1. Mycobacterium is a genus of bacteria that can cause tuberculosis and leprosy. It has a waxy lipid cell wall and grows slowly.
2. The tuberculosis-causing bacteria include M. tuberculosis, M. bovis, M. africanum, and M. microti. Lepra bacilli that cause leprosy include M. leprae.
3. Diagnosis involves microscopy, culture, nucleic acid tests, tuberculin skin tests, chest x-rays, and analysis of symptoms. Treatment uses several first-line and second-line drugs in combination over 6-8 months to prevent drug resistance.
Clostridium are anerobic gram positive rod shaped spore forming organisms responsible to cause various life threatening diseases in humans like Gas gangrene, Tetanus, Botulism, etc
Vibrio cholera with other vibrio species are described in thispresentation along with their biochemical properties and laboratory diagnosis, A short slide on halophilic vibrios is also added
The use of a machine designed to follow repeatedly and automatically a predetermined sequence of individual operations.
AUTOMATED WASHING
AUTOMATED MEDIA PREPARATORS
AUTOMATED COLLECTION AND
PROCESSING OF SAMPLES
CYTOSPIN
AUTOMATED GRAM STAINING
AUTOMATED STREAKING
SPIRAL PLATER
AUTOMATED ANTIBIOTIC -
SENSITIVITY SYSTEM
AUTOMATIC COLONY COUNTER
AUTOMATED URINE MICROSCOPY -
ANALYSER
COLLECTION AND TRANSPORTATION OF CLINICAL SAMPLESNCRIMS, Meerut
Principles of Sample Collection:
Aseptic precautions to minimize chances of
contamination.
Appropriate anatomic sites
Adequate volume
Adequate no. of samples
Appropriate time
Appropriate container with proper labelling
Before initiation of anti-microbials
Adequate information in request form
Hepatitis B Surface Antigen (HBsAg), also known as Australia antigen is present on the surface of the Hepatitis B virus (HBV). This test detects the presence of Hepatitis B Surface Antigen (HBsAg) in the blood.
Reference: https://www.1mg.com/labs/test/hepatitis-b-s-1837
Clostridium are anerobic gram positive rod shaped spore forming organisms responsible to cause various life threatening diseases in humans like Gas gangrene, Tetanus, Botulism, etc
Vibrio cholera with other vibrio species are described in thispresentation along with their biochemical properties and laboratory diagnosis, A short slide on halophilic vibrios is also added
The use of a machine designed to follow repeatedly and automatically a predetermined sequence of individual operations.
AUTOMATED WASHING
AUTOMATED MEDIA PREPARATORS
AUTOMATED COLLECTION AND
PROCESSING OF SAMPLES
CYTOSPIN
AUTOMATED GRAM STAINING
AUTOMATED STREAKING
SPIRAL PLATER
AUTOMATED ANTIBIOTIC -
SENSITIVITY SYSTEM
AUTOMATIC COLONY COUNTER
AUTOMATED URINE MICROSCOPY -
ANALYSER
COLLECTION AND TRANSPORTATION OF CLINICAL SAMPLESNCRIMS, Meerut
Principles of Sample Collection:
Aseptic precautions to minimize chances of
contamination.
Appropriate anatomic sites
Adequate volume
Adequate no. of samples
Appropriate time
Appropriate container with proper labelling
Before initiation of anti-microbials
Adequate information in request form
Hepatitis B Surface Antigen (HBsAg), also known as Australia antigen is present on the surface of the Hepatitis B virus (HBV). This test detects the presence of Hepatitis B Surface Antigen (HBsAg) in the blood.
Reference: https://www.1mg.com/labs/test/hepatitis-b-s-1837
Mycobacterium tuberculosis-importance of TB day,classification of Mycobacterium species,Details on Mycobacterium tuberculosis-morphology,culture,resistance,biochemical reactions,antigenic characters,mode of transmission,pathogenesis,complications,lab diagnosis,treatment,DOTS Strategy and prophylaxis
Objective :
Describe the morphology and structure of mycobacterial tuberculosis ?
What are the tests required for mycobacterial infection :
Mantoux skin test
Sputum examination using Ziehl-Neelsen staining
Sputum culture using lowenstein-jensen media
Discuss the clinical features and transmission of mycobacterial tuberculosis.
What are the pathological changes in mycobacterium tuberculosis?
How to control mycobacterial infection in the environment and vaccine available?
done by : asem shadid , college of medicine .
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
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
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. 2 Long, slender bacilli with branching filamentous forms. Obligate pathogens, Saprophytic and Opportunistic. Lipid-rich waxy cell wall. Responsible for Chronic granulomatous lesions. In 1882 Robert Koch :
3. 3 CLASSIFICATION Tubercle bacilli: a. Human : M. tuberculosis, M. africanum b. Bovine : M. bovis c. Murine : M. microti. d. Avian : M. avium. e. Cold blooded: M.marinum Lepra bacilli: a. Human : M. leprae b. Rat : M. leprae murium
4. 4 3. Mycobacteria from skin ulcers. M. ulcerans, M. balnei, M. buruli. 4. Atypical Mycobacteriae: 5. Jhone’s bacillus: M. para tuberculosis. ( Chronic specific enteritis in cattle ) 6. Saprophytic Mycobacteria. M. butyricum. M. smegmatis, M.stercoris.
