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 that can affect the lungs and spread to other parts of the body. Diagnosis involves tests like chest x-rays, sputum examination, and the tuberculin skin test. Treatment requires taking multiple antibiotic drugs for 6-12 months to prevent resistance. Complications can include damage to bones, brain, liver, or kidneys if not properly treated.
Tuberculosis (TB) is a major public health issue in Nepal, with a high burden of the disease among vulnerable populations. This PowerPoint presentation provides a comprehensive overview of TB in Nepal, including the epidemiology, risk factors, diagnosis, treatment, and prevention strategies.
The presentation highlights the impact of TB on individuals, families, and communities in Nepal. We showcase the challenges of accessing healthcare in remote and impoverished areas, the lack of awareness and education about the disease, and the social stigma and discrimination faced by TB patients.
We also explore the efforts being made to address TB in Nepal. We showcase the national TB control program, which aims to improve access to diagnosis and treatment, and the partnerships between the government, non-governmental organizations, and international agencies to fight the disease.
Through this presentation, we aim to raise awareness about TB in Nepal and the importance of collaboration and innovation in finding solutions. We showcase the latest research and innovations in TB diagnosis and treatment, such as new drugs and vaccines, and the importance of integrating TB care with other health services.
We also highlight the importance of community engagement and empowerment in the fight against TB. We showcase the success stories of TB survivors and the role of community-based organizations in providing support and advocacy for TB patients and their families.
Overall, this PowerPoint presentation provides a valuable resource for understanding TB in Nepal and the efforts being made to address the disease. We hope to inspire action and collaboration to create a world where no one has to suffer from the devastating effects of TB.
Intro to TB
epidemiology of TB
Structure of Mycobacterium TB
pathogenesis of TB
Immunosuppression by Mycobacterium TB
types of TB
Clinical manifestation
Diagnosis
Treatment
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Tuberculosis (TB) is a major public health issue in Nepal, with a high burden of the disease among vulnerable populations. This PowerPoint presentation provides a comprehensive overview of TB in Nepal, including the epidemiology, risk factors, diagnosis, treatment, and prevention strategies.
The presentation highlights the impact of TB on individuals, families, and communities in Nepal. We showcase the challenges of accessing healthcare in remote and impoverished areas, the lack of awareness and education about the disease, and the social stigma and discrimination faced by TB patients.
We also explore the efforts being made to address TB in Nepal. We showcase the national TB control program, which aims to improve access to diagnosis and treatment, and the partnerships between the government, non-governmental organizations, and international agencies to fight the disease.
Through this presentation, we aim to raise awareness about TB in Nepal and the importance of collaboration and innovation in finding solutions. We showcase the latest research and innovations in TB diagnosis and treatment, such as new drugs and vaccines, and the importance of integrating TB care with other health services.
We also highlight the importance of community engagement and empowerment in the fight against TB. We showcase the success stories of TB survivors and the role of community-based organizations in providing support and advocacy for TB patients and their families.
Overall, this PowerPoint presentation provides a valuable resource for understanding TB in Nepal and the efforts being made to address the disease. We hope to inspire action and collaboration to create a world where no one has to suffer from the devastating effects of TB.
Intro to TB
epidemiology of TB
Structure of Mycobacterium TB
pathogenesis of TB
Immunosuppression by Mycobacterium TB
types of TB
Clinical manifestation
Diagnosis
Treatment
Antenatal care (ANC) coverage is an indicator of access and use of health care during pregnancy. The antenatal period presents opportunities for reaching pregnant women with interventions that may be vital to their health and wellbeing and that of their infants.
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Relation between family medicine.
Classification of medicine
Differentiating point between Different medicine
Medicine and health
Health and community medicine
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2. Pulmonary tuberculosis (TB)
ī¨ DEF:Tuberculosis is the infectious disease primarily
affecting lung parenchyma is most often caused by
mycobacterium tuberculosis.it may spread to any part
of the body including meninges,kidney,bones and
lymphnodes.
