1. Drug resistant tuberculosis (DRTB) poses challenges for treatment due to long treatment durations and side effects, as well as risks of transmission in healthcare and workplace settings.
2. DRTB patients can be considered non-infectious and able to return to work when they have received adequate chemotherapy for two to three weeks, show clinical improvement, and have a negligible chance of transmitting MDR-TB.
3. Preventing DRTB transmission requires administrative controls like early identification and quarantine of infectious patients, as well as environmental controls like proper ventilation and use of negative-pressure rooms.
Multidrugresistant tuberculosis
Among the most menacing forms of MDR is multidrug
resistant tuberculosis (MDR-TB). WHO estimates that
were about 450,000 new cases and 170,000 deaths from
MDR-TB in 2012. The number of cases reported to
WHO rose by an alarming 35% between 2011 and 2012,
although this probably mostly reflects increased recognition
and reporting. Over half the new cases were in India,
China or the Russian Federation.3
This issue of Homeopathy features a paper by Dr Kusum
Chand and colleagues reporting a randomized, double blind,
placebo-controlled clinical trial of individualized homeopathic
treatment or placebo in addition to standard antituberculous
chemotherapy as specified by the Indian Revised
National Tuberculosis Control Program, for MDR-TB
Treatment of COVID-19; old tricks for new challengesLuisaSarlat
Coronavirus disease (COVID-19), which appeared in December 2019, presents a global challenge, particularly in the rapid increase of critically ill patients with pneumonia and absence of definitive treatment. To date, over 81,000 cases have been confirmed, with over 2700 deaths. The mortality appears to be around 2%; early published data indicate 25.9% with SARS-CoV-2 pneumonia required ICU admission and 20.1% developed acute respiratory distress syndrome
Clinical Research Centre (CRC) Perak (Hospital Ipoh, Hospital Taiping, Hospital Seri Manjung) has just released their new Network Bulletin. This edition focused on COVID-19 Vaccine Trial and COVID-19 Research Priorities.
Multidrugresistant tuberculosis
Among the most menacing forms of MDR is multidrug
resistant tuberculosis (MDR-TB). WHO estimates that
were about 450,000 new cases and 170,000 deaths from
MDR-TB in 2012. The number of cases reported to
WHO rose by an alarming 35% between 2011 and 2012,
although this probably mostly reflects increased recognition
and reporting. Over half the new cases were in India,
China or the Russian Federation.3
This issue of Homeopathy features a paper by Dr Kusum
Chand and colleagues reporting a randomized, double blind,
placebo-controlled clinical trial of individualized homeopathic
treatment or placebo in addition to standard antituberculous
chemotherapy as specified by the Indian Revised
National Tuberculosis Control Program, for MDR-TB
Treatment of COVID-19; old tricks for new challengesLuisaSarlat
Coronavirus disease (COVID-19), which appeared in December 2019, presents a global challenge, particularly in the rapid increase of critically ill patients with pneumonia and absence of definitive treatment. To date, over 81,000 cases have been confirmed, with over 2700 deaths. The mortality appears to be around 2%; early published data indicate 25.9% with SARS-CoV-2 pneumonia required ICU admission and 20.1% developed acute respiratory distress syndrome
Clinical Research Centre (CRC) Perak (Hospital Ipoh, Hospital Taiping, Hospital Seri Manjung) has just released their new Network Bulletin. This edition focused on COVID-19 Vaccine Trial and COVID-19 Research Priorities.
Sinusitis and Immunodeficiency - IDF Conferencesinusblog
This is Dr. Andrew Pugliese's powerpoint on the connection between chronic sinusitis and immunodeficiencies. This was specifically for an educational conference for the Immune Deficiency Foundation.
