Leprosy is caused by Mycobacterium leprae, an obligate intracellular bacterium. It principally affects the skin and peripheral nerves. The disease exists on a spectrum depending on the host's immune response. A strong cell-mediated response results in mild disease while a strong antibody response results in severe lepromatous leprosy. Diagnosis is primarily clinical based on skin lesions, nerve damage, and identification of acid-fast bacilli. Treatment involves multidrug therapy administered for 6 months to 2 years depending on disease classification as paucibacillary or multibacillary.
This document discusses the pathology of tuberculosis and leprosy lesions. It describes the types and morphology of granulomatous lesions caused by each disease. For tuberculosis, it covers primary and secondary pulmonary TB as well as extrapulmonary TB. It discusses non-caseating and caseating granulomas and the role of host immunity. For leprosy, it describes the clinical classifications and pathophysiology of tuberculoid and lepromatous forms. It also notes complications that can arise from delayed diagnosis or treatment of each disease.
A colostomy is a surgical procedure where part of the large intestine is diverted through an opening in the abdominal wall called a stoma. This creates an artificial path for waste to exit the body. The document discusses the different types of colostomies based on location and stoma construction. It also covers potential complications, nursing care after surgery, diet guidelines, and proper pouch and stoma maintenance.
Bursitis is an inflammation of the bursa, fluid-filled sacs located around joints that reduce friction, most commonly affecting the elbow, shoulder, knee, and hip. It is typically caused by infections, age, gout, rheumatoid arthritis, diabetes or obesity. Symptoms include pain, fever, swelling, tenderness, and trouble moving the affected joint. Treatment involves medications like NSAIDs or corticosteroids, rest, ice, and lifestyle changes such as weight loss.
This document provides information about cholelithiasis (gallstones). It defines cholelithiasis as the presence of stones in the gallbladder, which are usually composed of cholesterol, calcium salts, and bile pigments. Risk factors include a high-fat diet, obesity, rapid weight loss, older age, alcoholism, diabetes, lack of physical activity, and family history. Symptoms may include abdominal pain, nausea, and jaundice. Diagnosis involves ultrasound, CT scans, cholangiography, and ERCP. Treatment options include surgery (open or laparoscopic cholecystectomy), stone dissolution, diet modification, and pain medication. Complications can include cholangitis, pancreatitis,
The document discusses skin infections and dermatosis. It defines dermatosis as diseases of the integumentary system, including skin, nails, and hair. It describes four main types of skin infections - bacterial, viral, fungal, and parasitic - listing examples of each type and their symptoms. The document also covers causes, diagnosis, treatment and prevention of skin infections. It then discusses various skin conditions that are considered dermatosis, providing examples of common and less common forms.
This document discusses the pathology of tuberculosis and leprosy lesions. It describes the types and morphology of granulomatous lesions caused by each disease. For tuberculosis, it covers primary and secondary pulmonary TB as well as extrapulmonary TB. It discusses non-caseating and caseating granulomas and the role of host immunity. For leprosy, it describes the clinical classifications and pathophysiology of tuberculoid and lepromatous forms. It also notes complications that can arise from delayed diagnosis or treatment of each disease.
A colostomy is a surgical procedure where part of the large intestine is diverted through an opening in the abdominal wall called a stoma. This creates an artificial path for waste to exit the body. The document discusses the different types of colostomies based on location and stoma construction. It also covers potential complications, nursing care after surgery, diet guidelines, and proper pouch and stoma maintenance.
Bursitis is an inflammation of the bursa, fluid-filled sacs located around joints that reduce friction, most commonly affecting the elbow, shoulder, knee, and hip. It is typically caused by infections, age, gout, rheumatoid arthritis, diabetes or obesity. Symptoms include pain, fever, swelling, tenderness, and trouble moving the affected joint. Treatment involves medications like NSAIDs or corticosteroids, rest, ice, and lifestyle changes such as weight loss.
This document provides information about cholelithiasis (gallstones). It defines cholelithiasis as the presence of stones in the gallbladder, which are usually composed of cholesterol, calcium salts, and bile pigments. Risk factors include a high-fat diet, obesity, rapid weight loss, older age, alcoholism, diabetes, lack of physical activity, and family history. Symptoms may include abdominal pain, nausea, and jaundice. Diagnosis involves ultrasound, CT scans, cholangiography, and ERCP. Treatment options include surgery (open or laparoscopic cholecystectomy), stone dissolution, diet modification, and pain medication. Complications can include cholangitis, pancreatitis,
The document discusses skin infections and dermatosis. It defines dermatosis as diseases of the integumentary system, including skin, nails, and hair. It describes four main types of skin infections - bacterial, viral, fungal, and parasitic - listing examples of each type and their symptoms. The document also covers causes, diagnosis, treatment and prevention of skin infections. It then discusses various skin conditions that are considered dermatosis, providing examples of common and less common forms.
Dermatitis is an inflammation of the skin that causes redness, swelling and itchiness. There are many types of dermatitis including atopic dermatitis, contact dermatitis and seborrheic dermatitis. Contact dermatitis occurs when the skin comes into contact with an irritant or allergen and can be either irritant or allergic in nature. Symptoms vary depending on the type but may include a rash, blisters, dry cracked skin and itchiness. Treatment involves identifying and avoiding triggers, using moisturizers and topical or oral medications like corticosteroids and antihistamines.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae bacteria. It mainly affects nerves and skin. The disease presents on a spectrum depending on the host's immune response. Patients with strong immunity typically have localized tuberculoid leprosy lesions, while those with weak immunity are more likely to develop disseminated lepromatous leprosy with high bacterial loads. Leprosy is classified using systems that consider clinical features and bacterial loads. Treatment involves multidrug therapy to cure the disease and prevent disability and transmission.
Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Leprosy has been recognized throughout history in many ancient civilizations. It is transmitted via droplets from the nose and mouth during close contact with untreated cases. While not highly infectious, untreated leprosy can cause permanent damage to skin, nerves, limbs, and eyes. Diagnosis is based on clinical signs and symptoms, and confirmation is through skin smears or biopsy. Treatment involves multidrug therapy with dapsone, rifampicin, and clofazimine.
