase chain reaction (PCR) is a method widely used to make
millions to billions of copies of a specific DNA sample rapidly, allowing scientists
to amplify a very small sample of DNA (or a part of it) sufficiently to enable
detailed study. PCR was invented in 1983 by American biochemist Kary Mullis ,
• serological tests.
• Direct fluorescent antibody (DFA)

104. TREATMENT
• Antibiotics: Macrolides (e.g., azithromycin) are commonly used to
treat pertussis.
• Supportive Care: Management of symptoms and complications,
especially in severe cases.

106. INTRO
• Definition: Tetanus, also known as lockjaw, is a serious bacterial infection
caused by the bacterium Clostridium tetani.
• Importance: Tetanus remains a global health concern despite being
preventable through vaccination.
• Clostridium tetani: Anaerobic, spore-forming bacterium found in soil, dust,
and animal feces.
• Entry: Spores enter the body through wounds or breaks in the skin.
• Anaerobic Environment: Spores germinate in anaerobic conditions, such
as deep puncture wounds.

107. Epidemiology
• Global Distribution: Tetanus cases occur worldwide but are more
common in low- and middle-income countries with limited access to
healthcare.
• High-Risk Factors: Unvaccinated individuals and those with
inadequate wound care.

108. Symptoms:
• Tetanus often begins with mild spasms in the jaw muscles—also
known as lockjaw.
• Stiff neck, difficulty swallowing, muscle stiffness, and painful muscle
contractions.
• Complications: Respiratory failure, fractures, and death, especially
in severe cases.

109. • Trismus is defined as painful restriction in opening the mouth due to
a muscle spasm, however it can also refer to limited mouth opening
of any cause. Another definition of trismus is simply a limitation of
movement. Historically and commonly, the term lockjaw was
sometimes used as a synonym for both trismus and tetanus.

110. • Neonatal tetanus (trismus nascentium) is a form of
generalised tetanus that occurs in newborns. Infants who have not
acquired passive immunity from an immunized mother are at risk. It
usually occurs through infection of the unhealed umbilical stump,
particularly when the stump is cut with a non-sterile instrument.
Neonatal tetanus mostly occurs in developing countries, particularly
those with the least developed health infrastructure. It is rare
in developed countries.[1]

111. • Back muscle spasms often cause arching, called opisthotonus.
Sometimes, the spasms affect muscles utilized during inhalation
and exhalation, which can lead to breathing problems
• The spasms can also affect the facial muscles, resulting in an
appearance called risus sardonicus.

113. • Prolonged muscular action causes sudden, powerful, and painful
contractions of muscle groups, called tetany. These episodes can
cause fractures and muscle tears. Other symptoms
include fever, headache, restlessness, irritability, feeding
difficulties, breathing problems, burning sensation during
urination, urinary retention, and loss of stool control.
• Even with treatment, about 10% of people who contract tetanus
die.[1] The mortality rate is higher in unvaccinated individuals, and in
people over 60 years of age.

114. TREATMENT
• Wound Care: Cleaning and debridement of wounds to remove
bacterial spores.
• Tetanus Immunoglobulin (TIG): Administration to neutralize
circulating toxin.
• Antibiotics: Penicillin or metronidazole to eradicate the bacterium.
• Supportive Care: Management of symptoms and complications,
including respiratory support.

115. • DOC: Methocarbamol, sold under the brand
name Robaxin among others, is a medication used for short-
term musculoskeletal pain
• Diazepam, first marketed as Valium, is a medicine of the
benzodiazepine family that acts as an anxiolytic. It is commonly
used to treat a range of conditions, including anxiety, seizures,
alcohol withdrawal syndrome, muscle spasms, insomnia, and
restless legs syndrome.

116. HSV

117. Introduction to Herpes Simplex Virus
(HSV)
• The herpes simplex virus, also known as HSV, is a viral infection
that causes genital and oral herpes.
• Definition: HSV is a common viral infection that causes sores or
blisters on the mouth (oral herpes) or genital area (genital herpes).
• Two Types: HSV-1 primarily causes oral herpes, while HSV-2 is
mainly responsible for genital herpes.
• Prevalence: HSV is highly prevalent worldwide, affecting millions of
individuals of all ages.