Background- Multidrug-resistant tuberculosis (MDR-TB) is caused by strain of Mycobacterium tuberculosis, it is transmitted through air droplets from infected person and Close contacts of MDR-TB patients have a high potential to developing TB. This study aims to determine the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Material and Methods- The cases were recruited from the King George’s Medical University, Lucknow, India. In this cross-sectional study, Close contacts of MDR-TB patients were screened for tuberculosis. clinical, radiological and bacteriological experiments were performed to find out the evidence of TB/MDR-TB. Results- The cases were enrolled Between December 2015 to December 2016, a total of 100 index MDR-TB patients were recruited which initiated on MDR-TB treatment. A total of 428 contacts who could be studied, 11 (2.57%) were diagnosed with MDR-TB and 4 (0.93%) had TB. The most frequent symptoms observed in patients were cough, chest pain and fever. Conclusions- Tracing symptomatic contacts of MDR-TB cases could be a high yield strategy for early detection and treatment of MDR-TB cases to contribute to reduced morbidity, mortality and to cut the chain of transmission of infection in the community. The approach should be bringing about for wider implementation and dissemination. Key-words- TB, MDR-TB, Symptomatic, Household, Transmission
Antibacterial therapy in COVID-19 patients - an evidence based guidelineDr Jay Prakash
Overuse of antibiotics, delivery of tests and procedures that have little or no clinical benefit is a huge problem in health care, and one that has gained much more attention over the past decade. But despite efforts to reduce overuse like Choosing Wisely, rates of low-value care have barely budged.
Respond to this discussion . Add some facts with at least 2 cita.docxcwilliam4
Respond to this discussion . Add some facts with at least 2 citations APA Format
Discussion: Community-Acquired Pneumonia
Case Study
HH is a 68-yr M who has been admitted to the medical ward with community-acquired pneumonia for the past three days. His PMH is
significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, including ceftriaxone 1 g IV q day (day 3) and
azithromycin 500 mg IV q day (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a
diet at this time, complaining of nausea and vomiting. Ht: 5'8" Wt: 89 kg Allergies: Penicillin (rash).
Diagnosis: Community-Acquired Pneumonia (CAP)
CAP is the term used to describe an acute infection of the lungs that develops outside the hospital setting by an immune-competent
individual who has not been recently hospitalized (Shoar & Musher, 2020). Adults with CAP typically present with cough, fever, sputum production or
shortness of breath, oxygen desaturation, confusion, leukocytosis or leukopenia, and pleuritic chest pain, along with the presence of an acute
infiltrate on the chest radiograph (Shoar & Musher, 2020).
Antibiotic suggested for CAP's empiric treatment is based on agents useful against CAP's major treatable bacterial causes. The bacterial
pathogens responsible for CAP include Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus
influenzae, Staphylococcus aureus, Legionella species, and Moraxella catarrhalis (Metlay et al., 2019).
The patient is on right treatment, his clinical status has improved, with decreased oxygen requirement. Recommended treatment plan for
patients with comorbidities such as alcoholism, COPD, post influenza, asplenia, diabetes mellitus, lung/liver/renal diseases include: Combination
of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h (Donovan, 2019).
The therapy duration is a minimum of 5 days. The patient needs to be afebrile for 48-72 hours, controlled blood pressure, adequate oral intake, and
room air oxygen saturation of greater than 90% and treatment duration can be extended if symptoms are not recovered in some cases (Donovan,
2019).
In this case, the patient symptoms are improving, his oxygen requirement is decreased, but he is not tolerating a diet at this time,
complaining of nausea and vomiting. The patient received antibiotics for three days, so antibiotics need to be continued. With appropriate antibiotic
therapy, some improvement in the patient's clinical course is usually seen within 48 to 72 hours (File, 2020).
Health Needs and Treatment Regimen
The patient is not tolerating diet and complaining of nausea and vom.
Community Acquired Pneumonia IntroCommunity-acquired pneumo.docxcargillfilberto
Community Acquired Pneumonia: Intro
Community-acquired pneumonia (CAP) is a common group of infectious diseases that are responsible for significant global health and economic burden. CAP affects approximately 5.5/1000 people annually, and is a leading cause of hospital admissions, morbidity, and mortality in developed countries (especially for older people). Among all patients with CAP, those aged 65 or older account for about one-third, but they account for more than half of all health costs due to this disease. COPD is one of the most common comorbidities in patients with CAP, characterized by persistent respiratory symptoms. COPD was the third-most common cause of death in 2008, and the morbidity from COPD is projected to increase by 2020 (Liu, Han, & Liu, 2018).
Brief Summary of Client Case
Client HH is a 68 year-old male admitted with a diagnosis of community-acquired pneumonia for the past 3 days. This client’s medical HX includes COPD, HTN, hyperlipidemia, and diabetes. Mr. HH is on day three of two empiric antibiotics (ceftriaxone 1 g IV daily and azithromycin 500 mg IV daily). The client’s clinical status has improved since admission, with decreased oxygen requirements. However, he is not tolerating anything PO at this time and complains of nausea and vomiting. The client’s height is 5’8” and he weighs 89 kg. The only known drug allergy is PCN which results in a rash.