ī¨ Itâs the one of the most prevalent infections of
human beings and cotnributes considerably to
illness and death around the world . It is spread by
inhealing tiny droplets of salaiva from the coughs
or sneezes of an infected person . It is slowly
spreading ,chronic , granulomatus bacterial
infection charactarized by gradual wieght loss
5. CLASSIFICATION
ī¨ Class I (TB exposure)
īŽ (+) exposure
īŽ (-) Mantoux tuberculin test
īŽ (-) signs and symptoms suggestive of TB
īŽ (-) chest radiograph
6. CLASSIFICATION
ī¨ Class II (TB infection)
īŽ (Âą) exposure
īŽ (+) Mantoux tuberculin test
īŽ (-) signs and symptoms suggestive of TB
īŽ (-) chest radiograph
7. CLASSIFICATION
ī¨ Class III (TB disease)
ī¤ Has three or more of the ff. criteria
īŽ (+) history of exposure to an adult/adolescent with active TB
disease
īŽ (+) Mantoux tuberculin test
īŽ (+) signs and symptoms suggestive of TB
īŽ Cough/wheezing > 2 weeks; fever > 2 weeks
īŽ Painless cervical and/or other lymphadenopathy
īŽ Poor weight gain; failure to make a quick return to normal after
an infection (measles, tonsillitis, whooping cough) or failure to
respond to approriate antibiotic therapy (pneumonia, otitis media)
īŽ Abnormal Chest radiograph
īŽ Laboratory findings suggestive of TB (histological, cytological,
biochemical, immunological or molecular)
8. CLASSIFICATION
ī¨ Class IV (TB inactive)
ī¤ A child/adolescent with or without history of
previous TB and any of the ff:
īŽ (Âą) previous chemotherapy
īŽ (+) radiographic evidence of healed/calcified TB
īŽ (+) Mantoux tuberculin test
īŽ (-) signs and symptoms suggestive of TB
īŽ (-) smear/culture for M. tuberculosis
9. INCIDENCE
ī¨ With the increased incidence of AIDS, TB has
become more a problem in the U.S., and the world.
ī¨ It is currently estimated that 1/2 of the world's
population (3.1 billion) is infected with
Mycobacterium tuberculosis
ī¨ Global Emergency Tuberculosis kills 5,000 people
a day
ī¨ 2.3 million die each year
11. Risk Factors
1. Age: infants and adolescents are at highest risk
of disease
2. Close contact with an untreated sputum positive
patient
3. Impaired host defenses: immunodeficiency
states, particularly that associated with HIV
infection; immunosuppression related to
accompanying viral infection, or drug induced;
malnutrition.
4. Other disease staes: Hodgkinâs lymphomas,
diabetes mellitus, leukemia, malignancy (head
and neck) severe kidney disease, silicosis,
prolonged treatment with corticosteroids
12. Risk Factors
5. Persons whose tuberculin skin test results
converted to (+) In the past 1-2 years.
6. Persons who have CXR suggestive of old TB.
7. IMMUNO COMPROMISED STATUS
(ELDERLY,CANCER).
8. DRUG ABUSE AND ALCOHOLISM.
9. PEOPLE LACKING ADEQUATE HEALTH CARE.
10. IMMIGRANTS FROM COUNTRIES WITH HIGHER
INCIDENCE OF TB.
11. INSTITUTIONALISATION(LONG TERM CARE
FACILITIES).
13. PATHOPHYSIOLOGY
ī¨ (INITIAL INFECTION OR PRIMARY INFECTION)
ī¨ ENTRY OF MICRO ORGANISM THROUGH DROPLET NUCLEI
ī¨ BACTERIA IS TRANSMITTED TO ALVEOLI THROUGH AIRWAYS
ī¨ DEPOSITION AND MULTIPLICATION OF BACTERIA
ī¨ BACILLI ARE ALSO TRANSPORTED TO OTHER PARTS OF THE BODY THROUGH
BLOOD STREAM AND LYMPHNODE
INFLAMMATION
14. PATHOPHYSIOLOGY
ī¨ PHAGOCYTOSIS BY NEUTROPHILS AND MACROPHAGES
ī¨ ACCUMULATION OF EXUDATE IN ALVEOLI
ī¨ BRONCHO PNEMONIA
ī¨ NEW TISSUE MASSES OF LIVE AND DEAD BACILLI ARE SURROUNDED BY
MACROPHAGES WHICH FORM A PROTECTIVE MASS AROUND GRANULOMAS
