National TB program (New), Nepal
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From the introduction of new diagnosing technique Gene Xpert , diagnosing & treating TB has been a lot easier. So Nepal Govt. has adapted few changes in past t/t. This slide consists of slides on new case as well as MDR t/t.
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NTEP (National Tuberculosis Elimination Programme).pptx
Dr. Immanuel Joshua outlines key priorities and goals for ending tuberculosis (TB) globally and in India by 2025. The goals include reducing TB deaths and incidence rates by 90% and 80% respectively compared to 2015, and achieving zero catastrophic expenditures due to TB. Treatment duration and costs vary depending on whether TB is drug-sensitive or drug-resistant. India has committed to ending TB five years ahead of the global 2030 goal through its TB Free India campaign launched in 2018.
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Pulmonary tuberculosis is caused by the bacterium Mycobacterium tuberculosis and is spread through inhaling droplets from an infected person when they cough, sneeze, or laugh. It is a chronic infection characterized by weight loss. Diagnosis involves chest x-rays, sputum tests, and the Mantoux tuberculin skin test. Treatment requires taking multiple antibiotics like isoniazid and rifampin daily for 6-12 months to prevent resistance. Complications can include infection of bones, brain, liver or kidneys if left untreated. Prevention involves proper ventilation, covering coughs, mask wearing, vaccination, and completing the full drug regimen.
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CASE PRESENTATION : PYREXIA OF UNKNOWN ORIGIN / Hemophagocytic lymphohistioc...
CASE PRESENTATION : PYREXIA OF UNKNOWN ORIGIN / Hemophagocytic lymphohistioc...Dr. Darayus P. Gazder
A 71-year-old male presented with 2 months of fever, headaches, and weight loss. Initial workup revealed anemia, elevated liver enzymes and inflammatory markers. He was treated for enteric fever but did not improve. Further testing showed pancytopenia, a weakly positive ANA, and a bone marrow biopsy suggestive of granulomas. He developed cough and hypoxemia. Imaging found pleural effusions and lung consolidation. The working diagnosis shifted to tuberculosis given suggestive bone marrow findings. Treatment with antitubercular therapy and steroids was started.Approch to cough in children
This document provides an overview of the approach to cough in children. It begins with background on cough and the cough reflex pathway. It then discusses classifications of cough based on duration, quality, and etiology. The document outlines the important components of history taking and physical examination for a child with cough. It recommends investigations such as chest X-ray, pulmonary function tests, and bronchoscopy if needed. The document concludes with guidelines for managing cough in children based on its underlying cause.
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This document discusses shortness of breath (dyspnoea), including its definition, grading scales, common causes, history taking, physical examination findings, differential diagnosis, initial investigations, and basic management. It defines dyspnoea as an uncomfortable sensation of breathing that feels inappropriate or disproportionate. Grading scales like the MRC and NYHA are described. Common causes involve the cardiovascular, respiratory, and other body systems. A thorough history and physical exam are important for determining the underlying etiology. Initial tests may include pulse oximetry, peak flow measurement, chest x-ray, ECG, and lung biopsy. Treatment is aimed at addressing the specific cause, and may involve pharmacological therapies, oxygen supplementation, or non-
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NTEP (National Tuberculosis Elimination Programme).pptx
Dr. Immanuel Joshua outlines key priorities and goals for ending tuberculosis (TB) globally and in India by 2025. The goals include reducing TB deaths and incidence rates by 90% and 80% respectively compared to 2015, and achieving zero catastrophic expenditures due to TB. Treatment duration and costs vary depending on whether TB is drug-sensitive or drug-resistant. India has committed to ending TB five years ahead of the global 2030 goal through its TB Free India campaign launched in 2018.
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This document provides guidelines for tuberculosis management under the Revised National Tuberculosis Control Program (RNTCP) in India. It discusses Delhi's high TB incidence rate and key risk factors. It outlines diagnostic tools and algorithms for presumptive pulmonary, extra-pulmonary, pediatric, and drug-resistant TB. It also describes case definitions, classification by anatomical site and drug resistance, and drug sensitive TB treatment regimens. Key points covered include the national guidance on regimens, fixed-dose drug combinations, daily dosage schedules, managing treatment adherence through ICT-based monitoring, and pediatric dispersible formulations.
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Pulmonary tuberculosis (tb)
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CASE PRESENTATION : PYREXIA OF UNKNOWN ORIGIN / Hemophagocytic lymphohistioc...
CASE PRESENTATION : PYREXIA OF UNKNOWN ORIGIN / Hemophagocytic lymphohistioc...Dr. Darayus P. Gazder
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This document provides an overview of the approach to cough in children. It begins with background on cough and the cough reflex pathway. It then discusses classifications of cough based on duration, quality, and etiology. The document outlines the important components of history taking and physical examination for a child with cough. It recommends investigations such as chest X-ray, pulmonary function tests, and bronchoscopy if needed. The document concludes with guidelines for managing cough in children based on its underlying cause.