118. Transmission of HSV
• Modes of Transmission: Direct contact with infected skin or mucous
membranes, including kissing, sexual contact, and childbirth.
• Asymptomatic Shedding: HSV can be transmitted even when no
visible symptoms are present, increasing the risk of transmission.

121. Symptoms of HSV
• Oral Herpes (HSV-1): Cold sores or fever blisters on or around the
lips, mouth, or gums.
• Genital Herpes (HSV-2): Painful blisters or sores on the genital or
anal area, buttocks, and inner thighs. Sores can also develop inside the
vagina. accompanied by itching, burning, or tingling .
• Recurrence: HSV infections may recur periodically, triggered by
factors such as stress, illness, or immune suppression.

122. • Primary episodes often include flu-like symptoms, such as:
• fever
• swollen lymph nodes
• body aches and pains, including headache
• unusual tiredness or fatigue
• lack of appetite
• shooting pain at the site of the infection

123. Diagnosis of HSV
• Clinical Examination: Physical examination of sores or blisters by a
healthcare provider.
• Laboratory Tests: Polymerase chain reaction (PCR) tests or viral
cultures to detect HSV DNA or antibodies in blood or swab
samples.

124. Treatment Options for HSV
• Antiviral Medications: Prescription drugs such as acyclovir,
valacyclovir, or famciclovir to reduce the severity and duration of
outbreaks.
• Management of Symptoms: Pain relievers, topical ointments, and
antiviral creams to alleviate discomfort and promote healing.
• Prevention of Transmission: Use of condoms or dental dams during
sexual activity, abstaining from sexual contact during outbreaks,
and avoiding sharing personal items.

125. Complications and Risks
• Neonatal Herpes: Transmission of HSV from mother to newborn
during childbirth, which can lead to severe complications or even
death in newborns.
• Increased Risk of HIV: HSV infection may increase the risk of
acquiring or transmitting the human immunodeficiency virus (HIV)
during sexual contact.

126. Use ice or a cool compress on the
area

127. Apply a warm compress

128. Dab propolis onto the affected area.
• Propolis is a waxy resin made by bees that has antiviral properties
and appears to accelerate the healing of sores.

129. Apply chilled aloe to help relieve
pain. Aloe gel or an aloe ointment can be
used for pain relief, and it works even
better if it’s cool

130. Try taking a lysine supplement. Three
1,000 mg doses of lysine per day may
shorten the length of an outbreak.

131. Apply olive oil to the lesions. Olive oil
is known for moisturizing the skin. It is
rich in antioxidants and is one of the best
home remedies for herpes sores.

132. Apply oregano oil directly on the
area. Oregano oil, with its anti-viral
properties, helps in the speedy recovery
of herpes blisters

133. Oatmeal bath

135. Filariasis
• Filariasis is a parasitic disease caused by an infection
with roundworms of the Filarioidea type. These are spread by
blood-feeding insects such as black flies and mosquitoes. They
belong to the group of diseases called helminthiases.
• Filariasis is a parasitic disease caused by thread-like nematode
worms called filarial worms. These worms are transmitted to
humans through the bites of infected mosquitoes. The most
common types of filarial worms that infect humans are Wuchereria
bancrofti, Brugia malayi, and Brugia timori.

136. clinical manifestations
• Filariasis can lead to a variety of clinical manifestations, including
lymphedema (swelling of the limbs), elephantiasis (severe and
disfiguring swelling), and hydrocele (swelling of the scrotum).
These symptoms are primarily due to the blockage of lymphatic
vessels by the adult worms and the immune system's response to
the infection.

137. • The disease is prevalent in tropical and subtropical regions,
particularly in parts of Africa, Asia, the Western Pacific, and some
areas of the Americas. Filariasis is considered a neglected tropical
disease (NTD) and primarily affects communities with poor
sanitation and limited access to healthcare.

