- Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and usually affects the lungs. It spreads through the airborne transmission of droplet nuclei produced by infected individuals.
- M. tuberculosis bacteria are rod-shaped, acid-fast bacilli that are ingested by alveolar macrophages in the lungs after inhalation. This begins an infection that may develop into active or latent tuberculosis depending on the immune response.
- Active tuberculosis may be primary, occurring after initial infection, or post-primary, occurring from reactivation of dormant bacteria. It often involves the upper lungs and can cause cavitary lesions and pneumonia if untreated.
This presentation includes introduction, properties, transmission, epidemiology, pathogenesis, mechanism of infection, immunity and hypersensitivity, clinical manifestations, diagnosis, treatment, prevention and control of MYCOBACTERIUM TUBERCULOSIS.
A type of virus that causes herpes infections and has DNA as its genetic material. There are two types of human herpesviruses. Infections with type 1 viruses cause cold sores on the lips or nostrils. Infections with type 2 viruses cause sores on the genitals (external and internal sex organs and glands).
Forms round colonies with a fluorescent greenish color, sweet odor, and b-hemolysis.
Pyocyanin- nonfluorescent bluish pigment;
pyoverdin- fluorescent greenish pigment;
pyorubin, and pyomelanin
Some strains have a prominent capsule (alginate).
Proteases
Serine protease, metalloprotease and alkaline protease cause tissue damage and help bacteria spread.
Phospholipase C: a hemolysin
Exotoxin A: causes tissue necrosis and is lethal for animals (disrupts protein synthesis); immunosuppressive.
Exoenzyme S and T: cytotoxic to host cells. Ear infections
Otitis externa: mild in swimmers; malignant (invasive) in diabetic patients.
Chronic otitis media
Osteochondritis of the foot.
Urinary tract infection
Sepsis: most cases originate from infections of lower RT, UT, and skin and soft tissue. Ecthyma gangrenosum (hemorrhagic necrosis of skin) may be seen in some patients
Haemophilus is the name of a group of bacteria. There are several types of Haemophilus. They can cause different types of illnesses involving breathing, bones and joints, and the nervous system. One common type, Hib (Haemophilus influenzae type b), causes serious disease. It usually strikes children under 5 years old
This presentation includes introduction, properties, transmission, epidemiology, pathogenesis, mechanism of infection, immunity and hypersensitivity, clinical manifestations, diagnosis, treatment, prevention and control of MYCOBACTERIUM TUBERCULOSIS.
A type of virus that causes herpes infections and has DNA as its genetic material. There are two types of human herpesviruses. Infections with type 1 viruses cause cold sores on the lips or nostrils. Infections with type 2 viruses cause sores on the genitals (external and internal sex organs and glands).
Forms round colonies with a fluorescent greenish color, sweet odor, and b-hemolysis.
Pyocyanin- nonfluorescent bluish pigment;
pyoverdin- fluorescent greenish pigment;
pyorubin, and pyomelanin
Some strains have a prominent capsule (alginate).
Proteases
Serine protease, metalloprotease and alkaline protease cause tissue damage and help bacteria spread.
Phospholipase C: a hemolysin
Exotoxin A: causes tissue necrosis and is lethal for animals (disrupts protein synthesis); immunosuppressive.
Exoenzyme S and T: cytotoxic to host cells. Ear infections
Otitis externa: mild in swimmers; malignant (invasive) in diabetic patients.
Chronic otitis media
Osteochondritis of the foot.
Urinary tract infection
Sepsis: most cases originate from infections of lower RT, UT, and skin and soft tissue. Ecthyma gangrenosum (hemorrhagic necrosis of skin) may be seen in some patients
Haemophilus is the name of a group of bacteria. There are several types of Haemophilus. They can cause different types of illnesses involving breathing, bones and joints, and the nervous system. One common type, Hib (Haemophilus influenzae type b), causes serious disease. It usually strikes children under 5 years old
TB
Tuberculosis
Extra-pulmonary TB.
As of 2017, about two billion people worldwide are infected with Mycobacterium tuberculosis, the causative pathogen of tuberculosis disease, commonly known as ‘TB’.