Analysis
The client in this scenario is responding well to the current antibiotic therapy, as evidence by a drop in WBC count from 18.2 upon admission to 14.6 currently (normal range is between 5.0 and 10). It is also pleasing that the client’s O2 saturation is now 92% on room air alone, compared to 90% while requiring 4L of supplemental oxygen upon admission. Overall, the client’s lab results are not significantly concerning. Neutrophil (normal range 40-60%) and band (normal range 0.0-03%) percentages are slightly elevated as expected given the infectious process (NIH, 2020). Aside from an elevated WBC count that is trending down, a marginally elevated blood glucose, and a HCO3 elevated eight points above the normal limit, the other lab results are within the normal ranges of a healthy adult male (Farinde, 2019). The issues of concern in this client case are the client’s inability to tolerate a diet due to nausea and vomiting, elevated temperature, and continuing antibiotics to treat the pneumonia.
Treatment Considerations
According to Donovan (2019), the client’s empiric antibiotic regime is consistent with what is recommended by the Infectious Diseases Society of America (IDSA). Initial empiric antimicrobial treatment should be initiated until laboratory results can be obtained to guide more specific therapy. Also, a combination of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h is consistent with IDSA guidelines for a client with comorbidities such as COPD and diab.
Community Acquired Pneumonia IntroCommunity-acquired pneumo.docxdrandy1
Community Acquired Pneumonia: Intro
Community-acquired pneumonia (CAP) is a common group of infectious diseases that are responsible for significant global health and economic burden. CAP affects approximately 5.5/1000 people annually, and is a leading cause of hospital admissions, morbidity, and mortality in developed countries (especially for older people). Among all patients with CAP, those aged 65 or older account for about one-third, but they account for more than half of all health costs due to this disease. COPD is one of the most common comorbidities in patients with CAP, characterized by persistent respiratory symptoms. COPD was the third-most common cause of death in 2008, and the morbidity from COPD is projected to increase by 2020 (Liu, Han, & Liu, 2018).
Brief Summary of Client Case
Client HH is a 68 year-old male admitted with a diagnosis of community-acquired pneumonia for the past 3 days. This client’s medical HX includes COPD, HTN, hyperlipidemia, and diabetes. Mr. HH is on day three of two empiric antibiotics (ceftriaxone 1 g IV daily and azithromycin 500 mg IV daily). The client’s clinical status has improved since admission, with decreased oxygen requirements. However, he is not tolerating anything PO at this time and complains of nausea and vomiting. The client’s height is 5’8” and he weighs 89 kg. The only known drug allergy is PCN which results in a rash.
Analysis
The client in this scenario is responding well to the current antibiotic therapy, as evidence by a drop in WBC count from 18.2 upon admission to 14.6 currently (normal range is between 5.0 and 10). It is also pleasing that the client’s O2 saturation is now 92% on room air alone, compared to 90% while requiring 4L of supplemental oxygen upon admission. Overall, the client’s lab results are not significantly concerning. Neutrophil (normal range 40-60%) and band (normal range 0.0-03%) percentages are slightly elevated as expected given the infectious process (NIH, 2020). Aside from an elevated WBC count that is trending down, a marginally elevated blood glucose, and a HCO3 elevated eight points above the normal limit, the other lab results are within the normal ranges of a healthy adult male (Farinde, 2019). The issues of concern in this client case are the client’s inability to tolerate a diet due to nausea and vomiting, elevated temperature, and continuing antibiotics to treat the pneumonia.
Treatment Considerations
According to Donovan (2019), the client’s empiric antibiotic regime is consistent with what is recommended by the Infectious Diseases Society of America (IDSA). Initial empiric antimicrobial treatment should be initiated until laboratory results can be obtained to guide more specific therapy. Also, a combination of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h is consistent with IDSA guidelines for a client with comorbidities such as COPD and diab.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Sinusitis and Immunodeficiency - IDF Conferencesinusblog
This is Dr. Andrew Pugliese's powerpoint on the connection between chronic sinusitis and immunodeficiencies. This was specifically for an educational conference for the Immune Deficiency Foundation.