This document provides information on lower respiratory tract infections including bronchitis, pneumonia, and pulmonary tuberculosis. It defines each condition and discusses causes, risk factors, signs and symptoms, diagnostic testing, medical management, nursing management, and prevention. Bronchitis is inflammation of the bronchial tubes caused by viruses or bacteria. Pneumonia is inflammation of the lungs that can be bacterial, viral, or fungal in origin. Pulmonary tuberculosis is a chronic lung infection caused by the bacterium Mycobacterium tuberculosis. Standard treatments and preventative measures are outlined for each condition.
This document provides instructions for collecting a sputum sample to test for acid fast bacillus (AFB) and diagnose tuberculosis (TB). Sputum samples should be collected upon waking to detect mycobacterial infections like pulmonary TB. Precautions like shielding samples from sunlight must be taken to preserve the TB bacteria. Patients are instructed to take deep breaths and cough hard into a collection container, avoiding contamination. Proper collection and handling of samples enables timely diagnosis and treatment monitoring of TB infections.
This document provides information about chickenpox (varicella). It defines chickenpox as a highly contagious disease caused by the varicella-zoster virus, characterized by an itchy rash of small blisters. The document discusses the incubation period, signs and symptoms, diagnosis, medical management including antiviral medications and vaccines, nursing care, complications, and prevention of chickenpox.
Diarrhoea is defined as having three or more loose or liquid stools per day. Worldwide, approximately 2.5 billion cases of diarrhea occur each year resulting in 1.5 million child deaths. Rotavirus is the most common cause of diarrhoea in children under 5. Diarrhoea can be acute lasting less than 14 days or chronic lasting more than 14 days. Management involves oral rehydration therapy with increased fluids for mild cases or IV fluids for severe cases. Education of mothers on prevention through hygiene and sanitation is important to reduce incidence of diarrhoea.
This document provides information on cholera including its incidence, signs and symptoms, transmission, diagnosis, prevention and treatment. Cholera is an acute diarrheal illness caused by the Vibrio cholerae bacteria. It kills approximately 95,000 people in India each year and infects 2.9 million. Symptoms include watery diarrhea and vomiting which can lead to rapid dehydration. It is transmitted by drinking or eating contaminated food or water. Diagnosis involves culture, microscopy and biochemical testing of stool samples. Prevention focuses on drinking safe water, hand washing and properly cooking food. Treatment involves oral rehydration and antibiotics.
This document provides information on diarrhea, including its definition, types, causes, symptoms, diagnostic evaluations, management, and nursing considerations. Diarrhea is defined as 3 or more loose stools per day. It can be classified as acute or chronic based on duration. Causes include viral, bacterial, and parasitic infections. Management involves rehydration, antidiarrheal medications, and antibiotics in some cases. Key nursing diagnoses for patients with diarrhea include deficits in fluid volume and nutrition.
Dysentery is an inflammation of the intestines that causes bloody diarrhea, abdominal cramps, and mucus in the stool. It is typically caused by either bacteria (bacillary dysentery) like Shigella species, which spreads through poor hygiene and contaminated food/water, or by the amoeba Entamoeba histolytica (amoebic dysentery), which is more common in tropical areas and spreads through ingestion of cysts. Symptoms include abdominal pain and bloating, bloody diarrhea, nausea, and in severe cases, fever, chills, and dehydration. Diagnosis involves examining a stool sample under a microscope to look for bacteria or parasites.
This document provides information about measles including:
1. Measles is caused by a paramyxovirus that is transmitted via respiratory droplets and spreads from the nasopharynx.
2. Clinical features include an incubation period of 10-12 days followed by a prodrome of fever and cough, appearance of Koplik spots in the mouth, and a maculopapular rash that starts on the face and spreads.
3. Complications can include diarrhea, otitis media, pneumonia, encephalitis, and death in rare cases. Vaccination with two doses of the MMR vaccine is recommended for prevention.
Leprosy is a chronic infection caused by the bacteria Mycobacterium leprae. It principally affects the skin, nerves, respiratory tract and eyes. Symptoms include numbness, skin lesions and facial disfigurement. People living in areas with poor sanitation and nutrition are at higher risk. The disease is transmitted through droplets or direct contact with untreated patients. Diagnosis involves clinical examination and bacteriological tests. Treatment consists of multidrug therapy along with treatment of complications.
This document discusses the importance and relevance of microbiology to nursing. It explains that nurses must understand microbiology to control infections in hospitals and know which microorganisms are harmful or harmless to humans. Microbiology knowledge helps nurses with drug production, diagnosis, sterilization, and maintaining cleanliness. The document also provides brief historical perspectives on Koch's phenomenon and Koch's postulates, which were methods for identifying disease-causing pathogens established by Robert Koch.
this is the power point presentation for coughing and breathing exercises, most probably we used this for the respiratory problems, it is very helpful for the COPD patient
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
This document defines hernia and describes the different types of hernias. It explains that a hernia is an abnormal protrusion of an organ or tissue through a weak spot in the muscle wall of the cavity it is normally contained within. The most common locations for hernias are the abdominal cavity, inguinal canal, umbilicus, and femoral ring. Symptoms can include a bulge or lump, pain, discomfort, vomiting, and difficulty breathing. Hernias are typically diagnosed through physical examination, ultrasound, x-ray, or barium swallow. Treatment options include medical management with a truss or surgical repair through herniotomy, herniorrhaphy, or hernioplasty procedures.
Marasmus is a form of severe protein-energy malnutrition that occurs due to negative energy balance, particularly in infants. It is characterized by severe wasting of over 60% of expected weight, loss of subcutaneous fat and muscle wasting. The causes include poor feeding habits, physical defects preventing eating, diseases interfering with food assimilation, infections causing loss of appetite, and loss of food through vomiting or diarrhea. Treatment involves rehydration and refeeding through intravenous fluids or feeding tubes to prevent complications like organ failure or coma from developing.
1) Abdominal paracentesis is a procedure where a needle is inserted into the peritoneal cavity to remove ascitic fluid. It can be performed for diagnostic purposes to obtain a small fluid sample for testing or therapeutically to remove over 5 liters of fluid.
2) The optimal site for paracentesis is the left lower quadrant of the abdomen to access the thicker abdominal wall and larger fluid pool. Ultrasound guidance can be used.
3) After marking the skin and administering local anesthesia using the "Z-track" technique, the needle is slowly inserted while aspirating to check for blood. Fluid flow indicates proper needle placement in the peritoneal cavity.
