The document discusses the Mantoux tuberculin skin test, which detects infection with Mycobacterium tuberculosis. It involves injecting a small amount of purified protein derivative (PPD) intradermally and checking for induration 48-72 hours later. A positive result indicates delayed hypersensitivity to TB antigens, though it does not distinguish between latent and active infection. Interpretation depends on induration size and is complicated by BCG vaccination, exposure to environmental mycobacteria, and immunosuppression. Proper administration and reading technique is required to avoid false results.
This document provides detailed information about the Mantoux tuberculin skin test (TST) used to detect tuberculosis (TB) infection. It describes how the TST works by measuring delayed hypersensitivity to purified protein derivative (PPD) from Mycobacterium tuberculosis. The standard Mantoux technique of intradermally injecting PPD and measuring induration 48-72 hours later is discussed. Interpretation of TST results and limitations are covered. Newer interferon gamma release assays to detect TB infection are also mentioned.
The document discusses the Mantoux tuberculin skin test, which is used to detect infection with Mycobacterium tuberculosis. It describes how the test works, involving injecting a small amount of purified protein derivative (PPD) intradermally and checking for induration 48-72 hours later. Positive results typically show induration of 10mm or more, though interpretation depends on risk factors like BCG vaccination or exposure. Proper administration and reading of the test is important to avoid false negatives or positives.
The Mantoux test, also known as the tuberculin skin test, is used to determine if a person has been infected with tuberculosis. It involves injecting a small amount of purified protein derivative into the skin on the lower arm. After 48 to 72 hours, a health care worker measures any induration, or hard, raised area that develops on the arm, which can indicate infection. A positive result is based on the size of the induration and the person's risk factors. While very accurate, the test can sometimes produce false positives or negatives, requiring further evaluation and testing to diagnose active TB disease.
This document provides an overview of Non-Tuberculous Mycobacteria (NTM) and Mycobacterium leprae, the bacterium that causes leprosy. It discusses the characteristics, pathogenicity, epidemiology, clinical presentation, diagnosis, treatment and prevention of NTM and leprosy. Key points include that NTM can cause disease in immunocompromised individuals, M. leprae causes the chronic disease leprosy which primarily affects the skin and peripheral nerves, and treatment involves multidrug therapy to cure the infection and prevent disability.
Pulmonary tuberculosis is caused by Mycobacterium tuberculosis, which commonly affects the lungs. The disease is characterized by a cough lasting over 3 weeks, production of sputum, fever, night sweats, and weight loss. Diagnosis involves sputum examination, chest x-rays, and the Mantoux skin test. Treatment involves a combination of antibiotics like isoniazid, rifampin, pyrazinamide, and ethambutol over a period of 6-9 months to prevent development of drug resistance. India has a high burden of tuberculosis with an estimated annual incidence of 1.96 million new cases.
Tuberculosis is caused by mycobacterium species, mainly M. tuberculosis, which is transmitted via airborne droplets. It most commonly affects the lungs, causing symptoms like cough and sputum production. Diagnosis involves chest x-ray, sputum smear and culture. Treatment involves a multi-drug regimen over 6-12 months to prevent resistance. Complications include pleural effusion, pneumonia or other organ involvement. Prevention focuses on treatment of active cases, BCG vaccination, and improving socioeconomic conditions.
Tuberculosis is a contagious infection caused by the bacterium Mycobacterium tuberculosis, which usually affects the lungs. It spreads through the air when people with the active respiratory disease cough, sneeze or speak. Common symptoms include weakness, weight loss, fever, night sweats and cough. Diagnosis involves a medical history, physical exam, tuberculin skin test or blood test, chest x-ray and microbiological tests. Treatment requires multiple antibiotics taken for several months and directly observed therapy is recommended to prevent drug resistance and ensure adherence.
This document provides detailed information about the Mantoux tuberculin skin test (TST) used to detect tuberculosis (TB) infection. It describes how the TST works by measuring delayed hypersensitivity to purified protein derivative (PPD) from Mycobacterium tuberculosis. The standard Mantoux technique of intradermally injecting PPD and measuring induration 48-72 hours later is discussed. Interpretation of TST results and limitations are covered. Newer interferon gamma release assays to detect TB infection are also mentioned.
The document discusses the Mantoux tuberculin skin test, which is used to detect infection with Mycobacterium tuberculosis. It describes how the test works, involving injecting a small amount of purified protein derivative (PPD) intradermally and checking for induration 48-72 hours later. Positive results typically show induration of 10mm or more, though interpretation depends on risk factors like BCG vaccination or exposure. Proper administration and reading of the test is important to avoid false negatives or positives.
The Mantoux test, also known as the tuberculin skin test, is used to determine if a person has been infected with tuberculosis. It involves injecting a small amount of purified protein derivative into the skin on the lower arm. After 48 to 72 hours, a health care worker measures any induration, or hard, raised area that develops on the arm, which can indicate infection. A positive result is based on the size of the induration and the person's risk factors. While very accurate, the test can sometimes produce false positives or negatives, requiring further evaluation and testing to diagnose active TB disease.
This document provides an overview of Non-Tuberculous Mycobacteria (NTM) and Mycobacterium leprae, the bacterium that causes leprosy. It discusses the characteristics, pathogenicity, epidemiology, clinical presentation, diagnosis, treatment and prevention of NTM and leprosy. Key points include that NTM can cause disease in immunocompromised individuals, M. leprae causes the chronic disease leprosy which primarily affects the skin and peripheral nerves, and treatment involves multidrug therapy to cure the infection and prevent disability.
Pulmonary tuberculosis is caused by Mycobacterium tuberculosis, which commonly affects the lungs. The disease is characterized by a cough lasting over 3 weeks, production of sputum, fever, night sweats, and weight loss. Diagnosis involves sputum examination, chest x-rays, and the Mantoux skin test. Treatment involves a combination of antibiotics like isoniazid, rifampin, pyrazinamide, and ethambutol over a period of 6-9 months to prevent development of drug resistance. India has a high burden of tuberculosis with an estimated annual incidence of 1.96 million new cases.