Background- Multidrug-resistant tuberculosis (MDR-TB) is caused by strain of Mycobacterium tuberculosis, it is transmitted through air droplets from infected person and Close contacts of MDR-TB patients have a high potential to developing TB. This study aims to determine the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Material and Methods- The cases were recruited from the King George’s Medical University, Lucknow, India. In this cross-sectional study, Close contacts of MDR-TB patients were screened for tuberculosis. clinical, radiological and bacteriological experiments were performed to find out the evidence of TB/MDR-TB. Results- The cases were enrolled Between December 2015 to December 2016, a total of 100 index MDR-TB patients were recruited which initiated on MDR-TB treatment. A total of 428 contacts who could be studied, 11 (2.57%) were diagnosed with MDR-TB and 4 (0.93%) had TB. The most frequent symptoms observed in patients were cough, chest pain and fever. Conclusions- Tracing symptomatic contacts of MDR-TB cases could be a high yield strategy for early detection and treatment of MDR-TB cases to contribute to reduced morbidity, mortality and to cut the chain of transmission of infection in the community. The approach should be bringing about for wider implementation and dissemination. Key-words- TB, MDR-TB, Symptomatic, Household, Transmission
Antibacterial therapy in COVID-19 patients - an evidence based guidelineDr Jay Prakash
Overuse of antibiotics, delivery of tests and procedures that have little or no clinical benefit is a huge problem in health care, and one that has gained much more attention over the past decade. But despite efforts to reduce overuse like Choosing Wisely, rates of low-value care have barely budged.
Respond to this discussion . Add some facts with at least 2 cita.docxcwilliam4
Respond to this discussion . Add some facts with at least 2 citations APA Format
Discussion: Community-Acquired Pneumonia
Case Study
HH is a 68-yr M who has been admitted to the medical ward with community-acquired pneumonia for the past three days. His PMH is
significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, including ceftriaxone 1 g IV q day (day 3) and
azithromycin 500 mg IV q day (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a
diet at this time, complaining of nausea and vomiting. Ht: 5'8" Wt: 89 kg Allergies: Penicillin (rash).
Diagnosis: Community-Acquired Pneumonia (CAP)
CAP is the term used to describe an acute infection of the lungs that develops outside the hospital setting by an immune-competent
individual who has not been recently hospitalized (Shoar & Musher, 2020). Adults with CAP typically present with cough, fever, sputum production or
shortness of breath, oxygen desaturation, confusion, leukocytosis or leukopenia, and pleuritic chest pain, along with the presence of an acute
infiltrate on the chest radiograph (Shoar & Musher, 2020).
Antibiotic suggested for CAP's empiric treatment is based on agents useful against CAP's major treatable bacterial causes. The bacterial
pathogens responsible for CAP include Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus
influenzae, Staphylococcus aureus, Legionella species, and Moraxella catarrhalis (Metlay et al., 2019).
The patient is on right treatment, his clinical status has improved, with decreased oxygen requirement. Recommended treatment plan for
patients with comorbidities such as alcoholism, COPD, post influenza, asplenia, diabetes mellitus, lung/liver/renal diseases include: Combination
of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h (Donovan, 2019).
The therapy duration is a minimum of 5 days. The patient needs to be afebrile for 48-72 hours, controlled blood pressure, adequate oral intake, and
room air oxygen saturation of greater than 90% and treatment duration can be extended if symptoms are not recovered in some cases (Donovan,
2019).
In this case, the patient symptoms are improving, his oxygen requirement is decreased, but he is not tolerating a diet at this time,
complaining of nausea and vomiting. The patient received antibiotics for three days, so antibiotics need to be continued. With appropriate antibiotic
therapy, some improvement in the patient's clinical course is usually seen within 48 to 72 hours (File, 2020).
Health Needs and Treatment Regimen
The patient is not tolerating diet and complaining of nausea and vom.
Community Acquired Pneumonia IntroCommunity-acquired pneumo.docxcargillfilberto
Community Acquired Pneumonia: Intro
Community-acquired pneumonia (CAP) is a common group of infectious diseases that are responsible for significant global health and economic burden. CAP affects approximately 5.5/1000 people annually, and is a leading cause of hospital admissions, morbidity, and mortality in developed countries (especially for older people). Among all patients with CAP, those aged 65 or older account for about one-third, but they account for more than half of all health costs due to this disease. COPD is one of the most common comorbidities in patients with CAP, characterized by persistent respiratory symptoms. COPD was the third-most common cause of death in 2008, and the morbidity from COPD is projected to increase by 2020 (Liu, Han, & Liu, 2018).