This document provides information about diphtheria, including its causes, symptoms, treatment, and prevention through vaccination. It notes that diphtheria is caused by Corynebacterium diphtheriae and presents as a membrane in the throat or other areas that can lead to breathing issues. Symptoms vary depending on the infected area. Treatment involves antitoxin and antibiotics. Prevention relies on widespread immunization with diphtheria and tetanus toxoids, especially for children. Maintaining high vaccination rates through multiple doses is important to protect communities from this potentially fatal disease.
This document provides information about leprosy (Hansen's disease), including:
- It is caused by the bacterium Mycobacterium leprae and primarily affects the skin, nerves, and mucous membranes.
- There are six classifications of leprosy based on clinical features, ranging from indeterminate leprosy to lepromatous leprosy.
- Symptoms vary but can include skin lesions, nerve damage, numbness, and disfigurement if untreated.
- Diagnosis involves assessment of symptoms, skin tests, biopsy of skin or nerves, and PCR analysis to detect M. leprae.
- Treatment is mainly multidrug therapy with drugs like rifampin,
Leprosy is an infectious disease caused by Mycobacterium leprae bacteria that affects the skin and nerves. It causes skin lesions and nerve damage in the arms and legs. Around 250,000 new cases are identified each year, with most in India. Leprosy exists on a spectrum, from mild tuberculoid leprosy to more severe lepromatous leprosy. It is diagnosed through skin and nasal smears and biopsies, and treated with multidrug therapy, which has effectively decreased cases. Nursing care includes wound management, education, and rehabilitation.
Dermatitis is an inflammation of the skin that causes redness, swelling and itchiness. There are many types of dermatitis including atopic dermatitis, contact dermatitis and seborrheic dermatitis. Contact dermatitis occurs when the skin comes into contact with an irritant or allergen and can be either irritant or allergic in nature. Symptoms vary depending on the type but may include a rash, blisters, dry cracked skin and itchiness. Treatment involves identifying and avoiding triggers, using moisturizers and topical or oral medications like corticosteroids and antihistamines.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae bacteria. It mainly affects nerves and skin. The disease presents on a spectrum depending on the host's immune response. Patients with strong immunity typically have localized tuberculoid leprosy lesions, while those with weak immunity are more likely to develop disseminated lepromatous leprosy with high bacterial loads. Leprosy is classified using systems that consider clinical features and bacterial loads. Treatment involves multidrug therapy to cure the disease and prevent disability and transmission.
Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Leprosy has been recognized throughout history in many ancient civilizations. It is transmitted via droplets from the nose and mouth during close contact with untreated cases. While not highly infectious, untreated leprosy can cause permanent damage to skin, nerves, limbs, and eyes. Diagnosis is based on clinical signs and symptoms, and confirmation is through skin smears or biopsy. Treatment involves multidrug therapy with dapsone, rifampicin, and clofazimine.
This document provides information on lower respiratory tract infections including bronchitis, pneumonia, and pulmonary tuberculosis. It defines each condition and discusses causes, risk factors, signs and symptoms, diagnostic testing, medical management, nursing management, and prevention. Bronchitis is inflammation of the bronchial tubes caused by viruses or bacteria. Pneumonia is inflammation of the lungs that can be bacterial, viral, or fungal in origin. Pulmonary tuberculosis is a chronic lung infection caused by the bacterium Mycobacterium tuberculosis. Standard treatments and preventative measures are outlined for each condition.
This document provides instructions for collecting a sputum sample to test for acid fast bacillus (AFB) and diagnose tuberculosis (TB). Sputum samples should be collected upon waking to detect mycobacterial infections like pulmonary TB. Precautions like shielding samples from sunlight must be taken to preserve the TB bacteria. Patients are instructed to take deep breaths and cough hard into a collection container, avoiding contamination. Proper collection and handling of samples enables timely diagnosis and treatment monitoring of TB infections.
This document provides information about chickenpox (varicella). It defines chickenpox as a highly contagious disease caused by the varicella-zoster virus, characterized by an itchy rash of small blisters. The document discusses the incubation period, signs and symptoms, diagnosis, medical management including antiviral medications and vaccines, nursing care, complications, and prevention of chickenpox.
Diarrhoea is defined as having three or more loose or liquid stools per day. Worldwide, approximately 2.5 billion cases of diarrhea occur each year resulting in 1.5 million child deaths. Rotavirus is the most common cause of diarrhoea in children under 5. Diarrhoea can be acute lasting less than 14 days or chronic lasting more than 14 days. Management involves oral rehydration therapy with increased fluids for mild cases or IV fluids for severe cases. Education of mothers on prevention through hygiene and sanitation is important to reduce incidence of diarrhoea.
This document provides information on cholera including its incidence, signs and symptoms, transmission, diagnosis, prevention and treatment. Cholera is an acute diarrheal illness caused by the Vibrio cholerae bacteria. It kills approximately 95,000 people in India each year and infects 2.9 million. Symptoms include watery diarrhea and vomiting which can lead to rapid dehydration. It is transmitted by drinking or eating contaminated food or water. Diagnosis involves culture, microscopy and biochemical testing of stool samples. Prevention focuses on drinking safe water, hand washing and properly cooking food. Treatment involves oral rehydration and antibiotics.
This document provides information on diarrhea, including its definition, types, causes, symptoms, diagnostic evaluations, management, and nursing considerations. Diarrhea is defined as 3 or more loose stools per day. It can be classified as acute or chronic based on duration. Causes include viral, bacterial, and parasitic infections. Management involves rehydration, antidiarrheal medications, and antibiotics in some cases. Key nursing diagnoses for patients with diarrhea include deficits in fluid volume and nutrition.
Dysentery is an inflammation of the intestines that causes bloody diarrhea, abdominal cramps, and mucus in the stool. It is typically caused by either bacteria (bacillary dysentery) like Shigella species, which spreads through poor hygiene and contaminated food/water, or by the amoeba Entamoeba histolytica (amoebic dysentery), which is more common in tropical areas and spreads through ingestion of cysts. Symptoms include abdominal pain and bloating, bloody diarrhea, nausea, and in severe cases, fever, chills, and dehydration. Diagnosis involves examining a stool sample under a microscope to look for bacteria or parasites.