Tuberculosis is caused by mycobacterium species, mainly M. tuberculosis, which is transmitted via airborne droplets. It most commonly affects the lungs, causing symptoms like cough and sputum production. Diagnosis involves chest x-ray, sputum smear and culture. Treatment involves a multi-drug regimen over 6-12 months to prevent resistance. Complications include pleural effusion, pneumonia or other organ involvement. Prevention focuses on treatment of active cases, BCG vaccination, and improving socioeconomic conditions.
Tuberculosis is a contagious infection caused by the bacterium Mycobacterium tuberculosis, which usually affects the lungs. It spreads through the air when people with the active respiratory disease cough, sneeze or speak. Common symptoms include weakness, weight loss, fever, night sweats and cough. Diagnosis involves a medical history, physical exam, tuberculin skin test or blood test, chest x-ray and microbiological tests. Treatment requires multiple antibiotics taken for several months and directly observed therapy is recommended to prevent drug resistance and ensure adherence.
This document provides information on the diagnosis and treatment of tuberculosis. It discusses methods for collecting and analyzing sputum samples under microscopy and culture to identify Mycobacterium tuberculosis. It also summarizes techniques for assessing drug resistance and extra-pulmonary tuberculosis diagnosis. Treatment involves short course multidrug regimens and directly observed therapy programs.
This document provides information on tuberculosis (TB), including:
- TB is a contagious bacterial infection that mainly affects the lungs, caused by Mycobacterium tuberculosis.
- Over 9 million new cases and 2 million deaths occur worldwide each year, with 1/3 of the world's population infected.
- Diagnosis involves sputum smear microscopy, culture, chest x-ray, and the tuberculin skin test. Standard treatment lasts 6-9 months using multiple antibiotic drugs.
This document provides guidelines for pediatric tuberculosis diagnostics and investigations in India. It discusses common TB symptoms in children and various diagnostic tests including non-confirmatory tests like chest X-rays and tuberculin skin tests as well as confirmatory microbiological tests. Newer nucleic acid amplification tests like Xpert MTB/RIF, Truenat MTB-RIFDx, and line probe assays that can detect TB and drug resistance are highlighted. Microbial cultures using liquid media are also described as an important diagnostic approach, though time-consuming. Overall guidelines emphasize the role of clinical assessment, radiology, and rapid molecular tests in improving pediatric TB diagnosis given challenges of paucibacillary disease in children.
This document discusses tuberculosis (TB), caused by Mycobacterium tuberculosis. It affects the respiratory system. Key points:
- TB is a major global health problem, infecting over 2 billion people worldwide. It is more common in developing countries.
- Transmission occurs via airborne droplets from untreated pulmonary TB cases. People at highest risk include healthcare workers, miners, and immunocompromised individuals.
- Diagnosis involves microscopy, culture, tuberculin skin testing, chest imaging, and PCR. Treatment consists of a multi-drug regimen over 6-9 months, guided by sensitivity testing to prevent drug resistance. Prevention strategies include contact screening, BCG vaccination of newborns, and public
- Tuberculosis is caused by Mycobacterium tuberculosis and primarily affects the lungs. It spreads through airborne droplets from the lungs of infected individuals.
- Case finding through sputum smear microscopy is the main method for tuberculosis control. Patients with at least 10 bacilli per 100 oil immersion fields in their sputum are considered positive and most infectious.
- The standard WHO recommended treatment regimen for new sputum-positive pulmonary TB cases is 2 months of isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by 4 months of isoniazid and rifampicin. Effective treatment reduces infectivity by 90% within 48 hours.
Pulmonary tuberculosis is caused by infection with Mycobacterium tuberculosis, which is a small, aerobic bacillus. Symptoms include a prolonged cough lasting over 3 weeks, coughing up sputum or blood, fever, night sweats, and weight loss. Diagnosis involves chest x-ray, sputum smear and culture, and the Mantoux tuberculin skin test. Treatment requires a combination of antibiotics like isoniazid, rifampin, pyrazinamide, and ethambutol over a period of 6-9 months to prevent drug resistance from developing. Tuberculosis remains a major global health problem and India has a high burden of cases.
The document summarizes information about tuberculosis (TB). It describes TB as affecting mainly the lungs and causing symptoms like cough, weight loss, and fatigue. The causative agent is identified as Mycobacterium tuberculosis bacteria. The pathogenesis involves the bacteria being inhaled and surviving inside immune cells in the lungs, eventually forming nodules that can spread infection. Diagnosis involves tests like chest x-rays and detecting the bacteria in sputum. Treatment consists of a combination of antibiotics taken for several months.
Tuberculosis pathophysiology and diagnosis | Jindal Chest ClinicJindal Chest Clinic
Tuberculosis is an infectious lung disease caused by bacteria, spreading through the air through coughing, sneezing, or spit. It is preventable and curable. This presentation gives an overview on "Tuberculosis pathophysiology and diagnosis". For more information, please contact us: 9779030507.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. The document provides examples of communicable diseases like smallpox, chickenpox, cholera, diphtheria and describes their causative agents, hosts, modes of transmission and signs/symptoms. It also discusses epidemiological concepts like epidemiological triad and provides more detailed descriptions of specific diseases like smallpox, chickenpox, rubella and mumps. The document outlines prevention, treatment and control measures for communicable diseases.
This document provides an overview of Mycobacteria and Tuberculosis. It describes the characteristics and staining properties of Mycobacteria, including their classification. Tuberculosis is caused by Mycobacterium tuberculosis and remains a major public health problem worldwide. The document outlines the pathogenesis, epidemiology, clinical presentation, diagnosis and management of tuberculosis. Laboratory diagnosis involves staining, culture and molecular identification methods. Treatment involves a combination of antibiotics over several months. Prevention relies on identification and treatment of cases, contact tracing and BCG vaccination.
Neonatal infections can occur through several modes of transmission, including antenatally from the mother, intranatally during birth, or postnatally after birth. Common infections presented include ophthalmic neonatorum (conjunctivitis), omphalitis (umbilical cord infection), tetanus neonatorum, necrotizing enterocolitis, oral thrush, and various skin infections. Proper infection prevention practices and timely treatment of infections are important for neonatal health outcomes.