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This document discusses shortness of breath (dyspnoea), including its definition, grading scales, common causes, history taking, physical examination findings, differential diagnosis, initial investigations, and basic management. It defines dyspnoea as an uncomfortable sensation of breathing that feels inappropriate or disproportionate. Grading scales like the MRC and NYHA are described. Common causes involve the cardiovascular, respiratory, and other body systems. A thorough history and physical exam are important for determining the underlying etiology. Initial tests may include pulse oximetry, peak flow measurement, chest x-ray, ECG, and lung biopsy. Treatment is aimed at addressing the specific cause, and may involve pharmacological therapies, oxygen supplementation, or non-
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1. Status asthmaticus is acute severe asthma that fails to respond to conventional therapy like inhaled beta-agonists and oral steroids.
2. Management involves 3 pillars - oxygen, nebulized beta-agonists like salbutamol, and steroids like intravenous hydrocortisone.
3. If the child does not improve with initial treatments, additional therapies may be needed like subcutaneous or intravenous beta-agonists, magnesium sulfate, or aminophylline. Mechanical ventilation could be required if the child does not respond to medical management
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This document describes several neonatal reflexes present in newborn infants, including Moro's reflex, the palmar grasp, tonic neck reflex, rooting reflex, and sucking reflex. These reflexes are unconditioned responses to specific stimuli and help assess neurodevelopment. The document provides details on what elicits each reflex, the typical response, when they appear and disappear during development, and potential abnormalities if a reflex is absent, exaggerated, or persists beyond the normal timeframe. Understanding neonatal reflexes is important for evaluating infant development and identifying possible neurodevelopmental issues.
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1. Status asthmaticus is acute severe asthma that fails to respond to conventional therapy like inhaled beta-agonists and oral steroids.
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3. If the child does not improve with initial treatments, additional therapies may be needed like subcutaneous or intravenous beta-agonists, magnesium sulfate, or aminophylline. Mechanical ventilation could be required if the child does not respond to medical management
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This document describes several neonatal reflexes present in newborn infants, including Moro's reflex, the palmar grasp, tonic neck reflex, rooting reflex, and sucking reflex. These reflexes are unconditioned responses to specific stimuli and help assess neurodevelopment. The document provides details on what elicits each reflex, the typical response, when they appear and disappear during development, and potential abnormalities if a reflex is absent, exaggerated, or persists beyond the normal timeframe. Understanding neonatal reflexes is important for evaluating infant development and identifying possible neurodevelopmental issues.
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Simple vs. Complex seizure
Possible explanation of febrile seizure
Risk Factors for Febrile Seizures
Risk Factors for Recurrence of Febrile Seizure
Risk Factors for Occurrence of Subsequent Epilepsy After a Febrile Seizure
Genetic Factors
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ATT.pptx
This document provides guidelines for the treatment of tuberculosis (TB). It discusses the causative bacteria of TB, types of TB infections, methods for diagnosing TB, treatment approaches, and special considerations for treating TB in high-risk groups like those with HIV/AIDS or liver disease. The treatment guidelines recommend a two-phase antibiotic regimen using a combination of first-line drugs over a period of 6-9 months depending on risk factors and response to treatment. Considerations for treating drug-resistant TB and managing TB in patients with renal or hepatic impairment are also covered.
RS TB UPDATE.pptx
The document provides information on tuberculosis (TB) in India, including:
1. Objectives of the National Strategic Plan for TB which include achieving high notification and treatment success rates as well as improving outcomes for drug resistant and HIV-associated TB cases.
2. Definitions related to TB including presumptive TB, drug resistant TB, new and previously treated cases, and treatment outcomes.
3. Guidelines for diagnosis and treatment of drug susceptible and drug resistant TB, including use of newer drugs and shorter regimens for MDR-TB.
4. Criteria for diagnosis of non-tuberculous mycobacterial lung disease.
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B (PMDT) can be defined as “all associated functions related to providing services based in the TB strategy in order to achieve the targets set for drug-resistant TB in the Global Plan to Stop TB 2011–2015”
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This document provides information on multi-drug resistant tuberculosis (MDR-TB). It discusses the epidemiology and definitions of drug-resistant TB. It describes how to diagnose DR-TB through tests like Xpert MTB/RIF, line probe assay, and culture and drug susceptibility testing. Treatment options for DR-TB are also outlined, including shorter standardized treatment regimens and longer regimens. Criteria for determining appropriate treatment regimens and defining treatment outcomes are also summarized.
MOT
1. Tuberculosis remains a major global health problem, with an estimated 2 billion people infected and 10 million new active cases each year resulting in 1.5 million deaths.
2. Standard short course DOTS therapy involves a combination of drugs administered over 6-9 months depending on the category of TB. Adverse effects of the main anti-TB drugs are discussed.
3. Multidrug resistant TB and extensively drug resistant TB present significant treatment challenges, requiring prolonged courses of second-line drugs and close monitoring given their increased toxicity. Preventing further emergence of drug resistance is critical.