This document provides information about measles including:
1. Measles is caused by a paramyxovirus that is transmitted via respiratory droplets and spreads from the nasopharynx.
2. Clinical features include an incubation period of 10-12 days followed by a prodrome of fever and cough, appearance of Koplik spots in the mouth, and a maculopapular rash that starts on the face and spreads.
3. Complications can include diarrhea, otitis media, pneumonia, encephalitis, and death in rare cases. Vaccination with two doses of the MMR vaccine is recommended for prevention.
Leprosy is a chronic infection caused by the bacteria Mycobacterium leprae. It principally affects the skin, nerves, respiratory tract and eyes. Symptoms include numbness, skin lesions and facial disfigurement. People living in areas with poor sanitation and nutrition are at higher risk. The disease is transmitted through droplets or direct contact with untreated patients. Diagnosis involves clinical examination and bacteriological tests. Treatment consists of multidrug therapy along with treatment of complications.
This document discusses the importance and relevance of microbiology to nursing. It explains that nurses must understand microbiology to control infections in hospitals and know which microorganisms are harmful or harmless to humans. Microbiology knowledge helps nurses with drug production, diagnosis, sterilization, and maintaining cleanliness. The document also provides brief historical perspectives on Koch's phenomenon and Koch's postulates, which were methods for identifying disease-causing pathogens established by Robert Koch.
this is the power point presentation for coughing and breathing exercises, most probably we used this for the respiratory problems, it is very helpful for the COPD patient
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
This document defines hernia and describes the different types of hernias. It explains that a hernia is an abnormal protrusion of an organ or tissue through a weak spot in the muscle wall of the cavity it is normally contained within. The most common locations for hernias are the abdominal cavity, inguinal canal, umbilicus, and femoral ring. Symptoms can include a bulge or lump, pain, discomfort, vomiting, and difficulty breathing. Hernias are typically diagnosed through physical examination, ultrasound, x-ray, or barium swallow. Treatment options include medical management with a truss or surgical repair through herniotomy, herniorrhaphy, or hernioplasty procedures.
Marasmus is a form of severe protein-energy malnutrition that occurs due to negative energy balance, particularly in infants. It is characterized by severe wasting of over 60% of expected weight, loss of subcutaneous fat and muscle wasting. The causes include poor feeding habits, physical defects preventing eating, diseases interfering with food assimilation, infections causing loss of appetite, and loss of food through vomiting or diarrhea. Treatment involves rehydration and refeeding through intravenous fluids or feeding tubes to prevent complications like organ failure or coma from developing.
1) Abdominal paracentesis is a procedure where a needle is inserted into the peritoneal cavity to remove ascitic fluid. It can be performed for diagnostic purposes to obtain a small fluid sample for testing or therapeutically to remove over 5 liters of fluid.
2) The optimal site for paracentesis is the left lower quadrant of the abdomen to access the thicker abdominal wall and larger fluid pool. Ultrasound guidance can be used.
3) After marking the skin and administering local anesthesia using the "Z-track" technique, the needle is slowly inserted while aspirating to check for blood. Fluid flow indicates proper needle placement in the peritoneal cavity.
This document provides information about diphtheria, including its causes, symptoms, treatment, and prevention through vaccination. It notes that diphtheria is caused by Corynebacterium diphtheriae and presents as a membrane in the throat or other areas that can lead to breathing issues. Symptoms vary depending on the infected area. Treatment involves antitoxin and antibiotics. Prevention relies on widespread immunization with diphtheria and tetanus toxoids, especially for children. Maintaining high vaccination rates through multiple doses is important to protect communities from this potentially fatal disease.
This document provides information about leprosy (Hansen's disease), including:
- It is caused by the bacterium Mycobacterium leprae and primarily affects the skin, nerves, and mucous membranes.
- There are six classifications of leprosy based on clinical features, ranging from indeterminate leprosy to lepromatous leprosy.
- Symptoms vary but can include skin lesions, nerve damage, numbness, and disfigurement if untreated.
- Diagnosis involves assessment of symptoms, skin tests, biopsy of skin or nerves, and PCR analysis to detect M. leprae.
- Treatment is mainly multidrug therapy with drugs like rifampin,
Leprosy is an infectious disease caused by Mycobacterium leprae bacteria that affects the skin and nerves. It causes skin lesions and nerve damage in the arms and legs. Around 250,000 new cases are identified each year, with most in India. Leprosy exists on a spectrum, from mild tuberculoid leprosy to more severe lepromatous leprosy. It is diagnosed through skin and nasal smears and biopsies, and treated with multidrug therapy, which has effectively decreased cases. Nursing care includes wound management, education, and rehabilitation.
Cutaneous leprosy, also known as Hansen's disease, is a chronic infection caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Animals like armadillos and chimpanzees can also be infected. The disease progresses slowly and symptoms may not appear for years. Initial lesions often appear as pale patches on the skin in cooler areas of the body. A definitive diagnosis is made based on skin lesions, nerve thickening, and loss of sensation. Leprosy is classified based on clinical features and response to treatment involves multidrug therapy administered for 6-12 months depending on a patient's classification.
Cutaneous leprosy, also known as Hansen's disease, is a chronic infection caused by the bacterium Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Animals like armadillos and chimpanzees can also be infected. The disease progresses slowly and symptoms may not appear for years. Initial lesions often appear as pale patches on the skin in cooler areas of the body. A definitive diagnosis is made based on skin lesions, nerve thickening, and loss of sensation. Leprosy is classified based on clinical features and response to treatment involves multidrug therapy administered for 6-12 months depending on a patient's classification.
Leprosy, also known as Hansen's disease, is caused by the bacteria Mycobacterium leprae. It primarily affects the nerves, skin, and mucous membranes of the body. Leprosy is curable with multidrug therapy. While leprosy is moderately contagious, about 95% of people have natural immunity. Left untreated, leprosy can cause permanent damage to the skin, nerves, limbs, and eyes. Clinical signs include pale skin lesions with loss of sensation. Diagnosis involves skin smears and biopsy to detect bacteria. Treatment depends on the classification of leprosy into paucibacillary or multibacillary forms.
- Mycobacterium leprae is the causative bacteria of leprosy (Hansen's disease), which was first recognized in ancient times and described by Hippocrates. The bacteria was discovered in 1873 and causes a chronic granulomatous disease primarily affecting the skin, nerves, and respiratory tract.