Brief Summary of Client Case
Client HH is a 68 year-old male admitted with a diagnosis of community-acquired pneumonia for the past 3 days. This client’s medical HX includes COPD, HTN, hyperlipidemia, and diabetes. Mr. HH is on day three of two empiric antibiotics (ceftriaxone 1 g IV daily and azithromycin 500 mg IV daily). The client’s clinical status has improved since admission, with decreased oxygen requirements. However, he is not tolerating anything PO at this time and complains of nausea and vomiting. The client’s height is 5’8” and he weighs 89 kg. The only known drug allergy is PCN which results in a rash.
Analysis
The client in this scenario is responding well to the current antibiotic therapy, as evidence by a drop in WBC count from 18.2 upon admission to 14.6 currently (normal range is between 5.0 and 10). It is also pleasing that the client’s O2 saturation is now 92% on room air alone, compared to 90% while requiring 4L of supplemental oxygen upon admission. Overall, the client’s lab results are not significantly concerning. Neutrophil (normal range 40-60%) and band (normal range 0.0-03%) percentages are slightly elevated as expected given the infectious process (NIH, 2020). Aside from an elevated WBC count that is trending down, a marginally elevated blood glucose, and a HCO3 elevated eight points above the normal limit, the other lab results are within the normal ranges of a healthy adult male (Farinde, 2019). The issues of concern in this client case are the client’s inability to tolerate a diet due to nausea and vomiting, elevated temperature, and continuing antibiotics to treat the pneumonia.
Treatment Considerations
According to Donovan (2019), the client’s empiric antibiotic regime is consistent with what is recommended by the Infectious Diseases Society of America (IDSA). Initial empiric antimicrobial treatment should be initiated until laboratory results can be obtained to guide more specific therapy. Also, a combination of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h is consistent with IDSA guidelines for a client with comorbidities such as COPD and diab.
Community Acquired Pneumonia IntroCommunity-acquired pneumo.docxdrandy1
Community Acquired Pneumonia: Intro
Community-acquired pneumonia (CAP) is a common group of infectious diseases that are responsible for significant global health and economic burden. CAP affects approximately 5.5/1000 people annually, and is a leading cause of hospital admissions, morbidity, and mortality in developed countries (especially for older people). Among all patients with CAP, those aged 65 or older account for about one-third, but they account for more than half of all health costs due to this disease. COPD is one of the most common comorbidities in patients with CAP, characterized by persistent respiratory symptoms. COPD was the third-most common cause of death in 2008, and the morbidity from COPD is projected to increase by 2020 (Liu, Han, & Liu, 2018).
Brief Summary of Client Case
Client HH is a 68 year-old male admitted with a diagnosis of community-acquired pneumonia for the past 3 days. This client’s medical HX includes COPD, HTN, hyperlipidemia, and diabetes. Mr. HH is on day three of two empiric antibiotics (ceftriaxone 1 g IV daily and azithromycin 500 mg IV daily). The client’s clinical status has improved since admission, with decreased oxygen requirements. However, he is not tolerating anything PO at this time and complains of nausea and vomiting. The client’s height is 5’8” and he weighs 89 kg. The only known drug allergy is PCN which results in a rash.
Analysis
The client in this scenario is responding well to the current antibiotic therapy, as evidence by a drop in WBC count from 18.2 upon admission to 14.6 currently (normal range is between 5.0 and 10). It is also pleasing that the client’s O2 saturation is now 92% on room air alone, compared to 90% while requiring 4L of supplemental oxygen upon admission. Overall, the client’s lab results are not significantly concerning. Neutrophil (normal range 40-60%) and band (normal range 0.0-03%) percentages are slightly elevated as expected given the infectious process (NIH, 2020). Aside from an elevated WBC count that is trending down, a marginally elevated blood glucose, and a HCO3 elevated eight points above the normal limit, the other lab results are within the normal ranges of a healthy adult male (Farinde, 2019). The issues of concern in this client case are the client’s inability to tolerate a diet due to nausea and vomiting, elevated temperature, and continuing antibiotics to treat the pneumonia.