Whooping cough | pertussis ( medical information ) - a detailed studymartinshaji
Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop." Before the vaccine was developed, whooping cough was considered a childhood disease.
this chart comprises all the major aspects of whooping cough / pertussis
please comment
thank u
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis that primarily affects the lungs. It spreads through inhaling droplets from infected individuals and can affect other organs. Young, malnourished, and immunocompromised children are most at risk. Diagnosis involves clinical features, tuberculin skin testing, chest x-rays, and microscopic examination of samples. Treatment consists of a multi-drug regimen over several months. Close contacts of active TB cases, such as young children, should receive preventive treatment to avoid infection.
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
Clostridium difficile is a spore-forming bacterium that can cause antibiotic-associated diarrhea and colitis. It is transmitted through the fecal-oral route via contaminated surfaces or hands. Antibiotic use disrupts normal gut flora and allows C. difficile to cause infection. Symptoms range from mild diarrhea to life-threatening complications. Treatment involves discontinuing antibiotics if possible and using metronidazole or vancomycin for severe cases. Preventing transmission requires contact precautions, thorough hand hygiene and environmental disinfection.
This document provides information about tuberculosis screening and vaccination. It discusses tuberculin skin testing including administration, interpretation, and causes of false positives and negatives. It also covers BCG vaccination including the vaccine itself, schedule and efficacy, typical reactions, and adverse effects. Key points include that a positive TST indicates possible infection and additional testing may be needed, BCG vaccination is given in endemic areas from birth up to 5 years of age, and the vaccine protects against extrapulmonary and disseminated TB but has varying efficacy against pulmonary TB.
This document provides an overview of tuberculosis (TB) presented by several individuals from NIPER Kolkata. It discusses the history, biology, pathogenesis, stages of infection, virulent mechanisms, prevalence, current scenario, WHO recommendations for diagnosis and treatment, and preventive measures for TB. The WHO aims to reduce global TB incidence rate by 2035 through its End TB Strategy which focuses on early detection, accurate diagnosis, effective treatment, and monitoring & evaluation of programs.
PREGNANCY AND PHYSIOLOGICAL CHANGES.pptxAshraf Shaik
During pregnancy, the female body undergoes many physiological changes to support the growing fetus. The genital organs like the uterus, cervix, and breasts enlarge and the vascularity increases. The uterus grows enormously and its shape changes from globular to spherical. Other changes include increased blood volume and cardiac output, skin and cutaneous changes, weight gain, respiratory alkalosis, and hormonal changes mediated by the placenta and pituitary gland. These changes help provide nutrients and oxygen to the developing fetus and prepare the body for childbirth.
This document provides information on diagnosing pregnancy through various stages. In the first trimester, signs may include missed period, morning sickness, frequent urination, and breast changes. HCG levels can be detected in blood and urine from 8-11 days after conception. Ultrasound can visualize the gestational sac from 4-5 weeks. In the second trimester, signs include quickening, abdominal growth, and fetal movement felt externally from 20 weeks. Anatomy scan at 18-20 weeks evaluates fetal development. In the third trimester, signs include increased size, lightening, and engagement of the presenting part. Fundal height corresponds to weeks until 36 weeks. Differential diagnosis includes conditions that cause abdominal swelling.
This document provides information on the diagnosis and treatment of tuberculosis. It discusses methods for collecting and analyzing sputum samples under microscopy and culture to identify Mycobacterium tuberculosis. It also summarizes techniques for assessing drug resistance and extra-pulmonary tuberculosis diagnosis. Treatment involves short course multidrug regimens and directly observed therapy programs.
This document provides information on tuberculosis (TB), including:
- TB is a contagious bacterial infection that mainly affects the lungs, caused by Mycobacterium tuberculosis.
- Over 9 million new cases and 2 million deaths occur worldwide each year, with 1/3 of the world's population infected.
- Diagnosis involves sputum smear microscopy, culture, chest x-ray, and the tuberculin skin test. Standard treatment lasts 6-9 months using multiple antibiotic drugs.
This document provides guidelines for pediatric tuberculosis diagnostics and investigations in India. It discusses common TB symptoms in children and various diagnostic tests including non-confirmatory tests like chest X-rays and tuberculin skin tests as well as confirmatory microbiological tests. Newer nucleic acid amplification tests like Xpert MTB/RIF, Truenat MTB-RIFDx, and line probe assays that can detect TB and drug resistance are highlighted. Microbial cultures using liquid media are also described as an important diagnostic approach, though time-consuming. Overall guidelines emphasize the role of clinical assessment, radiology, and rapid molecular tests in improving pediatric TB diagnosis given challenges of paucibacillary disease in children.
This document discusses tuberculosis (TB), caused by Mycobacterium tuberculosis. It affects the respiratory system. Key points:
- TB is a major global health problem, infecting over 2 billion people worldwide. It is more common in developing countries.
- Transmission occurs via airborne droplets from untreated pulmonary TB cases. People at highest risk include healthcare workers, miners, and immunocompromised individuals.
- Diagnosis involves microscopy, culture, tuberculin skin testing, chest imaging, and PCR. Treatment consists of a multi-drug regimen over 6-9 months, guided by sensitivity testing to prevent drug resistance. Prevention strategies include contact screening, BCG vaccination of newborns, and public
- Tuberculosis is caused by Mycobacterium tuberculosis and primarily affects the lungs. It spreads through airborne droplets from the lungs of infected individuals.
- Case finding through sputum smear microscopy is the main method for tuberculosis control. Patients with at least 10 bacilli per 100 oil immersion fields in their sputum are considered positive and most infectious.
- The standard WHO recommended treatment regimen for new sputum-positive pulmonary TB cases is 2 months of isoniazid, rifampicin, pyrazinamide, and ethambutol, followed by 4 months of isoniazid and rifampicin. Effective treatment reduces infectivity by 90% within 48 hours.