- Leprosy has a long incubation period of 5-7 years on average and can be classified based on clinical presentation and bacterial load as tuberculoid, borderline, or lepromatous. Effective treatment involves multidrug therapy with rifampicin, dapsone, and clofazimine for 6-12 months depending on classification.
- Without treatment, le
Leprosy Department of Physiotherapy, SHUATS, PrayagrajSurabhi Srivastava
The document discusses leprosy (Hansen's disease), caused by Mycobacterium leprae bacteria. It covers the disease's incidence, risk factors, modes of transmission, immunology, pathogenesis, classification, signs and symptoms, complications, diagnosis, and treatment. Leprosy mainly affects the skin and nerves and can cause disabilities if left untreated. It remains prevalent in tropical countries and India accounts for over half of all new cases globally each year. Treatment involves multidrug therapy with dapsone, rifampicin and clofazimine for 6-12 months depending on classification.
This document provides information about leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae and primarily affects the skin, nerves, and mucosa.
- There are several classification systems including paucibacillary, multibacillary, lepromatous, tuberculoid, and borderline. Classification depends on immune response and bacterial load.
- It remains a major public health problem with millions of cases worldwide, especially in India, Brazil, and African countries. Treatment involves multidrug therapy to prevent disability.
- Leprosy, also known as Hansen's disease, is caused by the bacterium Mycobacterium leprae. It affects the skin and peripheral nerves.
- There are different types of leprosy including tuberculoid, lepromatous, borderline, and indeterminate. Symptoms vary depending on type but may include skin lesions and nerve damage.
- Leprosy is treated with multidrug therapy which includes dapsone, rifampicin, and clofazimine. Treatment duration depends on whether a patient has paucibacillary or multibacillary leprosy. Nursing care focuses on monitoring for side effects, educating patients, and preventing
THESE SLIDES ARE PREPAREED TO UNDERSTAND about water born diseases IN EASY WAY Important links- NOTES- https://mynursingstudents.blogspot.com/ youtube channel https://www.youtube.com/c/MYSTUDENTSU... CHANEL PLAYLIST- ANATOMY AND PHYSIOLOGY-https://www.youtube.com/playlist?list=PL93S13oM2gAPM3VTGVUXIeswKJ3XGaD2p COMMUNITY HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPyslPNdIJoVjiXEDTVEDzs CHILD HEALTH NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gANcslmv0DXg6BWmWN359Gvg FIRST AID- https://www.youtube.com/playlist?list=PL93S13oM2gAMvGqeqH2ZTklzFAZhOrvgP HCM- https://www.youtube.com/playlist?list=PL93S13oM2gAM7mZ1vZhQBHWbdLnLb-cH9 FUNDAMENTALS OF NURSING- https://www.youtube.com/playlist?list=PL93S13oM2gAPFxu78NDLpGPaxEmK1fTao COMMUNICABLE DISEASES- https://www.youtube.com/playlist?list=PL93S13oM2gAOWo4IwNjLU_LCuhRN0ZLeb ENVIRONMENTAL HEALTH- https://www.youtube.com/playlist?list=PL93S13oM2gAPkI6LvfS8Zu1nm6mZi9FK6 MSN- https://www.youtube.com/playlist?list=PL93S13oM2gAOdyoHnDLAoR_o8M6ccqYBm HINDI ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAN4L-FJ3s_IEXgZCijGUA1A ENGLISH ONLY- https://www.youtube.com/playlist?list=PL93S13oM2gAMYv2a1hFcq4W1nBjTnRkHP facebook profile- https://www.facebook.com/suresh.kr.lrhs/ FACEBOOK PAGE- https://www.facebook.com/My-Student-S... facebook group NURSING NOTES- https://www.facebook.com/groups/24139... FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG – BLOGGER- https://mynursingstudents.blogspot.com/ Instagram- https://www.instagram.com/mystudentsu... Twitter- https://twitter.com/student_system?s=08 #PEM, #water,#prification#largescale,#nurses,#ASSESSMENT, #APPEARENCE,#PULSE,#GRIMACE,#REFLEX,#RESPIRATION,#RESUSCITATION,#NEWBORN,#BABY,#VIRGINIA, #CHILD, #OXYGEN,#CYANOSIS,#OPTICNERVE, #SARACHNA,#MYSTUDENTSUPPORTSYSTEM, #rashes,#nursingclasses, #communityhealthnursing,#ANM, #GNM, #BSCNURING,#NURSINGSTUDENTS, #WHO,#NURSINGINSTITUTION,#COLLEGEOFNURSING,#nursingofficer,#COMMUNITYHEALTHOFFICER
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Epidemiology and recent advances in leprosy Bhavna Jain
Leprosy is a major public health problem in India and the World. Despite of having many programs to eliminate it, India is sharing a major burden of this disease. To understand this problem and the present measures adopted this presentation has been created.
The information about Leprosy is a basic content intended to share Students of Graduate and postgraduate in Life Sciences.
The up loader has no Commercial interests
This document provides information about leprosy (Hansen's disease) including:
- It is caused by slow-growing bacteria that can affect nerves, skin, eyes and nose.
- Signs include pale or reddish skin patches with loss of sensation and thickened nerves.
- It is diagnosed through skin smears and biopsies looking for acid-fast bacilli.
- Treatment involves multidrug regimens to cure it and prevent complications like paralysis.
- Nursing care focuses on nutrition, hydration, eye and nasal care to preserve function.
This document provides information on leprosy (Hansen's disease), including:
- It is caused by Mycobacterium leprae and mainly involves the skin and peripheral nerves.
- It has a worldwide distribution but is more common in developing countries. Global prevalence has dropped 90% since 1985.
- India has achieved the goal of leprosy elimination at the national level with a prevalence rate of less than 1 per 10,000 people.