138. • Preventive measures against filariasis include vector control
strategies such as the use of insecticide-treated bed nets, indoor
residual spraying to reduce mosquito populations, and mass drug
administration (MDA) of antifilarial drugs to at-risk populations.
Treatment usually involves antifilarial drugs such as
diethylcarbamazine (DEC) or ivermectin, albendazole which can
help kill the microfilariae (larval stage) of the worms.

139. Dengue, breakbone fever[
• Dengue fever is a mosquito-borne tropical disease caused by dengue
virus. It is frequently asymptomatic; if symptoms appear they typically
begin 3 to 14 days after infection. These may include a
high fever, headache, vomiting, muscle and joint pains, and a
characteristic skin itching and skin rash. Recovery generally takes two to
seven days. In a small proportion of cases, the disease develops
into severe dengue (previously known as dengue hemorrhagic fever or
dengue shock syndrome)[8] with bleeding, low levels of blood
platelets, blood plasma leakage, and dangerously low blood pressure

140. When skin is blanched, it takes on a
whitish appearance as blood flow to the
region is prevented.

141. • Dengue virus has four confirmed serotypes; infection with one type
usually gives lifelong immunity to that type, but only short-term
immunity to the others. Subsequent infection with a different type
increases the risk of severe complications.[9] The symptoms of
dengue resemble many other diseases including malaria, influenza,
and Zika.[10] Blood tests are available to confirm the diagnosis
including detecting antibodies to the virus or its RNA

142. • There is no specific treatment for dengue fever. In mild cases,
treatment is focused on treating pain symptoms. Severe cases of
dengue require hospitalisation; treatment of acute dengue is
supportive and includes giving fluid either by mouth
or intravenously.

143. • Dengue is spread by several species of female mosquitoes of
the Aedes genus, principally Aedes aegypti. Infection can be
prevented by mosquito elimination and the prevention of bites.[ Two
types of dengue vaccine have been approved and are
commercially available. Dengvaxia became available in 2016 but it
is only recommended to prevent re-infection in individuals who
have been previously infected.[13] The second vaccine, Qdenga,
became available in 2022 and is suitable for adults, adolescents
and children from four years of age.

146. • Severe dengue symptoms often come after the fever has gone away:
• severe abdominal pain
• persistent vomiting
• rapid breathing
• bleeding gums or nose
• fatigue
• restlessness
• blood in vomit or stool
• being very thirsty
• pale and cold skin
• feeling weak.

147. Complications
• following severe dengue include fatigue, somnolence, headache,
concentration impairment and memory impairment.[21][25] A pregnant
woman who develops dengue is at higher risk of miscarriage, low
birth weight birth, and premature birth.

148. prevention
• The World Health Organization stresses that the vaccine is not an
effective tool on its own to reduce dengue fever in areas where the
illness is common. Preventing mosquito bites and controlling the
mosquito population are still the main methods for preventing the
spread of dengue fever.

149. • Stay in air-conditioned or well-screened housing. The
mosquitoes that carry the dengue viruses are most active from
dawn to dusk, but they can also bite at night.
• Wear protective clothing. When you go into mosquito-infested
areas, wear a long-sleeved shirt, long pants, socks and shoes.

150. • Use mosquito repellent. Permethrin can be applied to your clothing,
shoes, camping gear and bed netting. You can also buy clothing made
with permethrin already in it. For your skin, use a repellent containing at
least a 10% concentration of DEET. (known to chemists as N,N-Diethyl-meta-
toluamide)
• Reduce mosquito habitat. The mosquitoes that carry the dengue virus
typically live in and around houses, breeding in standing water that can
collect in such things as used automobile tires. You can help lower
mosquito populations by eliminating habitats where they lay their eggs. At
least once a week, empty and clean containers that hold standing water,
such as planting containers, animal dishes and flower vases. Keep
standing water containers covered between cleanings.