Pulmonary tuberculosis is caused by infection with Mycobacterium tuberculosis, which is a small, aerobic bacillus. Symptoms include a prolonged cough lasting over 3 weeks, coughing up sputum or blood, fever, night sweats, and weight loss. Diagnosis involves chest x-ray, sputum smear and culture, and the Mantoux tuberculin skin test. Treatment requires a combination of antibiotics like isoniazid, rifampin, pyrazinamide, and ethambutol over a period of 6-9 months to prevent drug resistance from developing. Tuberculosis remains a major global health problem and India has a high burden of cases.
The document summarizes information about tuberculosis (TB). It describes TB as affecting mainly the lungs and causing symptoms like cough, weight loss, and fatigue. The causative agent is identified as Mycobacterium tuberculosis bacteria. The pathogenesis involves the bacteria being inhaled and surviving inside immune cells in the lungs, eventually forming nodules that can spread infection. Diagnosis involves tests like chest x-rays and detecting the bacteria in sputum. Treatment consists of a combination of antibiotics taken for several months.
Tuberculosis pathophysiology and diagnosis | Jindal Chest ClinicJindal Chest Clinic
Tuberculosis is an infectious lung disease caused by bacteria, spreading through the air through coughing, sneezing, or spit. It is preventable and curable. This presentation gives an overview on "Tuberculosis pathophysiology and diagnosis". For more information, please contact us: 9779030507.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. The document provides examples of communicable diseases like smallpox, chickenpox, cholera, diphtheria and describes their causative agents, hosts, modes of transmission and signs/symptoms. It also discusses epidemiological concepts like epidemiological triad and provides more detailed descriptions of specific diseases like smallpox, chickenpox, rubella and mumps. The document outlines prevention, treatment and control measures for communicable diseases.
This document provides an overview of Mycobacteria and Tuberculosis. It describes the characteristics and staining properties of Mycobacteria, including their classification. Tuberculosis is caused by Mycobacterium tuberculosis and remains a major public health problem worldwide. The document outlines the pathogenesis, epidemiology, clinical presentation, diagnosis and management of tuberculosis. Laboratory diagnosis involves staining, culture and molecular identification methods. Treatment involves a combination of antibiotics over several months. Prevention relies on identification and treatment of cases, contact tracing and BCG vaccination.
Neonatal infections can occur through several modes of transmission, including antenatally from the mother, intranatally during birth, or postnatally after birth. Common infections presented include ophthalmic neonatorum (conjunctivitis), omphalitis (umbilical cord infection), tetanus neonatorum, necrotizing enterocolitis, oral thrush, and various skin infections. Proper infection prevention practices and timely treatment of infections are important for neonatal health outcomes.
Whooping cough | pertussis ( medical information ) - a detailed studymartinshaji
Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop." Before the vaccine was developed, whooping cough was considered a childhood disease.
this chart comprises all the major aspects of whooping cough / pertussis
please comment
thank u
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis that primarily affects the lungs. It spreads through inhaling droplets from infected individuals and can affect other organs. Young, malnourished, and immunocompromised children are most at risk. Diagnosis involves clinical features, tuberculin skin testing, chest x-rays, and microscopic examination of samples. Treatment consists of a multi-drug regimen over several months. Close contacts of active TB cases, such as young children, should receive preventive treatment to avoid infection.
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
Clostridium difficile is a spore-forming bacterium that can cause antibiotic-associated diarrhea and colitis. It is transmitted through the fecal-oral route via contaminated surfaces or hands. Antibiotic use disrupts normal gut flora and allows C. difficile to cause infection. Symptoms range from mild diarrhea to life-threatening complications. Treatment involves discontinuing antibiotics if possible and using metronidazole or vancomycin for severe cases. Preventing transmission requires contact precautions, thorough hand hygiene and environmental disinfection.
This document provides information about tuberculosis screening and vaccination. It discusses tuberculin skin testing including administration, interpretation, and causes of false positives and negatives. It also covers BCG vaccination including the vaccine itself, schedule and efficacy, typical reactions, and adverse effects. Key points include that a positive TST indicates possible infection and additional testing may be needed, BCG vaccination is given in endemic areas from birth up to 5 years of age, and the vaccine protects against extrapulmonary and disseminated TB but has varying efficacy against pulmonary TB.
This document provides an overview of tuberculosis (TB) presented by several individuals from NIPER Kolkata. It discusses the history, biology, pathogenesis, stages of infection, virulent mechanisms, prevalence, current scenario, WHO recommendations for diagnosis and treatment, and preventive measures for TB. The WHO aims to reduce global TB incidence rate by 2035 through its End TB Strategy which focuses on early detection, accurate diagnosis, effective treatment, and monitoring & evaluation of programs.
PREGNANCY AND PHYSIOLOGICAL CHANGES.pptxAshraf Shaik
During pregnancy, the female body undergoes many physiological changes to support the growing fetus. The genital organs like the uterus, cervix, and breasts enlarge and the vascularity increases. The uterus grows enormously and its shape changes from globular to spherical. Other changes include increased blood volume and cardiac output, skin and cutaneous changes, weight gain, respiratory alkalosis, and hormonal changes mediated by the placenta and pituitary gland. These changes help provide nutrients and oxygen to the developing fetus and prepare the body for childbirth.
This document provides information on diagnosing pregnancy through various stages. In the first trimester, signs may include missed period, morning sickness, frequent urination, and breast changes. HCG levels can be detected in blood and urine from 8-11 days after conception. Ultrasound can visualize the gestational sac from 4-5 weeks. In the second trimester, signs include quickening, abdominal growth, and fetal movement felt externally from 20 weeks. Anatomy scan at 18-20 weeks evaluates fetal development. In the third trimester, signs include increased size, lightening, and engagement of the presenting part. Fundal height corresponds to weeks until 36 weeks. Differential diagnosis includes conditions that cause abdominal swelling.
1. An episiotomy is a surgically planned incision made in the perineum during the second stage of labor to enlarge the vaginal opening and facilitate delivery while minimizing perineal tearing.
2. It is most commonly done for primigravid women, those with a rigid perineum, or those requiring forceps delivery or breech birth.
3. The incision is usually mediolateral, extending from the midline outwards, and is repaired in three layers after delivery to restore anatomy and function.