However, for the vast majority, (90-95%) of infected individuals, the infection is contained by the immune system and cannot multiply.
In other words, the TB disease remains latent, or dormant, as opposed to active, which usually causes symptoms and can easily be transmitted to others.
When the host’s immune system becomes compromised, e.g. due to HIV or malnutrition and aging, TB can reactivate, and become very serious, especially if the infection spreads through the body.
Moreover, people with active TB can easily infect 10-15 other people via close contact within a year.
Mycobacteria are slender, rod-shaped, and need high levels of oxygen to survive, i.e., “strict aerobes”.
They possess a waxy cell wall that is capable of retaining dyes even when exposed to alcohol.
Thus they are referred to as “acid-fast”, appearing as bright- red colored rods when a Ziehl–Neelsen stain is used.
The wall also makes them incredibly hardy and allows them to resist weak disinfectants and survive on dry surfaces for months.
M. tuberculosis is usually transmitted via inhalation, which is how they gain entry into the lungs.
Although we breathe in all sorts of viruses and bacteria all the time, we have defenses that take care of most of them.
For one, the air that we breathe in is turbulent in the upper airways and drives most bacteria against mucus which is then cleared pretty quickly.
Ultimately, though, TB can avoid the mucus traps and make its way to the deep airways and alveoli where we have macrophages that eat up foreign cells, digest and destroy them.
With TB, they recognize foreign proteins on their cell surface, and phagocytize them, or essentially package them into a space called a phagosome.
In most cases, the macrophage then fuses the phagosome with a lysosome, which has hydrolytic enzymes that can pretty much break down any biochemical molecule.
TB’s tricky, though, and once inside the macrophage, they produce a protein that inhibits this fusion, which allows the mycobacterium to survive.
It doesn’t just survive, though, it proliferates and creates a localized infection.
At this point, somebody has developed primary tuberculosis, which means that they have signs of infection soon after being exposed to TB.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
India Diagnostic Labs Market: Dynamics, Key Players, and Industry Projections...Kumar Satyam
According to the TechSci Research report titled “India Diagnostic Labs Market Industry Size, Share, Trends, Competition, Opportunity, and Forecast, 2019-2029,” the India Diagnostic Labs Market was valued at USD 16,471.21 million in 2023 and is projected to grow at an impressive compound annual growth rate (CAGR) of 11.55% through 2029. This significant growth can be attributed to various factors, including collaborations and partnerships among leading companies, the expansion of diagnostic chains, and increasing accessibility to diagnostic services across the country. This comprehensive report delves into the market dynamics, recent trends, drivers, competitive landscape, and benefits of the research report, providing a detailed analysis of the India Diagnostic Labs Market.
Collaborations and Partnerships
Collaborations and partnerships among leading companies play a pivotal role in driving the growth of the India Diagnostic Labs Market. These strategic alliances allow companies to merge their expertise, strengthen their market positions, and offer innovative solutions. By combining resources, companies can enhance their research and development capabilities, expand their product portfolios, and improve their distribution networks. These collaborations also facilitate the sharing of technological advancements and best practices, contributing to the overall growth of the market.
Expansion of Diagnostic Chains
The expansion of diagnostic chains is a driving force behind the growing demand for diagnostic lab services. Diagnostic chains often establish multiple laboratories and diagnostic centers in various cities and regions, including urban and rural areas. This expanded network makes diagnostic services more accessible to a larger portion of the population, addressing healthcare disparities and reaching underserved populations. The presence of diagnostic chain facilities in multiple locations within a city or region provides convenience for patients, reducing travel time and effort. A broader network of labs often leads to reduced waiting times for appointments and sample collection, ensuring that patients receive timely and efficient diagnostic services.
Rising Prevalence of Chronic Diseases
The increasing prevalence of chronic diseases is a significant driver for the demand for diagnostic lab services. Chronic conditions such as diabetes, cardiovascular diseases, and cancer require regular monitoring and diagnostic testing for effective management. The rise in chronic diseases necessitates the use of advanced diagnostic tools and technologies, driving the growth of the diagnostic labs market. Additionally, early diagnosis and timely intervention are crucial for managing chronic diseases, further boosting the demand for diagnostic lab services.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
2. Tuberculosis, one of the oldest diseases known to affect
humans, is caused by bacteria belonging to the
Mycobacterium tuberculosis complex.