- Classification systems include Ridley-Jopling (based on immunology) and WHO (for chemotherapy, divides into paucibacillary and multibacillary). Clinical features vary depending on classification from single well-defined lesions to numerous, diffuse infiltr
Mycobacterium leprae is the causative agent of Hansen's disease (leprosy), an infection that affects the skin, mucous membranes, and peripheral nerves. While once a major global problem, the World Health Organization launched an eradication program in 1985 that has reduced new cases by 90%. Currently, India, Brazil, and Indonesia account for over 80% of new cases globally. Hansen's disease is not highly contagious and can be transmitted through direct contact or inhalation of aerosols from skin lesions or the nasal passage. There are two main forms: tuberculoid leprosy and lepromatous leprosy, which differ in immune response and symptoms. Laboratory diagnosis
The document discusses the management of pregnancy, also called antenatal care. It provides definitions for key terms and outlines the objectives and components of Focused Antenatal Care. Focused Antenatal Care emphasizes quality over quantity of visits and aims to provide early detection of complications, disease prevention, birth preparedness, and health promotion. The document details the schedule of antenatal visits and the activities that should be conducted at each visit, including history taking, physical examinations, screening tests, immunizations, and health education.
Bipolar disorder is a mental illness characterized by extreme mood swings from mania to depression. There are three main types: bipolar I, bipolar II, and cyclothymia. Bipolar I involves severe manic or mixed episodes, while bipolar II involves hypomanic and depressive episodes. Symptoms include abnormal behavior, thoughts, and mood during manic or depressive phases. Treatment involves mood stabilizing medications, antipsychotics, psychotherapy, and prevention of self-harm. Nursing care focuses on safety, behavior modification, social skills training, hygiene, nutrition, and risk reduction.
Nephrotic syndrome is a kidney disorder characterized by heavy protein in the urine, low blood protein levels, fluid retention causing edema, and high cholesterol. It is caused by damage to the glomeruli in the kidneys, which allows protein to pass into the urine. Common causes include infections, cancers, autoimmune diseases, medications, and genetic factors. Symptoms include generalized edema, fatigue, loss of appetite, and shortness of breath. Diagnosis involves blood and urine tests to detect low protein and high protein in the urine. Treatment focuses on reducing edema with diuretics, lowering blood pressure and proteinuria with ACE inhibitors, and using steroids to reduce inflammation in some cases.
Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. It is caused by damage to the glomerular basement membrane that results in leakage of protein into the urine. This leads to decreased oncotic pressure and edema. Treatment involves diuretics to reduce edema, ACE inhibitors to reduce proteinuria, and steroids like prednisone to treat underlying causes. Nurses monitor for edema, infections, nutrition, and complications of treatment.
Renal failure occurs when the kidneys are unable to adequately remove waste from the body. It can be acute or chronic. Acute renal failure is sudden and can be prerenal from low blood flow, intrinsic from direct kidney damage, or postrenal from urinary tract obstruction. It causes a buildup of waste and electrolyte imbalances. Treatment focuses on restoring fluid balance, monitoring electrolytes, providing patient education, and potentially using medications or dialysis.
Hepatitis is an inflammatory condition of the liver that can be caused by viruses, alcohol, drugs, toxins, and autoimmune diseases. There are several types of viral hepatitis, with hepatitis A, B, and C being the most common. Hepatitis A is typically spread through fecal-oral transmission, while hepatitis B and C can spread through contact with infected blood or bodily fluids. Symptoms may include jaundice, abdominal pain, fatigue, nausea and vomiting. Treatment depends on the cause but often involves rest, a balanced diet, vitamins, fluids, and medications to manage symptoms. Complications can include liver scarring, liver cancer, and liver failure in some cases.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
2. LEPROSY
Definition: Leprosy is an infectious chronic
granulomatous disease principally affecting the
skin and peripheral nervous system, caused by
Mycobacterium leprae.
leprosy 2017 mwila
4. Mycobacterium.leprae is an obligate intracellular
acid-fast gram-positive bacillus with an affinity for
macrophages and Schwann cells, has slow
replication within the Schwann cells, hence the long
incubation period of leprosy.
leprosy 2017 mwila
5. CAUSES AND PREDISPOSING FACTORS
Humans are the primary reservoir of
Mycobacterium. leprae.
Animal reservoirs of leprosy have been found
in 3 species: 9-banded armadillos,
Chimpanzees, and Mangabey monkeys.
leprosy 2017 mwila
7. Leprosy is not a highly infectious disease. The
principle means of transmission is by aerosol
spread from infected nasal secretions to exposed
nasal and oral mucosa. Leprosy is not generally
spread by means of direct contact through intact
skin, though close contacts are most vulnerable.
leprosy 2017 mwila
8. The incubation period is 6 months to 40 years or
longer.
The mean incubation period is 4 years for
tuberculoid leprosy (TT) and 10 years for
lepromatous leprosy (LL).
leprosy 2017 mwila
9. Most persons are immuned to leprosy. Subclinical disease
is common in endemic areas, and the infection
progresses to clinical disease in only a selected few.
Exposure to nasal discharge of those that remain
untreated for years is thought to be the main cause of
infection.
leprosy 2017 mwila
10. In addition to exposure to respiratory secretions,
exposure to insect vectors and infected soil has been
suspected as a possible mode of transmission. In
endemic countries, household contacts of patients
are at increased risk for leprosy.
leprosy 2017 mwila
11. Of particular importance, HIV infection is not a
risk factor for acquiring leprosy, nor does it
increase the clinical symptoms or virulence of
leprosy
leprosy 2017 mwila
12. INCIDENCE AND PREVALENCE
RACE: Leprosy occurs in all races. African
blacks have a high incidence of the tuberculoid
form of leprosy. People with light skin and
Chinese individuals tend to have the
lepromatous type of leprosy.
Leprosy is endemic in Asia, Africa, the Pacific
basin, and Latin America.
leprosy 2017 mwila
13. It is more a rural than urban disease.
SEX: In adults, the lepromatous type of
leprosy is more common in men than in
women after puberty, with a male-to-female
ratio of 2:1. In children, the tuberculoid form
predominates, and no sex preference exists.
Women tend to have a delayed presentation,
which increases rates of deformity.
leprosy 2017 mwila
14. AGE: Leprosy has a bimodal age distribution,
with peaks at ages 10-14 years and 35-44 years.
The disease is rare in infants. Children appear to
be most susceptible to disease and tend to have
the tuberculoid form.
leprosy 2017 mwila
15. NOTE
Several different approaches for classifying leprosy
exist, but parallels exist.
WHO: paucibacillary and Multibacillary
Further divisions: PAUCIBACILLARY(Tuberculoid –TT
and Borderline tuberculoid BT this is by Ridley-
jopling classification)
MULTIBACILLARY(midborderline or borderline BB)
MULTIBACILLARY( borderline BL and
Lepromatous LL)
leprosy 2017 mwila
16. CLASSIFICATION
One classification classifies leprosy as either
tuberculoid or lepromatous. These are further
broken down into intermediate or borderline.