The document describes various obstetric instruments and their uses:
- Simple rubber catheters are used to empty the bladder during pregnancy, labor, and postpartum. Foley catheters provide continuous bladder drainage in cases like eclampsia.
- Sims' speculum and Cusco's speculum are used to inspect the cervix and vagina. Forceps like Allis tissue forceps gently hold tissues during procedures.
- Dilators like Hawkin-Ambler and Hegar's dilators are used to widen the cervical canal before evacuation procedures. Ovum forceps and uterine curettes remove products of conception.
- Vacuum aspiration cannulas of various sizes are
This document discusses obstructed labor and prolonged labor. Obstructed labor is defined as labor where there is poor or no progress despite uterine contractions, and is caused by issues with the pelvis, fetus, or other maternal conditions. Prolonged labor is labor lasting over 18 hours. Both can cause maternal and fetal complications like rupture, infection, asphyxia, and death if not properly managed. Management involves general supportive care, monitoring labor progress, and obstetric interventions like medications, instrumental delivery, or c-section depending on the stage of labor and specific issues present.
This document discusses paraneoplastic syndromes, which are clinical disorders associated with but not directly caused by malignant tumors. It provides examples of various paraneoplastic syndromes involving the endocrine system, hematologic system, skin, kidneys, lungs and other organs. It also discusses neurological manifestations such as opsoclonus-myoclonus syndrome, limbic encephalitis, cerebellar degeneration and others. Evaluation and treatment of the underlying malignancy is important for managing paraneoplastic syndromes.
Lung abscess is defined as necrosis of pulmonary tissue and formation of cavities containing necrotic debris or fluid, usually caused by microbial infection. It commonly results from aspiration of oropharyngeal contents colonized with anaerobic bacteria. Patients often present with nonspecific symptoms like fever, cough, sputum production, and weight loss. Physical exam may reveal consolidation and signs of any associated pleural effusions or pneumothoraces. Treatment involves prolonged antibiotic therapy, though surgery was historically used. Failure to treat lung abscess is associated with poor clinical outcomes.
The document discusses physiology and management of the normal postpartum period (puerperium). It defines puerperium as the 6-week period following childbirth when the body returns to a non-pregnant state. The puerperium involves involution of the uterus and other reproductive organs. It describes the stages of puerperium and changes that occur in the uterus, cervix, vagina, breasts and other organs during this period. Key signs like lochia, after pains, constipation and breast changes are also summarized.
This document provides information on uterovaginal prolapse including anatomy, supports of the uterus, types of prolapse, degree of uterine descent, aetiology, symptoms, clinical presentation, diagnostic approach, examination, complications, prevention, and management. The three main levels of uterine support are described as the upper, middle, and lower tiers. Genital prolapse is defined as the descent of one or more genital organs through the pelvic floor. The POPQ system is introduced for assessing prolapse. Childbirth is a primary risk factor for prolapse due to trauma, and prevention focuses on proper techniques during labor and repair of tears. Treatment includes pessaries, pelvic floor exercises, and various surgical procedures depending
This document discusses pulmonary thromboembolism (PE), which refers to blood clots (thrombi) traveling from deep veins to the lungs. Most clots originate in the lower extremities. Risk factors include inherited conditions, surgery, trauma, immobilization, cancer and pregnancy. PE can cause hypoxemia and pulmonary hypertension. Diagnosis involves clinical assessment, D-dimer testing, chest imaging like CT pulmonary angiogram (gold standard), ventilation-perfusion scanning and echocardiogram. Treatment aims to relieve symptoms and prevent complications like right heart strain.
Status asthmaticus is a severe exacerbation of asthma that is unresponsive to initial treatment. It involves both an early bronchospastic component and later inflammatory response leading to airway obstruction. Treatment goals are to reverse airway obstruction, correct hypoxemia, and prevent complications. Mainstay treatments include nebulized beta-2 agonists, systemic steroids, theophyllines, and mechanical ventilation if needed. Impulse oscillometry testing can objectively monitor response to treatment. With aggressive treatment, prognosis is generally good except when combined with other conditions.
1) Pneumoconiosis refers to lung diseases caused by inhaling mineral dust including coal workers' pneumoconiosis and silicosis.
2) Silicosis results from inhaling crystalline silica and presents as nodular lesions in the lungs. High risk jobs include mining, sandblasting, and foundry work.
3) Asbestosis is pulmonary fibrosis caused by inhaling asbestos fibers which can lead to complications like mesothelioma and lung cancer decades later. Asbestos was commonly used in insulation and construction.
This document discusses respiratory failure, which occurs when the respiratory system fails in gas exchange. It outlines the components of the respiratory system and centers in the brainstem that control breathing. There are four types of respiratory failure described based on gas exchange abnormalities: hypoxemic, hypercapnic, perioperative, and respiratory failure in shock. Diagnosis involves arterial blood gas analysis and evaluating for underlying causes. Treatment focuses on supporting oxygenation and ventilation, treating specific causes, and mechanical ventilation if needed.
This document discusses the history and health effects of smoking. It begins with the origins of tobacco use among Native Americans and its spread to Europe. It then discusses the addictive properties of nicotine and how cigarettes effectively deliver nicotine to the brain. The document outlines the various health risks of smoking such as increased risk of lung cancer, COPD, and heart disease. It also discusses challenges with smoking cessation and methods that can be used to help people quit smoking such as nicotine replacement therapies, bupropion, and varenicline. The document concludes by discussing approaches to harm reduction for smokers unable or unwilling to quit.
This document provides an overview of pulmonary hypertension (PH), including its definition, classification, pathophysiology, diagnostic workup, and treatment. PH is defined as a mean pulmonary arterial pressure over 25 mmHg at rest. It is classified into 5 groups, with Group 1 being pulmonary arterial hypertension. The pathophysiology involves vasoconstriction, endothelial dysfunction, and vascular remodeling. Diagnosis involves echocardiogram, right heart catheterization, and ruling out other causes. Treatment includes diuretics, anticoagulants, oxygen, and PAH-specific therapies, with the goal of improving functional status and survival.
This document provides information on tuberculosis (TB) control efforts in India, including:
1. India has a high TB burden and accounts for over 1/5 of global incidence, with an estimated 1.98 million new cases annually.