ī¨ GRANULOMAS THEN TRANSFORMS TO FIBROUS TISSUE MASS AND CENTRAL
PORTION OF WHICH IS CALLED GHON TUBERCLE
15. PATHOPHYSIOLOGY
ī¨ THE MATERIAL (BACTERIA AND MACROPHAGES
BECOMES NECROTIC FORMING CHEESY MASS
ī¨ MASS BECOMES CALCIFIED AND BECOMES COLAGENOUS SCAR
ī¨ BACTERIA BECOME DORMANT AND NO
FURTHER PROGRESSION OF ACTIVE DISEASE
ī¨ (ACTIVE DISEASE OR RE INFECTION)
ī¨ INADEQUATE IMMUNE RESPONSE
ī¨ ACTIVATION OF DORMANT BACTERIA
16. PATHOPHYSIOLOGY
ī¨ GHON TUBERCLE ULCERATES AND RELEASING CHEESY MATERIAL INTO BRONCHI
ī¨ BACTERIA THEN BECOME AIRBORNE RESULTING IN FURTHER SPREAD OF INFECTION
ī¨ ULCERATED TUBERCLE HEALS AND BECOMES SCAR TISSUE
ī¨ INFECTED LUNG BECOME INFLAMMED
ī¨ FURTHER DEVOLOPMENT OF PNEUMONIA AND TUBERCLE FORMATION
ī¨ UNLESS THE PROCESS IS ARRESTED IT SPREADS DOWNWARDS TO THE HILUM OF LUNGS
AND LATER EXTENDS TO ADJASCENT LOBES
17. CLINICAL MANIFESTATIONS
CONSTITUTIONAL SYMPTOMS
ī¨ Anorexia
ī¨ Low grade fever
ī¨ Night sweats
ī¨ Fatique
ī¨ Weight loss
PULMONARY SYMPTOMS
ī¨ Dyspnea
ī¨ Non resolving bronchopneumonia
ī¨ Chest tightness
ī¨ Non productive cough
ī¨ Mucopurulent sputum with hemoptpysis
ī¨ Chest pain
EXTRA PULMONARY SYMPTOMS
ī¨ Pain
ī¨ Inflammation
18. ASSESSMENT AND DIAGNOSTIC
FINDINGS
ī¨ HISTORY COLLECTION
ī¨ PHYSICAL EXAMINATION
ī¨ Clubbing of the fingers or toes (in people with advanced disease)
ī¨ Swollen or tender lymph nodes in the neck or other areas
ī¨ Fluid around a lung (pleural effusion)
ī¨ Unusual breath sounds (crackles)
ī¨ IF MILIARY TB;
ī¨ A physical exam may show:
ī¨ Swollen liver
ī¨ Swollen lymph nodes
ī¨ Swollen spleen
19. ASSESSMENT AND DIAGNOSTIC
FINDINGS
Tests may include:
ī¨ Biopsy of the affected tissue (rare)
ī¨ Bronchoscopy
ī¨ Chest CT scan
ī¨ Chest x-ray
ī¨ Interferon-gamma release blood
test such as the QFT-Gold test
to test for TB infection
ī¨ Sputum examination and cultures
ī¨ Thoracentesis
ī¨ Tuberculin skin test (also called a PPD test)
20. QUANTIFERON GOLD TEST
ī¨ QFT-Gold test measures interferon-gamma in
the testee's blood after incubating the blood
with specific antigens from M. Tuberculosis
proteins
21. COMPLICATIONS
ī¨ Bones. Spinal pain and joint destruction may result
from TB that infects your bones(TB spine or potss
spine)
ī¨ Brain(meningitis)
ī¨ Liver or kidneys
ī¨ Heart(cardiac tamponade)
ī¨ Pleural effusion
ī¨ Tb pneumonia
ī¨ Serious reactions to drug therapy(hepato
toxicity;hypersentivity)
22. MEDICAL MANAGEMENT
ī¨ PULMONARY TB is treated primarily with antituberculosis agents
for 6 to 12 months.
ī¨ Pharmacological management
ī¨ Streptomycin 15mg/kg
ī¨ Isoniazid or INH(Nydrazid) 5 mg/kg(300 mg max perday)
ī¨ Rifampin 10 mg/kg
ī¨ Pyrazinamide 15 â 30 mg/kg
ī¨ Ethambutol(Myambutol) 15 -25 mg/kg daily for 8 weeks and
continuing for up to 4 to 7 months
23. MEDICAL MANAGEMENT
ī¨ Capreomycin 12 -15 mg/kg
ī¨ Ethionamide 15mg/kg
ī¨ Paraaminosalycilate sodium 200 -300 mg/kg
ī¨ Cycloserine 15 mg/kg
ī¨ Vitamin b(pyridoxine) usually adminstered with INH
ī¨
24. ī¨ Other drugs that may be useful, but are not on the
WHO list of SLDs:
ī¨ Rifabutin
ī¨ Macrolides:e.g.,clarithromycin (CLR)
ī¨ Linezolid(LZD)
ī¨ Thioacetazone(T)
ī¨ Thioridazine
ī¨ Arginine
25. MULTIDRUG THERAPY
ī¨ Multiple-drug therapy to treat TB means taking
several different antitubercular drugs at the same
time.
ī¨ The standard treatment is to take isoniazid,
rifampin, ethambutol, and pyrazinamide for 2
months. Treatment is then continued for at least
4months with fewer medicines