Treatment Considerations
According to Donovan (2019), the client’s empiric antibiotic regime is consistent with what is recommended by the Infectious Diseases Society of America (IDSA). Initial empiric antimicrobial treatment should be initiated until laboratory results can be obtained to guide more specific therapy. Also, a combination of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h is consistent with IDSA guidelines for a client with comorbidities such as COPD and diab.
To Assess the Severity and Mortality among Covid 19 Patients after Having Vac...YogeshIJTSRD
The severity and mortality of COVID 19 cases has been associated with the Three category such as vaccination status, severity of disease and outcome. Objective presently study was aimed to assess the severity and mortality among covid 19 patients. Methods Using simple lottery random method 100 samples were selected. From these 100 patients, 50 patients were randomly assigned to case group and 50 patients in control group after informed consents of relative obtained. Patients in the case group who being died after got COVID 19 whereas 50 patients in the control group participated who were survive after got infected from COVID 19 patients. Result It has three categories such as a Vaccination status For the vaccination status we have seen 59 patients were not vaccinated and 41 patients was vaccinated out of 100. b Incidence There were 41 patients were vaccinated whereas 59 patients were not vaccinated. c Severity In the case of mortality we selected 50 patients who were died from the Corona and I got to know that out of 50 patients there were 12 24 patients were vaccinated whereas 38 76 patients were non vaccinated. Although for the 50 control survival group total 29 58 patients were vaccinated and 21 42 patients was not vaccinated all graph start. Conclusion we have find out that those people who got vaccinated were less infected and mortality rate very low. Prof. (Dr) Binod Kumar Singh | Dr. Saroj Kumar | Ms. Anuradha Sharma "To Assess the Severity and Mortality among Covid-19 Patients after Having Vaccinated: A Retrospective Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45065.pdf Paper URL: https://www.ijtsrd.com/other-scientific-research-area/other/45065/to-assess-the-severity-and-mortality-among-covid19-patients-after-having-vaccinated-a-retrospective-study/prof-dr-binod-kumar-singh
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
FEASIBILITY TO RETURN TO WORK IN DRUG RESISTANT TUBERCULOSIS PATIENTS Maelanti Norma.pptx
1. FEASIBILITY RETURN TO WORK IN DRUG RESISTANT
TUBERCULOSIS PATIENTS
Maelanti Norma
Scientific resources : dr. Feni Fitriani Taufik, Sp.P (K), M.Pd.Ked
Dr. dr. Fathiyah Isbaniyah,Sp.P(K) M.Pd.Ked
Scientific coordinator : dr. Erlina Burhan, M.Sc. Sp.P (K)
3rd Literature Review
February 21th 2022
Departement of Pulmonology and Respiratory Medicine
Faculty of Medicine University of Indonesia 2022
2. OUTLINE
1. INTRODUCTION
2. ANTIBIOTIC RESISTANCE MECHANISMS IN MYCOBACTRIUM TUBERCULOSIS
3. TB TRANSMISSION
4. CHALLANGES IN DRTB TREATMENT
5. OCCUPATIONAL TB
6. PREVENT AND CONTROL DR TB
7. CONCLUSION
4. INTRODUCTION
TB is an infectious disease caused by Mycobacterium tuberculosis
(M.Tb) that cureable and preventable.
One third of the world’s population gets infected with TB leading to nearly
1, 6 million deaths annually.
Global tuberculosis report 2020. Geneva: World Health Organization; 2020.
5. INTRODUCTION
Global tuberculosis report 2020. Geneva: World Health Organization; 2020.
Drug resistant TB (DRTB)
DRTB is M.Tb that are resistant to TB drugs as a result of non-adherence to
drugs TB treatment and ineffective TB therapy.
Only 333.304 people were treated for DRTB, 22% the 5-year target of 1.5 million.
Indonesia is one of the five countries with the highest number of people
receiving DR TB therapy between 2017 and 2019.
6. INTRODUCTION
Global tuberculosis report 2020. Geneva: World Health Organization; 2020
Bettex, AM. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases 21.2020
There is about three billion people working in the world but half are still in poverty,
low socioeconomic status as a factor in M.Tb transmission.