MOT
1. The document discusses the management of tuberculosis, including the history, statistics, principles of treatment, protocols, side effects of drugs, and the Revised National Tuberculosis Control Programme in India.
2. It covers topics like tuberculosis and diabetes, tuberculosis and HIV co-infection, multi-drug resistant tuberculosis, and paradoxical reactions seen with antituberculosis treatment and antiretroviral therapy.
3. Guidelines are provided for treatment of different categories of tuberculosis patients, management of drug interactions and adverse effects, and regimens for multi-drug resistant cases.
New Normal in radiation Oncology.pptx
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Updated Part -3 Management of TB.. DR. Kiran G. Piparva 2020 [Autosaved].pptx
The document discusses guidelines for treating tuberculosis (TB) according to the National Tuberculosis Elimination Programme (NTEP) in India. It outlines the goals of TB treatment, general principles of combination drug therapy, and categories of drug-sensitive and drug-resistant TB. It provides details on recommended drug regimens for different types of TB cases, including mono drug-resistant TB, rifampin-resistant or multidrug-resistant TB, and management of associated adverse drug reactions. It also covers TB treatment in special populations and preventive therapy for latent TB infection.
Tb treatment new
This document provides treatment guidelines for tuberculosis. It outlines the aims of TB treatment as curing the patient, preventing death from active or relapsed TB, decreasing transmission, and preventing drug resistance. It describes the initial and continuation phases of treatment for new and previously treated cases. It also defines different types of TB cases and provides recommended drug regimens and dosages depending on the category of TB patient. Isoniazid, rifampicin, pyrazinamide, and ethambutol are first-line oral drugs, while streptomycin and thioacetazone are also mentioned. BCG vaccination guidelines are also briefly covered.
Treatment of Tuberculosis
The presentation included treatment principles of Tuberculosis with first line drugs as per the recent RNTCP guidelines in India on DAILY ATT.
Similar to National TB program (New), Nepal (20)
Diagnosis and management of tuberculosis with revised rntcp
Diagnosis and management of tuberculosis with revised rntcp
Updated Part -3 Management of TB.. DR. Kiran G. Piparva 2020 [Autosaved].pptx
Updated Part -3 Management of TB.. DR. Kiran G. Piparva 2020 [Autosaved].pptx
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- 1. NATIONAL TB PROGRAM, NEPAL TB REGIMEN ANNUAL REPORT 2074/2075 8/13/2019 NISCHAL SHRESTHA 1
- 2. Type of TB Intensive Phase Continuation Phase New TB Cases All forms: - Adult & childhood - Bacteriological or clinically diagnosed - pulmonary or extra-pulmonary 2 HRZE 4HR New TB (severe cases) All forms: E.g. CNS TB, Musculoskeletal TB, Miliary TB 2HRZE 7 HRE with the possibility of 3 HRE in the end 8/13/2019 NISCHAL SHRESTHA 2
- 3. For all the retreatment cases • Xpert MTB/Rif test or CB-NAAT (cartridge based nucleic acid amplification test): >detect bacilli and resistance to Rif , within 2 hours. >This test is done to see the status of resistance to Rifampicin followed by line probe assay (LPA) among those having MTB +ve and Rifampicin sensitive for Isoniazid resistance status. ATT drug that goes resistance fastest is Isonoazid. 8/13/2019 NISCHAL SHRESTHA 3
- 4. Xpert MTB/ Rif Rifampicin sensitive LPA- isoniazid sensitive 2 HRZE 4 HR Rifampicin sensitive LPA –isoniazid resistant 6 HRZE + Levofloxacin (full duration) Rifampicin sensitive LPA –isoniazid not done because of no access to LPA 6 HRZE (full duration) All patients with TB meningitis and TB pericarditis will also receive steroids in addition to TB t/t. NTP no longer recommends category II which includes streptomycin to be used and officially phased out category II regimen 8/13/2019 NISCHAL SHRESTHA 4
- 5. MDR-TB t/t Regimen Kanamycin Km Moxifloxacin / levofloxacin Mfx / Lfx Ethionamide Eto Clofazimine Cfz Pyrazinimide Z Ethambutol E Cycloserine Cs For t/t of MDR regimen, NTP has also initiated a shorter MDR t/t regimen as well as conventional longer regimen. 8/13/2019 NISCHAL SHRESTHA 5
- 6. Z E Cs O Km Eto Z Cs O Eto 1ST LINE 2ND LINE 6 months 12 months Conventional MDR TB t/t 8/13/2019 NISCHAL SHRESTHA 6
- 7. Z E Cfz O K Eto Z E Cfz O 4-6 months 5 months 1ST LINE 2ND LINE Shorter MDR TB t/t Regimen (STR) 8/13/2019 NISCHAL SHRESTHA 7
- 8. Kanamycin is not to be included in t/t of MDR/RR –TB patients on longer regimens. Bedaquiline (Bdq) is a new class drug specifically targeting mycobacterial ATP synthetase. Is given for 6 months in pre- XDR and XDR TB t/t regimen. 8/13/2019 NISCHAL SHRESTHA 8