2. The Revised National Tuberculosis Control Programme (RNTCP) was launched in 1997 to expand the internationally recommended DOTS strategy across India.
3. RNTCP's objectives include achieving and maintaining an 85% cure rate and 70% case detection among new sputum-positive patients.
This document discusses the harmful effects of smoking on the lungs. It begins by describing the healthy human respiratory system and how smoking damages the lungs. Photos show a clear visual difference between healthy lungs and smoker's lungs. The rest of the document then outlines how smoking specifically harms parts of the lungs like the alveoli, damages the body's ability to clean and repair the lungs, and leads to reduced oxygen intake. It also lists many of the over 4000 chemicals found in cigarettes that are known to cause cancer and other serious health issues. The document emphasizes that quitting smoking can significantly improve health over time, even if some damage is permanent.
This document discusses pleural effusions, including their causes, characteristics, diagnosis and evaluation. Key points:
- Pleural effusions can be transudative or exudative based on their mechanism of formation and fluid chemistry. Common causes include heart failure, pneumonia, malignancy and pulmonary embolism.
- Diagnosis involves chest imaging, diagnostic thoracentesis and fluid analysis to determine if the fluid is an exudate or transudate based on pleural fluid to serum ratios of protein and LDH. Additional fluid tests provide clues to specific causes.
- Pleural fluid characteristics like glucose, pH and cell differentials provide diagnostic information and indicate need for drainage in some cases like parapneumonic effusions
This document provides an overview of approach and management of interstitial lung disease (ILD). It discusses common features of ILD, differentiating idiopathic from known causes such as environmental, drugs, radiation. It describes diagnostic evaluation including imaging patterns and lung biopsy if needed. Specific ILD types are outlined including idiopathic interstitial pneumonias, connective tissue disease-related ILD, hypersensitivity pneumonitis, and pneumoconioses. Rare ILD, treatment approaches, and prognostic factors are also summarized.
This document discusses pulmonary function tests (PFTs) and lung volumes and capacities. It provides details on:
- The four lung volumes (tidal volume, inspiratory reserve volume, expiratory reserve volume, and residual volume) and five lung capacities (inspiratory capacity, expiratory capacity, vital capacity, functional residual capacity, and total lung capacity) measured in PFTs.
- Definitions and normal ranges for the various lung volumes and capacities.
- Factors that influence volumes and capacities like height, age, posture, and disease.
- Uses and goals of PFTs in assessing lung function and disease.
Dr. Sherman Lai, MD — Guelph's Dedicated Medical ProfessionalSherman Lai Guelph
Guelph native Dr. Sherman Lai, MD, is a committed medical practitioner renowned for his thorough medical knowledge and caring patient care. Dr. Lai guarantees that every patient receives the best possible medical care and assistance that is customized to meet their specific needs. She has years of experience and is dedicated to providing individualized health solutions.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Nursing management of the patient with Tonsillitis PPTblessyjannu21
Prepared by Prof. Blessy Thomas MSc Nursing, FNCON, SPN. The tonsils are two small glands that sit on either side of the throat.
In young children, they help to fight germs and act as a barrier against infection.
Tonsils act as filters, trapping germs that could otherwise enter the airways and cause infection.
They also make antibodies to fight infection.
But sometimes, they get overwhelmed by bacteria or viruses.
This can make them swollen and inflamed.
Tonsillitis is an infection of the tonsils, two masses of tissue at the back of the throat.
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.
Tonsillitis is common, especially in children.
It can happen once in a while or come back again and again in a short period.Nursing management of Tonsillitis is important.
A comprehensive understanding of the operations for management of Tonsillitis and areas requiring special attention would be important.
8. CONTRAINDICATIONS: MOVEMENT IN YOGA
8. Introduction to Contraindications
Students come to yoga classes with a variety of physical, mental, and emotional conditions that should be given special attention and support by teachers.
While making clear the distinction between yoga teacher and licensed medical or mental health professional, as teachers we are responsible for creating a safe and supportive environment for all students, including those with injuries, depression, age-related needs, and conditions such as pregnancy and menopause.
Here we will look at practical approaches to working with students whose bodies, hearts, and minds (which are not really separate) indicate the need for special accommodation in classes or in one-on-one sessions. Bringing a specifically yogic perspective to this aspect of teaching starts with looking at and appreciating every student as the whole person he or she is, offering tools and techniques for using various challenging conditions to heal, feel better, and move into a deeper quality of integration.
At Malayali Kerala Spa Ajman we providing the top quality massage services for our customers.
Our massage center prioritizes efficiency to ensure a quality massage experience for our clients at Malayali Kerala Spa Ajman. We offer a convenient appointment system and precise massage services.
Reach us at Villa No 7, Near Ammar Bin Yasir Street Al Rashidiya 2 - Ajman - United Arab Emirates.
Phone : +971 529818279
Exploring Stem Cell Solutions for Parkinson's Disease with Dr. David Greene A...Dr. David Greene Arizona
Dr. David Greene of Arizona is at the forefront of stem cell therapy for Parkinson's Disease, focusing on innovative treatments to restore dopamine-producing neurons. His research explores the use of embryonic stem cells, induced pluripotent stem cells, and adult stem cells to replace lost neurons and potentially reverse disease progression. By transplanting differentiated cells into affected brain areas, Dr. Greene aims to address the root cause of Parkinson's. His work also investigates the neuroprotective benefits of stem cells, offering hope for effective, long-term treatments. Discover how Dr. Greene's pioneering efforts could transform Parkinson's Disease therapy.
About CentiUP - Product Information Slide.pdfCentiUP
A heightened child formula, with the trio of Nano Calcium, HMO, and DHA mixed in the golden ratio, combined with NANO technology to help nourish the body deeply and comprehensively, helps children increase height, boost brain power, and improve the immune system and overall well-being.
Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
2. TUBERCULIN SKIN TEST
Detect infection with tubercle bacilli
Low technology
In expensive
Easy to administer, read
3. Based on – infection with mycobacterium
tuberculosis produces sensitivity to certain
components called sensitins, which are
contained in culture extracts called tuberculins
4. Used among children for detection of
tuberculosis infection and as a supportive tool
for diagnosis of tb disease
Limited role in diagnosis of tb among adults
living in areas where tb is highly endemic
Used by epidemiologists for assesment of tb
situation in community
6. Sir robert koch – produces a filtrate prepared
from heat sterilized concentrated broth cultures
of human tubercle bacilli
Initialy prepared for treatment of
Tb , but proved ineffective .
Subcutaneous inoculation in a patient suffering
from tb resulted in local reaction at inoculation
site laid foundation of its use as diagnostic aid
Was namedOLDTUBERCULIN (OT)
7. Clement von pirquet
in 1907 , observed
that
Tiny scratch with a
little quantity of
tuberculin resulted in
a local reaction at the
test site
8. Moro in 1908 announced the patch test
Tuberculin was incorporated into an ointment
that was smeared onto skin , with a piece of
guaze over it
14. Siebert in 1934 showed that active principle in
tuberculin reaction was the protein fraction
Made a preparation from heat concentrated
synthetic medium OT by precipitation with
trichloroacetic acid .
It still contained lipopolysaccharides and
nucleic acid
Later precipitation achieved by ammonium
sulphate to obtain a preparation with less
nucleic acid and polysaccharide content
termed PURIFIED PROTEIN DERIVATIVE
(PPD)
16. •Statens serum institute , copenhagen
produced a large batch of PPD in 1952 at
behest of unicef andWHO, and was
designated RT23
•TWEEN 80 is added to prevent
reabsorption of tuberculin to glass surface
•Seed lot of PPD RT23 is maintained by
BCGVACCINE LABORATORY ,GUINDY ,
CHENNAI.
•It is reconstituted and is supplied as ready
to use preparation in isotonic buffer
solution as 5ml vials, 0.1 ml corresponding
to 1TU.
19. Skin changes in TST
Reaction include a delayed course reaching a
peak more than 24 hrs after injection and an
induration with occasional vesicilation and
necrosis
Delayed type hypersensitivity reaction peaks by
48 to 96 hours, with an area of erythmatous
induration
20. Standard tuberculin skin
test
Standard test employs a single batch
tuberculin ie PPD RT – 23
Dose – 0.02 microgram [ 1TU ] of PPD RT -23
in 0.1 ml of the diluent withTween 80
21. 2TU of PPD RT – 23 is now recomended as
the standard dose , based on a series of
studies conducted in india
It demonstrated equal sensitivity for 1TU &
2TU in detecting true infection with
mycobacterium tuberculosis.
Available in 1TU/0.1ml, 2TU/0.1ml, 5TU/0.1ml
and 10TU/0.1ml strengths.
23. Earlier special glass syringes with a platinum
needle was preferred for injection.
These days disposable tuberculin syringes
(1ml) are preferred.
25. Storage
Tuberculin vials – stored at 2-8 °C and used
before expiry period
Avoid exposure to sunlight and heat
Never freeze or keep at temp exceeding 20°C
Vial once used may be re- used within a
maximum of 48 hrs
26. Administration
Administerd 2-4 inches
below the elbow joint
Place the forearm palm
side up on a firm well lit
surface
Select an area free of
barriers ( scars, sores ) to
placing and reading
Clean the area with an
alcohol swab
27. Check expiry date on
vial and ensure vial
contains tuberculin
(5TU per 0.1ml)
Use a single dose
tuberculin syringe with
a ¼ to ½ inch 27 gauge
needle with a short
bevel
Fill the syringe with 0.1
ml of tuberculin
28. Insert slowly , bevel up
at 5- 15 degree angle
After injection a tense
pale wheal should
appear over the needle
Check the skin test-
wheal should be 6-10
mm in diameter . If not
repeat test at a site at
least 2 inches away from
original site
Record information (
date, time of
administration, injection
site, location, lot
number of tuberculin)
29.
30.
31. Educate the patient on the possible
reactions to theTST (e.g., mild itching,
swelling, irritation).
Instruct patient not to rub, scratch or put
an adhesive bandage or lotion on the test
site.
Schedule reading date and explain the
importance of the patient returning for
reading in 48 to 72 hours.
32. Reading (48-96 hrs)
Visually inspect site under good
light.
Use fingertips to find margins of
induration
Mark induration by using fingertips
as a guide for marking widest
edges of induration across forearm
Measure the induration ( not the
erythema) . Place the 0 ruler line
inside left dot edge. Read ruler
line inside right dot edge
Record measurement of induration
in mm
Do not record as positive or
negative
Records made of bullae, vesicles,
ulceration etc at test site
33.
34.
35. Interpretation
• Signifies reaction with tubercle
bacilli, irrespective of BCG
vaccination status
Size of induration
15 mm & above
• Cross sensitivity induced by environmental
mycobacteria
• BCG induced sensitivity
• Infection with mycobacterium tuberculosis
Size of induration
10-14 mm
• Cross sensitivity by environmental
mycobacteria/ BCG vaccination/ infection
with tubercle bacilli in the presence of
immunosuppresive conditions
Size of induration
5-9 mm
• Indicates absence of any type of
mycobacterial infection except in
individuals with severe degree of
immunosuppression
Size of induration
less than 5 mm
36. Adverse effects
Some atopic individuals, develop an urticarial
wheal, which may dissapear within minutes.
Occurence of such an allergic reaction does
not signify the presence of TB.
Systemic allergic reactions seldom occur
Formation of vesicles, bullae, lymphangitis,
ulceration or necrosis in a proportion of
children indicates high degree of tuberculin
sensitivity.
37.
38.
39. Skin sensitivity to tuberculin
Persons with sensitivity to tuberculin are
called ‘Reactors’.
Not all reactors are infected with tubercle
bacilli.
Sensitivity to tuberculin may oocur due to
infection with environmental
mycobacteria
BCGVaccination
Infection with Mycobacterium
tuberculosis
40. Infection with environmental
mycobacteria
Sensitivity induced by them cross-reacts with
tuberculin and is known as ‘NonSpecific
Sensitivity’ (NSS).
sensitivity induced by these results in smaller
reactions.