Long duration of work in the workplace can increase the risk TB transmission
TB mainly affects people in their most productive working years of life
8. Drug resistance mechanisms in Mycobacterium TB
Zu˜niga J, et al. J Clinical and Developmental Immunology Volume 2012
Richa S, et alJournal of Applied Microbiology.2019
Pathogenesis of tuberculosis Resistance mechanisms of M.Tb
10. Risk factors for DRTB
World Health Organization. Working together with businesses.WHO, ILO.2012;3
Simbwa et al. BMC Infect Dis (2021) 21:950
High-burden country
Previous exposure to antituberculosis drugs
Patients with MDR tuberculosis tend to be
younger
Socioeconomic or behavioural risk factors for
MDR
Poor access to high-quality health care
Abusers of alcohol
Intravenous drug users
12. Hypertransmitions:
prolonged hospitalization, delayed
diagnosis of drug resistance and
poor ventilation
- Cough strength and
frequency,
- Presence of lung cavities,
- Sputum viscosity
-Ventilation,
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
13. Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
The number of
infectious doses was
340 m3 of air
leading to effective
transmission
Animal studi:
the time needed for
become infected in the
pre-antibiotic era (i.e.
have TST conversion) was
12–18 months, on
average
what are the minimum frequency
and duration of contact for infection to occur?
14. Who is infectious?
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
which factors favour
disease
transmission?
- Patients
- Health staff and
- visitors.
The sources of
transmission in
hospitals
- Undetected,
- Untreated TB
- Patients with known TB, but
unknown drug resistance
(receiving ineffective therapy)
Hypertransmitions
15. Who is infectious?
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
Beccera MC. BMJ 2019;367
- The treatment is not effective
- Smear and culture do not convert
- Clinical and radiological indicators deteriorate Infectious
TB patients when
Smear sputum M.Tb positive more infectious
than smear sputum M.Tb negative whether
culture M.Tb positive or negative
Contacts of patients with multidrug
resistant tuberculosis were at higher risk of
tuberculosis infection than contacts exposed to
drug sensitive tuberculosis.
16. WHO operational handbook on tuberculosis. Module 4.2020
Simbwa et al. BMC Infect Dis (2021) 21:950
DRTB Therapy
Standar regimen :
A shorter DRTB regimen refers to a course
of treatment between 9-11 months.
Individualized :
Longer DRTB regimens are expected to be
about 18–24 months.
Poor adherence to TB
medication, especially
when patients leave
hospital to return home.
The long regimens and
associated side efects
make it very hard to fnish
the medication.
17. Migliori GB. Clinical Infectious Diseases. 2019
Treatment outcome definitions for DRTB
Cured
Died
Treatment failure
Relapse & Reinfection
Lost to follow-up
19. Thomas BE, et al. PLoS One 2016;
11
The long duration of
DRTB treatment
Psychological
distress
Poor adherence
20. Thomas BE, et al. PLoS One 2016;
11
The long duration of DRTB
treatment
Psychological
distress
Treatment
failure
Still
infectious
21. Monitoring therapy for DRTB patients
- Clinical,
- Laboratory
- Microbiology and
- Radiology.
WHO guidelines suggest monthly sputum smear microscopy and
culture as an adjunct to clinical monitoring of patients to assess
treatment outcome.
in DRTB patient Modest specificity and the best maximum
combined sensitivity and
specificity occurred between month 6 and month 10 of treatment
Dheda K, et al.Lancet Respir Med 2017;5
22. Treatment failure :
- Smear and culture do not convert, Initial response with
subsequent culture reversion,
- The need for a regimen change because of adverse events or
acquired drug resistance (the treatment is not effective).
- Clinical and radiological indicators deteriorate
Dheda K, et al.Lancet Respir Med 2017;5
23. HOSPITAL DISCHARGE CRITERIA
• No continuing clinical need for inpatient treatment
• Clinical improvement
• Effective treatment
• Continuity of care and DOT
Dheda K, et al.Lancet Respir Med 2017;5
Positive smear is not a contraindication for hospital discharge. The median time
to convert sputum culture to a negative result was 38.5 days
24. Prior to discharge from the hospital,
continuation of care and monitoring
during the outpatient phase of
treatment must be ensured.