10. 6 CULTURAL CHARACTERS Doubling time 14 – 15 hrs. Optimum temperature 37º C . (No growth < 25º C & > 40º C) 1. Egg media: Lowenstein – Jensen medium. Dorset egg medium. L J medium : 2 - 6 weeks Sterilized by Inspissation. Glycerol, asparagines. Malachite green as selective agent. Egg albumen as solidifying agent. 2. Blood (Tarshis medium ). 3. Serum (Loeffler’s serum slope ).
11. 7 LIQUID MEDIA : Dubo’s medium. Middle –Brook medium. Bactec 12B medium. Uses : Sensitivity tests. Chemical tests. Preparation of antigens & vaccines.
12. 8 GROWTH : M. tuberculosisM. bovis. Heaped up & luxuriant Sparse (dysgonic) growth. (eugonic) Dry, rough, tuff Moist, smooth flat buff colour. with white colour. 0.5 % glycerol Sodium pyruate ( L J medium)( Stone brink's medium ) Grows on surface. Grows as band few mm. (Aerobe) below the surface (Anaerobe)
21. Resistant to thiophen – 2 – Carboxylic acid hydrazide (TCH) which is related to INH.1. To differentiate M.tuberculosisfrom M. bovis and Atypical mycobacteriae 2. To identify virulent & avirulent strains.
22.
23. Two types: 1.Cell wall insoluble polysaccharide antigens. Group specificity. 2.Cytoplasmic soluble protein antigens. Type specificity. TUBERCULIN PROTEIN
24. 12 PATHOGENESIS: Pulmonary alveoli. Taken up by Macrophages & multiplied. Primary site of infection in lower part of upper lobes / upper part of lower lobes - Ghon’s focus. With hilar lymphadenopathy (PRIMARY COMPLEX) Initiates CMI Inhalation Droplets, aerosols from patients & Cough spray from Animal
25. 13 Pathogenesis Contd……: Activation of specific T - cells (cytokines, gamma interferon production) DTHImmune response Formation of Tubercle. Activate macrophages ( Avascular granuloma) (Inhibits multiplication). Consumes much of O2 & produces acidosis. Most of the bacilli are killed. Resolution Some remain dormant. Protective Immunity. Post – primary disease.
26. 14 Avascular granuloma Central Zone of Caseous (Cheese like ) material dead T &B cells and macrophages surrounded by different types of cells. IL 2: Proliferation of Ag-primed T cells Gama INF: Enhances activity of macrophages & NK cells. TNF-ά (Cachectin): Induces cytokine secretion in the inflammatory area. Muscle wasting, fever.
27. 15 Expanding large Avascular granuloma (Tuberculomata). Erodes through wall of bronchus. Liquified contents discharged into the bronchus. CAVITY formed. Shelter for huge number of bacilli. Gets access to sputum Open case of TB. ( Transmissible case of TB )
28. 16 2. Ingestion : Unpasteurised milk Primary complex in tonsils, cervical LN & Ileocaecal region ( Mesenteric LN ). Initiates CMI. 3. Inoculation : Rare ( Occupational in anatomists , pathologists ). Skin with involvement of regional LN. Prosector’s warts.
39. 21 IMMUNITY & DTH (Allergy): CMI is useful. 6 – 8 weeks after infection : Tuberculin test reaction occurs. Described by Koch’s Phenomenon.
40. 22 INJECTED with TU antigen SC 4-6 wks later. GUINEA PIGINFECTEDWITH TB BACILLI. After 1 – 2 days Indurated lesion at the site of Injection. Undergoes rapid necrosis. Shallow ulcer Heals rapidly without involvement of regional lymph nodes. Koch’s phenomenon
41. 23 TUBERCULIN TEST Clemens von Pirquet (1907) : OT. Seibert (1939) : Purified Ag by Ammonium sulphate fractionation (PPD). Strength of PPD expressed in TU. A measured amount ( 5 – 10 TU ) is injected.
42. 24 MONTOUX TEST 5 TU of PPD injected Intradermally in Flexor aspect of forearm. (Tuberculin syringe) No scratch on itching. Read after 48 - 72 hrs . Induration. Only erythema not considerable. >10mm - Significant
43. 25 EPIDEMIOLOGY Transmissionamong households. Dusty environment , Hill dwellers (Silica) . Low Socio-economic status, Malnutrition. (A barometer of social welfare ) Asia & sub- Saharan nations are more prone.