The disease usually affects the lungs, although in up to
one-third of cases other organs are involved
If untreated, the disease may be fatal within 5 years in
more than half of cases
Transmission usually takes place through the airborne
spread of droplet nuclei produced by patients with
infectious pulmonary tuberculosis
3. M. tuberculosis is a rod-shaped, non-spore-forming, thin
aerobic bacterium measuring 0.5 m by 3 m.
Once stained, the bacilli cannot be decolorized by acid
alcohol, a characteristic justifying their classification as
acid-fast bacilli.
Other organisms showing acid fastness include ;
Nocardia and Rhodococcus, Legionella micdadei, and
the protozoa Isospora and Cryptosporidium.
4.
5. Pathogenesis of tuberculosis
From exposure to infection;
M. tuberculosis is most commonly transmitted from a
patient with infectious pulmonary tuberculosis to other
persons by droplet nuclei, which are aerosolized by
coughing, sneezing, or speaking.
The tiny droplets dry rapidly; the smallest (10 m in
diameter) may remain suspended in the air for several
hours and may gain direct access to the terminal air
passages when inhaled.
6. There may be as many as 3000 infectious nuclei
per cough.
Determinants of transmission of tuberculosis;
1. The probability of contact with a case of
tuberculosis,
2. the intimacy and duration of that contact,
3. the degree of infectiousness of the case
4. Crowding in poorly ventilated rooms is one of
the most important factors in the transmission of
tubercle bacilli, since it increases the intensity of
contact with a case
7. Patients who have cavitary pulmonary disease or
tuberculosis of the respiratory tract (endobronchial or
laryngeal tuberculosis produce sputa containing as many
as 105 AFB/mL.
Patients with sputum smear–negative/culture-positive
tuberculosis are less infectious,
and those with culture-negative pulmonary disease and
extrapulmonary tuberculosis are essentially noninfectious.
8. From infection to disease;
the risk of developing disease after being infected
depends largely on endogenous factors, such as
1. the individual’s innate susceptibility to disease
2. and level of function of cell-mediated immunity.
Clinical illness directly following infection is classified as
primary tuberculosis and is common among children up
to 4 years of age.
Dormant bacilli, however, may persist for years before
reactivating to produce secondary (or postprimary)
tuberculosis, which is often infectious.
9. Risk factor for active tuberculosis;
Recent infection (1 year) 12.9
Fibrotic lesions (spontaneously healed) 12-20
Comorbidity
HIV infection
Silicosis
Chronic renal failure / hemodialysis
Diabetes
Intravenous drug abuse
Immunosuppresant treatment
Gastrectomy
Jejunoileal bypass
Post transplantation period
100
30
20-25
2-4
10-30
10
2-5
30-60
20-70
Malnutrition and severe underweight 2
10. PATHOGENESIS AND IMMUNITY
the majority of inhaled bacilli are trapped in the upper
airways and expelled by ciliated mucosal cells, a fraction
(usually 10%) reach the alveoli.
There, nonspecifically activated alveolar macrophages
ingest the bacilli.
The balance between the bactericidal activity of the
macrophage and the number and virulence of the bacilli
determines the events following phagocytosis.
11. In the initial stage of host-bacterium interaction, either the
host’s macrophages contain bacillary multiplication by
producing proteolytic enzymes and cytokines or the
bacilli begin to multiply.
About 2 to 4 weeks after infection, two additional host
responses to M. tuberculosis develop:
1. a tissue-damaging response and
2. a macrophage- activating response.
12. The tissue-damaging response is the result of a
delayed-type hypersensitivity (DTH) reaction to
various bacillary antigens; it destroys nonactivated
macrophages that contain multiplying bacilli.
The macrophage-activating response is a cell-
mediated phenomenon resulting in the activation
of macrophages that are capable of killing and
digesting tubercle bacilli. Although both of these
responses can inhibit mycobacterial growth, it is
the balance between the two that determines the
form of tuberculosis that will develop
subsequently.