HOSPITAL DISCHARGE CRITERIA
Dheda K, et al.Lancet Respir Med 2017;5
Confirmed TB
- Unable to produce sputum
- Overall symptoms have improved
Discharge decisions should be taken
by a multidisciplinary team
Confirmed MDR-TB
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
25. A proportion of cases still need to be admitted for
medical reasons, including
• Severe cases,
• Life threatening conditions,
• Comorbidities,
• Psychiatric problems,
• Adverse drug reactions and,
• For social reasons
Criteria for hospital admission
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
27. Dheda K, et al.Lancet Respir Med 2017;5
Healthcares
Mining
Oil and gas industries
Migrant
Commercial sex workers
Construction
Occupational risk for
TB infection
28. Drug-resistant TB (DR-TB) also affects
HCWs
Occupational TB
WHO:
1) Health professionals
2) Health associate professionals
3) Personal care workers in health services
4) Health management and support personnel
5) Other health service providers not
elsewhere classified.
Greater frequency than the
communities they serve.
World Health Organization. A people-centred model of
tuberculosis care. 1st ed. 2019: 4-38
29. Occupational TB
Hospital staff sharing air with contagious patients
with MDR/XDR-TB
TB among HCWs leads to :
- Worker absenteism,
- Disruption of health services, -
Loss of productivity.
World Health Organization. A people-centred model of
tuberculosis care. 1st ed. 2019: 4-38
31. Return to
work Criteria
for DR TB
patients
1. Have had three negative AFB sputum smear results
collected 8–24 hours apart (at least one of which should
be an early morning specimen)
2. Have responded to anti-TB treatment that should be
effective based on drug susceptibility testing results
Nathavitharana RR, et al. La Presse Médicale. 2021;46
The assessment of TB patient can return to work should be made by a physician who
has expertise in the management of TB.
Return to work will be linked to medical certification.
32. TB patient is no longer infectious and can return
to work
Patients with pulmonary DR TB can be
considered non-infectious when:
1. They have received adequate chemotherapy for
two to three weeks;
2. They show clinical improvement; and
3. There is a negligible chance of MDR-TB
Migliori GB, et al. World Health Organization Regional Office for Europe. Eur Respir J 2019
World Health Organization. Working together with businesses: 2012
Dheda K, et al.Lancet Respir Med 2017;5
Dharmadhikari et al:
reported rapid effect of treatment for
MDR-TB on transmission become less
infectious.
Fennelly et al:
found that aerosol cultures in patients
with MDR tuberculosis who were on
effective treatment declined faster than
sputum smears or cultures
33. Loudon and colleagues: Aerosolization and drug concentration as
the key for limiting the spread of disease from patients on effective
treatment
Evaporation of the droplet nuclei could increase the drug
concentration around bacilli
Inactivate the bacilli or hamper their
capacity to successfully infect human hosts
Migliori GB, et al.World Health Organization Regional Office for Europe. Eur Respir J 2019.
34. Treatment failure :
- No culture conversion from the outset,
- Initial response with subsequent culture reversion,
- The need for a regimen change because of adverse
events or acquired drug resistance.
Dheda K, et al.Lancet Respir Med 2017;5
36. Precautions against airborne infection transmission are necessary
because biohazards, such as the Mycobacterium tuberculosis that
causes TB, are transmitted by airborne droplets.
WHO suggests that people deemed to be at a low risk of RR-TB and
/MDR-TB should be placed in single rooms and that those at a high
risk should ideally be accommodated in a negative-pressure room
while rapid diagnostic tests are urgently performed until effective
treatment starts
International Labour Office Health WISE Action Manual. 2014;1
R.R. Nathavitharana, et al.Presse Med. (2017)
Mycobacterium tuberculosis as Biohazards
37. Administrative controls
International Labour Office Health WISE Action Manual. 2014;1
• Control the spread of pathogens by using cough etiquette
• Reduce the time a person stays in a health facility and treat promptly those
infected
• Identify promptly and early people with TB symptoms, quarantinee infectious
patients.
• Train health workers TB signs, symptoms, prevention, treatment, and
infection control.
40. CONCLUSION
1. Contacts of patients with DRTB were at higher risk of
tuberculosis infection than contacts exposed to drug
sensitive tuberculosis. The risk of developing tuberculosis
disease did not differ among contacts in both groups
(DRTB/DSTB)
2. Long duration of work in the workplace can increase the
risk TB transmission
3. There are side effects of DRTB therapy and significant
psychosocial that affect DRTB patients.
41. CONCLUSION
4. DRTB patients can return to work if they are not
infectious
5. The risk of DRTB in health workers is higher than
community, because of frequent contact
6. Prevention of DRTB transmission with management
control and environmental control.