44. 26 Every minute someone dies of TB in India. >5,00,000 die every year. If there is no effective action, 5 million may die of TB in the next few years. 1.8 million new cases every year. India has the highest burden of the disease in the world. Dr L S Chauhan, Director General (TBCP)Nov’ 6 2006 India Together
45. 27 RNTCP or Revised National Tuberculosis Control Program is the State-run Tuberculosis Control Initiative of the Government of India . It incorporates the principles of Directly observed treatment Short course (DOTS) - the global TB control strategy of the WHO. The program provides free of cost, quality Anti-Tubercular drugs through the PHCsand the private-sectorDOTS-providers.
46. 28 The DOTS strategy is cost-effective and is today the international standard for TB control programmes. To date, more than 180 countries are implementing the DOTS strategy. India has adapted the DOTS strategy in various parts of the country since 1993, with excellent results, and by March 2006 nationwide DOTS coverage has been achieved.
47. 29 Rapid DOTS expansion in India In 2000 , 2001 and 2002 more than a million patients were treated in this way in India. As a result nearly 2,00,000 lives were saved. Extensively drug-resistant TB (XDR-TB) in > 30 countries since 2006, multidrug-resistant TB (MDR-TB) and XDR-TB have recently become a particular focus of international concern.
48. 30 LAB. DIAGNOSIS 1.Primary TB If productive: Sputum If not productive: Bronchial washings/ brushings/ biopsy. 2.Secondary/Post Primary TB a. CSF b. Pleural fluid c. Synovial fluid.
49. 31 Decontamination & concentration methods. 1. Petroff’s method: Equal volumes of sputum & 4% NaoH Keep at 37º C with intermittent shaking for 20 mts. Neutralized with (Potassium dihydrogen orthophosphate). Centrifuge at 3000 rpm for 30mts. Deposit: Microscopy Culture.
50. 32 2.Non centrifugation & Non neutralization method: Equal volumes of sputum + 2% Cetrimonium bromide & 4% NaoH 5 mtsculture. Materials used for Homogenization: a. Diluted acids ( 6% H2 SO4, 3 % HCl ) b. N-Acetyl Cystein with NaoH. c. Pancreatin. d. Cetrimide.
51. 33 MICROSCOPY Minimum of 10,000 bacilli / ml of sputum. 100 fields must be examined . 1.Kinyoun’s method 2.Ziehl - Neelsen technique. 3.Fluorescent dye technique. Auramine Phenol, AuramineRhodamine dye.
52. 34 INTERPRETATION 3-9 bacilli in entire smear:1+ or more /entire smear: 2+ 10 or more / field: 3+ Beaded forms: M.tuberculosis Uniform: M.bovis
53. 35 2. CULTURE : A. Conventional method: Concentrated sample. L -J medium 35 - 37º C. Inspect weekly up to 8 weeks. B. Rapid diagnosis of growth: Bactec system: Radiometric detection of CO2.
54. 36 C. Fluorescent dye methods Activation of fluorescent dye by the released CO2 3.Nucleic acid technology: 1.Nucleic acid probes : Not sensitive 2.PCR: Conventional PCR is best. 4. Tuberculin test: 5. Serology: PHA . Ig M, Ig G and Ig A estimation ( Specific but not sensitive tests).
55. 37 X-Ray findings of pulmonary TB Primary complex in the hilar region
56. 38 PREVENTIVE MEASURES 1.General measures: Adequate nourishment. Good housing . Health education. Contact tracing. 2.Chemoprophylaxis: INH
57.
58. 40 3.IMMUNOPROPHYLAXIS:BCG Live attenuated vaccine. Bovine strain (Danish 1331 by 239 serial subcultures on Glycerin bile potato medium). Freeze dried vaccine (Normal saline). At birth / within 6 weeks of age. Intradermally over deltoid region. Dose : 0.1 mg in 0.1 ml. volume. Efficacy : 0 – 80 %.
59. 41 EVENTSAFTERINJECTION : Papule within 2 – 3 weeks. Enlarges to 4 – 8 mm within 5 weeks. Subsides and broken into ulcer. Heals spontaneously with scar formation within 6 - 12 weeks. Complications: Local : Abscess, indolent ulcer, Keloid. Regional: Local lymphadenopathy. General : Fever, mediastinal adenitis,
60. 42 CONTRAINDICATIONS Generalized eczema. Infective dermatosis. Hypo gamma globulinaemia. Immunodeficiency. Protection not absolute after vaccination, May suffer with milder form of disease.
61. 43 ANTI TUBERCULOSIS DRUGS First-line: Rifampicin (R) Pyrazinamide (Z) Isoniazid ( H ) Ethambutol Second-line: Amikacin, Capreomycin, Kanamycin and Ofloxacin, Streptomycin (Since 2005)
62. 44 SHORT COURSE CHEMOTHERAPY Drugs Initial Drugs Continuation phase phase Standard regime. RHZ 2M RH 4M Intermittent regime. RHZ 2M R3 H3 4M RHZ 2M R2 H2 4M R3H3Z3 2M R3 H3 4M Incase of high incidence of initial drug resistance. RHZE 2M RH 4M RHZS 2M RH 4M
63. 45 The challenge to Medical profession is to be prepared for all infectious diseases that may affect the practice.