13. With the development of specific immunity and
the accumulation of large numbers of activated
macrophages at the site of the primary lesion,
granulomatous lesions (tubercles) are formed.
These lesions consist of lymphocytes and
activated macrophages, such as epithelioid cells
and giant cells.
14. Cell-mediated immunity is critical at this early stage. In
the majority of infected individuals, local macrophages
are activated when bacillary antigens processed by
macrophages stimulate T lymphocytes to release a variety
of lymphokines.
These activated cells aggregate around the lesion’s center
and effectively neutralize tubercle bacilli without causing
further tissue destruction.
In the central part of the lesion, the necrotic material
resembles soft cheese (caseous necrosis)— a phenomenon
that may also be observed in other conditions, such as
neoplasms.
15. Even when healing takes place, viable bacilli may remain
dormant within macrophages or in the necrotic material
for years or even throughout the patient’s lifetime.
These “healed” lesions in the lung parenchyma and hilar
lymph nodes may later undergo calcification.
In a minority of cases, the macrophage-activating
response is weak, and mycobacterial growth can be
inhibited only by intensified DTH reactions, which lead
to tissue destruction.
16. The lesion tends to enlarge further, and the surrounding
tissue is progressively damaged. At the center of the
lesion, the caseous material liquefies. Bronchial walls as
well as blood vessels are invaded and destroyed, and
cavities are formed.
The liquefied caseous material, containing large numbers
of bacilli, is drained through bronchi. Within the cavity,
tubercle bacilli multiply well and spread into the airways
and the environment through expectorated sputum.
In the early stages of infection, bacilli are usually
transported by macrophages to regional lymph nodes,
from which they disseminate widely to many organs and
tissues
17. Cell-mediated immunity confers partial protection
against M. tuberculosis,while humoral immunity
has no defined role in protection.
Clinical manifestations
Tuberculosis is classified as pulmonary or
extrapulmonary.
Before the recognition of HIV infection, 80% of
all cases of tuberculosis were limited to the lungs.
18. PULMONARY TUBERCULOSIS
Pulmonary tuberculosis can be categorized as primary or
postprimary (secondary).
PRIMARY DISEASE
Primary pulmonary tuberculosis results from an initial
infection with tubercle bacilli.
The lesion forming after infection is usually peripheral
and accompanied by hilar or paratracheal
lymphadenopathy, which may not be detectable on chest
radiography. In the majority of cases, the lesion heals
spontaneously and may later be evident as a small
calcified nodule (Ghon lesion).
19. In children and in persons with impaired immunity (e.g.,
those with malnutrition or HIV infection), primary
pulmonary tuberculosis may progress rapidly to clinical
illness.
The initial lesion increases in size and can evolve in
different ways.
Pleural effusion, a frequent finding, results from the
penetration of bacilli into the pleural space from an
adjacent subpleural focus.
In severe cases, the primary site rapidly enlarges, its
central portion undergoes necrosis, and acute cavitation
develops (progressive primary tuberculosis).
20. Tuberculosis in young children is almost invariably
accompanied by hilar or mediastinal
lymphadenopathy due to the spread of bacilli from
the lung parenchyma through lymphatic vessels.
Hematogenous dissemination, which is common
and is often asymptomatic, may result in the most
severe manifestations of primary M. tuberculosis
infection.
21. POST PRIMARY DISEASE
Also called adult-type, reactivation, or secondary
tuberculosis, postprimary disease results from
endogenous reactivation of latent infection and is usually
localized to the apical and posterior segments of the upper
lobes, where the high oxygen concentration favors
mycobacterial growth.
The extent of lung parenchymal involvement varies
greatly, from small infiltrates to extensive cavitary
disease.
22. With cavity formation, liquefied necrotic contents are
ultimately discharged into the airways, resulting in
satellite lesions within the lungs that may in turn
undergo cavitation.
Massive involvement of pulmonary segments or
lobes, with coalescence of lesions, produces
tuberculous pneumonia.
While up to one-third of untreated patients reportedly
succumb to severe pulmonary tuberculosis within a
few weeks or months after onset, others undergo a
process of spontaneous remission or proceed along a
chronic, progressively debilitating course
(“consumption”).