Another classification classifies leprosy as
either paucibacillary or multibacillary
depending on the number of lesions and
bacterial index (BI).
leprosy 2017 mwila
17. PAUCIBACILLARY disease has fewer than 5
lesions and no bacilli on smear testing.
Five or more lesions with or without bacilli is
considered MULTIBACILLARY disease.
IL: This early form causes one to a few
hypopigmentated or sometimes erythematous
macules. Sensory loss is unusual.
leprosy 2017 mwila
18. TT: Skin lesions are few. One erythematous large
plaque is usually present, with well-defined
borders that are elevated and that slope down
into an atrophic center.
Borderline Tuberculoid leprosy (BT): Lesions in
this form are similar to those in the tuberculoid
form, but they are smaller and more numerous.
leprosy 2017 mwila
19. Borderline borderline leprosy (BB): Cutaneous
lesions consist of numerous, red, irregularly
shaped plaques that are less well defined than
those in the tuberculoid type.
Borderline lepromatous leprosy (BL): Lesions are
numerous and consist of macules, papules,
plaques, and nodules.
leprosy 2017 mwila
20. LL: Early cutaneous lesions consist mainly of pale
macules. Late infiltrations are present with
numerous bacilli. Macular lesions are small,
diffuse, and symmetric.
leprosy 2017 mwila
22. PATHOPHYSIOLOGY
In general, leprosy affects the skin, peripheral
nerves, and eyes. Systemic symptoms may occur.
Specific symptoms vary with the severity of the
disease.
leprosy 2017 mwila
23. Leprosy commonly affects the superficial
peripheral nerves, skin, mucous membranes of
the upper respiratory tract, anterior chamber of
the eyes, and testes.
leprosy 2017 mwila
24. Tissue damage depends on the degree to which
cell-mediated immunity is expressed, the type
and extent of bacillary spread and
multiplication, the appearance of tissue-
damaging immunologic complications (i.e. lepra
reactions), and the development of nerve
damage and its sequelae.
leprosy 2017 mwila
25. The strength of the host’s immune system
influences the clinical form of the disease. A
strong cell-mediated immunity and a weak
humoral response results in mild forms of
disease, with a few well-defined nerves involved
and lower bacterial loads.
leprosy 2017 mwila
26. A strong humoral response but relatively absent
cell-mediated immunity results in LL, with
widespread lesions, extensive skin and nerve
involvement, and high bacterial loads.
leprosy 2017 mwila
27. Therefore, a spectrum of disease exists such that
cell-mediated immunity dominates in mild forms
of leprosy and decreases with increasing clinical
severity. Meanwhile, humoral immunity is
relatively absent in mild disease and increases
with the severity of diseases.
leprosy 2017 mwila
28. TYPES OF REACTIONS
Leprosy reactions; During the course of
untreated or even treated leprosy, the immune
system may produce inflammatory reactions.
There are two (2) types.
.
leprosy 2017 mwila
29. Type 1: Results from a spontaneous increase in
cell-mediated immunity.
These reactions can cause fever and
inflammation of the pre-existing skin and
peripheral nerve lesions, resulting in skin
edema, erythema, and tenderness and
worsening nerve functioning.
leprosy 2017 mwila
30. These reactions particularly if not treated
early contribute significantly to nerve
damage. Because the immune response is
increased, these reactions are termed
reversal reactions, despite the apparent
clinical worsening.
leprosy 2017 mwila
31. Treatment for type 1: patients with type 1
reaction (except minor skin reaction) are given
Predinisolone 40-60mg per oral once per day
initially, followed by low maintenance dose of as
low as 10-15mg per day for a few months.
leprosy 2017 mwila
32. Type 2: Also known as Erythema Nodosum
Leprosum or (ENL) are systemic inflammatory
reactions that appear to be a vasculitis or
panniculitis and probably involve circulating
immune complex deposition or increased T-
helper cell function.
leprosy 2017 mwila
33. Patients may develop erythematous and painful
papules or nodules that may postulate and
ulcerate and cause fever, neuritis,
lymphadenitis, orchitis, arthritis (particularly in
large joints usually knees), and
glomerulonephritis. Hemolytic or bone marrow
suppression may cause anemia, and hepatic
inflammation may cause mild abnormalities in
liver function test.
leprosy 2017 mwila
34. Treatment for type 2: First and second episodes of
ENL may be treated if mild with Aspirin or, if
significant, with one week of Predinisolone 40-60mg
once per day plus antimicrobials. For recurrent cases
Thalidomide 100-300mg orally once per day.
leprosy 2017 mwila
35. However because of its teratogenicity,
thalidomide should not be given to women who
may become pregnant.
leprosy 2017 mwila
36. SIGNS AND SYMPTOMS
Specific Symptoms Vary With The Severity Of
The Disease
Prodromal symptoms are generally so slight that
the disease is not recognized until a cutaneous
eruption is present. However, 90% of patients
have a history of numbness first, sometimes
years before the skin lesions appear.
leprosy 2017 mwila
37. Temperature is the first sensation that is lost.
Patient cannot sense extremes of hot or cold.
The next sensation lost is light touch, then pain,
and finally deep pressure. These losses are
especially apparent in the hands and feet;
therefore, the chief complaint may be a burning
senastion or ulcer in an anaesthetic extremity.
.
leprosy 2017 mwila
38. Other parts of the body that might be affected
are the cool areas: superficial peripheral nerves,
anterior chamber of the eyes, testes, chin, malar
eminences, earlobes, and knees.
From this stage, most lesions evolve into the
tuberculoid, borderline, or lepromatous types
leprosy 2017 mwila
39. Important physical signs generally affect 3
general areas:
cutaneous (skin) lesions,
neuropathies, and
eyes
leprosy 2017 mwila
40. For cutaneous lesions, assess the number and
distribution of skin lesions. A hypo pigmented
macule with a raised border is often the first
cutaneous lesion. Plaques are also common.
Borderline disease often appears with lesions on
the buttocks.
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41. Regarding neuropathies, assess for areas of hypo
esthesia (light touch, pinprick, temperature and
anhidrosis), especially peripheral nerve trunks
and cutaneous nerves.