Distinction from true infection is not always
very clear.
Highly prevalent in most parts of India.
41. BCG Vaccination
Sensitivity may vary from very weak to about
the same level as natural infection.
Depends on strength of vaccine used,
handling, administration, and time interval
between vaccination and testing.
Generally peaks at 10 weeks then begin to
wane.
UnderUIP in India, a reduced dose of 0.05 ml
of Danish 1331 strain is administered.
42. About 70% of children upto 9 yrs of age with
a BCG scar elicited either no rection or
<10mm to 1TU PPD withTween 80.
It may be inferred that the BCG induced
sensitivity is generally weaker than that of
infection with tubercle bacilli.
Weak sensitivity does not imply that
vaccination is ineffective.
43. Infection with Mycobacterium
tuberculosis
Most individuals harbouringTB infection
usually elicit a larger reaction to tuberculin
The probability of true positives increases as
the reaction size increases
Probability is also increased in the presence
of history of contact with a sputum smear
positive case ofTB.
44. False positive reactions
Infection with environmental mycobacteria.
BCG vaccination.
Repeat testing.
Testing with high dose of tuberculin.
Reading errors.
Needle injury.
45. False negative reactions
Non significant reaction does not always
exclude the presence ofTB infection or
disease.
Most common reasons being :
Improper storage
Poor technique
Other reasons :
Immunosupression
DisseminatedTB
Undernutrition
46. Hodgkin’s
Malignancy
Sarcoidosis
HIV –AIDS
Vaccination with live virus vaccines
Acute viral infections
Window period
Infants < 3months ( immature immune system)
Old age
Cutaneous anergy
Supression due to live virus vaccines appears
after 48 hrs of vaccination and start waning 4-6
wks later.
47. Anergy
Anergy refers to failure to mount a full
immune response against a target.
Term ‘ANERGY’ was coined byVon Pirquet
Commonly used antigens for anergy panel
contain trychophyton, candida , etc
Anergic patients are more likely than
immunologically intact patients to present
with noncavitoryTB.
48. In sarcoidosis patients, anergy to tuberculin
can be restored by concurrent administration
of hydrocortisone.
This paradoxical reaction presumably also
occurs inTB patients who have been
desensitized for tuberculin.
49. Reversion, Conversion and
Booster Phenomenon
Reversion:
In elderly & many adults, significant
reactions to tuberculin declines with age.
Estimated to occur at a rate of 5% per yr.
Attributed to waning of CMI or loss of
lymphocyte blastogenic capacity in elderly.
50. Booster phenomenon
Boosting of the size of the second test by the
small amount of tuberculin injected for the first
test.
Results from ‘recall’ of the sensitivity.
To avoid this, repeat test should be given at a
different site within one week of the first test.
Boosting effect was observed when test
repeated after 2 months ,not when repeated
after 18 months.
51. Conversion
Simple tuberculin conversion from a non
significant reaction at first test to a significant
reaction at a subsequent test.
Larger increase in reaction size (10mm or more)
correlates better with the risk of developingTB.
Other causes can be boosting effect, infection
with environmental mycobacteria in the
intervening period.
For detection of new infections, there should be
a significant increase in reaction size (14mm or
more) in the subsequent test, one-and-half to 3
yrs apart.
52. Interpretation in HIV
patients
All HIV seropositive individuals should be
assessed for activeTB.
Once activeTB is excluded,TST is done as
soon as possible.
Reliability ofTST decreases asCD4+T-Cell
count diminishes, espp.To < 200/cmm.
As the prob. of significant induration indicative
ofTB infection is significantly lower in HIV-
infected persons, a lower cut-off point is
advised.
53. Irrespective of the test results, patients with
evidence of old healedTB inCXR or past H/O
activeTB and a significant reation toTST may
be considered infected for all practical
purposes.
TST should never be the sole criteria for
diagnosingTB.
54. Interpretation in
sarcoidosis
TST in patients with sarcoidosis has a high
specificity but poor sensitivity forTB.
A –veTST in general poulation is a sensitive
test for sarcoidosis.
A +veTST in patients suspected of havin
sarcoidosis is a specific test forTB, and is an
absolute indication for a thorough work-up for
TB.
55. Epidemiological use
Tuberculin surveys are carried out among
young children as the results obtained reflect
relatively recent situation.
Prevalence andAverageAnnual Risk of
Infection (ARI) are calculated.
ARI is defined as the avg. prob. of acquiring
newTB infection over the course of one year.
ARI reflects the overall impact of TB prevalence
in a community and the efficiency of TB control
activities.
56. Newer tuberculins
Further attempts are being made to develop
newer, more species-specific tuberculins.
One of the improvisations is to avoid heating
to prevent protein denaturation of PPD.
Electrophoresis andChromatography.
T-1327 andT-1456 are under progress.
57. Interferon gamma release
assays ( IGRA)
In vitro assays that detect the presence of
CMI towards M. tb-specific antigens.
These include the early secretory antigenic
target-6 (ESAT-6), culture filtrate protein 10
(CFP-10), and theTB7.7 antigens.
The antigens in IGRAs are absent in most of
NTM as well as in BCG strains.
60. Advantages of IGRA’s
Higher specificity thenTST.
Less cross reactivity with BCG vaccination and
NTM infection
Less inter-reader variations.
No boosting phenomenon.
Fewer patient visits.
61. Disadvantages of IGRA’s
A negative IGRA does not rule out activeTB
or LTBI.
IGRAs are not able to differentiate LTBI from
activeTB.
In high-TB incidence countries, there is no
added value in using IGRAs to diagnose LTBI,
as the focus of prevention and control is to
identify and treat active cases.
62. In presence of immunosuppression, a –ve
IGRA should not preclude further
investigations or treatment if clinical suspicion
is high.
Technically more demanding.
Higher cost.
63. Conclusion
Tuberculin test have stood the test of time and
is still widely used for over a century for
detecting the infection withTB and when used
wisely, has promising results.
For now, it is probably a good strategy to keep
both IGRA’s andTST on the LTBI diagnostic
menu, and select the appropriate test based on
population, purpose of testing and the
available resources.