The most common nerve affected is the posterior
tibial nerve. Others commonly damaged are the
ulnar, median, lateral popliteal, and facial nerves.
Bedsides sensory loss, there may be associated
tenderness and motor loss.
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42. Eye damage is most often seen with facial lesions.
Lagophthalmos (inability to close the eye), a late
finding in LL, results from involvement of the
zygomatic and temporal branches of the facial
nerve (cranial nerve, CN VII.
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43. Involvement of the ophthalmic branch of the
trigeminal nerve (CN V2) can result in reduced
corneal reflex, leaving dry eyes and reduced
blinking.
Others ;Saddle nose, madarosis
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45. DIAGNOSIS
The diagnosis of leprosy is primarily a clinical
one. Diagnosis was based on 1 of 3 signs:
Hypo pigmented or reddish patches with
definite loss of sensation
Thickened peripheral nerves
Acid-fast bacilli on skin smear or biopsy
material
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46. MANAGEMENT
INVESTIGATIONS
Tissue Smear Testing/Slit-skin Smear (Skin
Biopsy): An incision is made in the skin, and the
scalpel blade is used to obtain fluid from a
lesion. The fluid is placed on a glass slide and
stained by using the Ziehl-neelsen acid-fast
method or the fite method to look for organisms
per 100 bacilli.
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47. Skin smears have specificity but low sensitivity
because 70% of all patients with leprosy have
negative smears. However, this test is useful
because it detects the most infectious patients.
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48. HISTAMINE TESTING: This is used to diagnose
postganglionic nerve injury. Histamine
diphospate is dropped on normal skin and
affected skin, and a pinprick is made through
each site. The site forms a wheal on normal skin
but not where nerve damage is present.
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49. METHACHOLINE SWEAT TESTING: An
intradermal injection of methacholine
demonstrates the absence of sweating in
leprosy lesions. This test is useful in dark-
skinned patients in whom the flare with the
histamine test cannot be seen.
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50. TREATMENT
The management of leprosy includes early
pharmacotherapy and physical, social, and
psychological rehabilitation.
The goals of pharmacotherapy are to stop the
infection, reduce morbidity, prevent
complications and eradicate the disease.
leprosy 2017 mwila
51. Since 1981, MDT (Multiple drug therapy) has
been advocated by WHO and The USA. MDT
prevents dapsone resistance, quickly reduces
contagiousness, and reduces relapses, reactions,
and disabilities.
leprosy 2017 mwila
52. TREATMENT PLANS
NON- PHARMACOLOGICAL/ PATIENT
EDUCATION
Patients first need an explanation of the
diagnosis and prognosis. Their fears should be
addressed because of the cultural stigma
associated with leprosy.
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53. The physician should also refute any myths that
the patient may have about leprosy. Patients
may need psychological counseling because they
may have difficulty in coming to terms with the
disease or in feeling rejected by society. The
patient should be reassured that, within a few
days of starting MDT, they are not infectious and
can lead a normal life.
leprosy 2017 mwila
54. Patients need education about how to deal with
anesthesia of a hand or foot. They must learn to
carefully inspect their extremities for trauma daily.
Patients should also be told to wear proper
footwear and protective equipment as necessary.
Inexpensive canvas shoes with protective insoles
are as effective as special orthopedic shoes.
Inspecting limbs and eyes for onset of anesthesia or
weakness is also important.
leprosy 2017 mwila
55. Physical therapy and occupational therapy are
important tools in rehabilitation. Patients must
learn how to recognize the onset of lepra reactions,
and they should be told to seek immediate medical
attention if these reactions develop.
Potential deformities can be prevented by
educating patients about how to deal with existing
nerves damage and by treating any sequelae of this
damage.
leprosy 2017 mwila
56. PHARMACOLOGICAL TREATMENT
The length of treatment ranges from 6
months to 2 years.
Patients are considered non-infectious within 1-
2 weeks of treatment (usually after the first
dose). These drugs are conveniently packaged in
monthly calendar blister packs. Monitor for
drug resistance and adverse reactions to
medications.
leprosy 2017 mwila
57. Paucibacillary disease can be treated with a
combination of 2 drugs, whereas Multibacillary
disease requires triple-drug therapy.
Single skin lesions (Paucibacillary) can be treated
with a single dose of 3 drugs. The length of
treatment depends on the type of disease and
on the access to drugs.
leprosy 2017 mwila
58. Current WHO recommendations for
treatment of leprosy are as follows:
Paucibacillary disease: Dapsone 100mg/day plus
rifampicin 600mg once a month for 6 months.
Multibacillary disease: Dapsone 100mg/day plus
rifampicin 600mg once a month plus Clofazimine
300mg once a month and 50mg/day for 1 year.
Single skin lesion: A single dose of rifampicin 600mg,
Ofloxac in 400mg, and Minocycline 100mg. This is
given as single doses
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59. SURGICAL TREAMENT
Emergency surgery may be necessary if a
patient with profound nerve inflammation
presents with a nerve abscess or loss of nerve
function secondary to compression.
leprosy 2017 mwila
60. Prompt recognition and surgical drainage of the
abscess can often restore nerve function.
Elective surgery may be required for correction
of lagophthalmos (i.e. inability to close the eye).
Reconstructive surgery can be used to repair
nasal collapse in LL.
Other surgery may be needed to improve
function or for cosmesis. Contractures can be
surgically repaired.
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61. COMPLICATIONS
If severe and left untreated; leprosy can cause
clinically significant and debilitating deformity
such as loss of digits.
• Lagophthalmos
• Madalosis
• Saddle nose
• Nerve damage
• Reversal reactions.
leprosy 2017 mwila
62. REHABILITATION OF A PATIENT WITH
LEPROSY
Rehabilitation is the important in leprosy
control. Prompt treatment and detection is
important. This may include accessories and
corrective surgical procedures.
Socio-economic and vocational rehabilitation
also forms an integral part in the care of leprosy
patient.
leprosy 2017 mwila
64. Quiz t/f
1. Toxoplasmosis intermediate host could be a
birds.
2. The cats are the definitive hosts of T. Gondii
3. The period during an epileptic seizure is
referred to as ictal time
4. Toxoplasmosis is a fungal disease
5. Orientation of the patient after an epileptic
attack is not necessary
leprosy 2017 mwila