Tuberculosis is a chronic infectious disease caused by the bacterium Mycobacterium tuberculosis, which most commonly affects the lungs. It is one of the top 10 causes of death worldwide. The disease is transmitted through the air when people who are sick with TB expel bacteria into the air, for example by coughing. Common symptoms include cough with sputum and blood at times, fever, night sweats, and weight loss. Diagnosis involves tests such as chest X-rays, sputum smear microscopy, and culture. Treatment involves a combination of antibiotics over a period of 6-9 months. The Revised National Tuberculosis Control Programme aims to reduce mortality and transmission of TB in India through improved case detection and
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
Clinical presentation of active TB
Differential diagnosis of TB
Etiology
Transmission
Factors influencing transmission
Pathogenesis of Latent
TB Disease
Co-pathogenesis
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
Clinical presentation of active TB
Differential diagnosis of TB
Etiology
Transmission
Factors influencing transmission
Pathogenesis of Latent
TB Disease
Co-pathogenesis
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. TUBERCULOSIS
Is the most prevalent communicable infectious
disease on earth and remains out of control in many
developing nations
It is a chronic specific inflammatory infectious disease
caused by Mycobacterium tuberculosis in humans
Usually attacks the lungs but it can also affect any
parts of the body
Also Known as “ KOCH’s Disease”, “wasting disease”
and the “white plague.”
3. Tuberculosis can produce atypical signs and
symptoms in
Infants,
Elderly, and
Immunocompromised hosts
It can progress rapidly in these patients
5. EPIDEMIOLOGY
Roughly one of every three people on earth is
infected by M. tuberculosis (WHO, 2008)
The distribution is very uneven, with the highest
incidences found in southern Asia and sub-Saharan
Africa
In the United States, about 13 million people have
LTBI, evidenced by a positive skin test [purified
protein derivative (PPD)] but no signs or symptoms of
disease
6. EPIDEMIOLOGY
Every year approximately 1.7 million people
develop TB
Tuberculosis (TB) kills about 2 million people
each year
The emergence of drug resistant organism
threatens to make this disease once again
incurable
India has the highest number of TB cases in the
world, accounting for around one in four cases
globally, according to the WHO.
7. ETIOLOGY
MYCOBACTERIUM TUBERCULOSIS
It presents either
as latent TB infection (LTBI) or
as progressive active disease.
The latter typically causes progressive destruction
of the lungs, leading to death in most patients who
do not receive treatment
8. CHARACTERISTICS OF
M. TUBERCULOSIS
Rod shaped,
0.2-0.5 µ in D, 2-4 µ in L
Mycolic acid present in its cell wall,
makes it acid fast
It resists decolourization with acid &
alcohol
Aerobic and non motile
It multiplies slowly, can remain
dormant for decades
9. Main species of mycobacterium
causing tuberculosis:
TYPICAL MYCOBACTERIA
1. Mycobacterium tuberculosis
2. Mycobacterium hominis
3. Mycobacterium bovine
ATYPICAL MYCOBACTERIA
1. Saprophytic mycobacteria
2. Mycobacterium avium
10. RISK FACTORS OF TUBERCULOSIS
Low socioeconomic status
Crowded living conditions
Diseases that weakens immune
system like HIV
Person on immunosuppressant
like steroid
Health care workers
Migration from a country with a
high number of cases
Alcoholism
Recent Tubercular infection
(within last 2 years)
11. CO-INFECTION WITH
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
HIV is the most important risk factor for active TB,
because the immune deficit prevents patients from
containing the initial infection
Coinfection with HIV
Accelerates the progression of both diseases
Requiring rapid diagnosis and treatment of both
diseases
12. Classification of TB
TB
Pulmonary (85-90%) Extra-pulmonary (10-15%)
Sputum
Positive TB
(Those who
have
bacteria in
sputum)
Sputum
Negative TB
(Those who
do not have
bacteria in
sputum)
Lymph Nodes
Bones & Joints
Genitourinary tract
Meninges
Intestines
Skin
13. How is TB Transmitted?
Person-to-person through the
air by a person with active TB
disease of the lungs
Less frequently transmitted
by: Ingestion of M. bovis
found in unpasteurized milk
Inoculation (in skin
tuberculosis)
Transplacental route (rare
route)
14. Type of tuberculosis infection
Pulmonary TB :
1. PRIMARY TUBERCULOSIS :
The infection of an individual who has not been previously infected or
sensitized is called Primary tuberculosis or Ghon’s complex or childhood
tuberculosis.
2. SECONDARY TUBERCULOSIS :
The infection that individual who has been previously infected or
sensitized is called secondary or post primary or reinfection or
chronic tuberculosis.
15. PRIMARY TUBERCULOSIS
PRIMARY INFECTION
The progression to clinical disease in a previously
unexposed, immunocompetent person depends on
three factors:
1. The number of M. tuberculosis organisms inhaled
2. Infecting dose and the virulence of these organisms
3. The development of anti-mycobacterial cell-mediated
immunity
Immunity to M. tuberculosis is primarily mediated by
TH1 cells, which stimulate macrophages to kill the
bacteria
16. PRIMARY TUBERCULOSIS
Disease that develops in a previously unexposed
person.
Almost always begins in lungs
Inhaled bacilli implant in the distal airspaces of lower
part of upper lobe or upper part of lower lobe
1-1.5 cm area of grey white inflammation with
consoldation develops, called as Ghon focus which
often caseates
17. FATE OF PRIMARY TUBERCULOSIS
No progression
Healing by fibrosis and calcification
Ghons complex after undergoing progressive fibrosis
produces radiologically detectable calcification called
as RANKE COMPLEX
Progressive primary tuberculosis
Primary miliary tuberculosis
Dissemination to organs like liver, spleen, kidney,
..etc.
18.
19. FATE OF SEC. PULMONARY TB
The lesion may heal with fibrous scarring and
calcification
The lesions may coalesce together to form large area
of tuberculous pneumonia and produce progressive
secondary pulmonary tuberculosis producing
pulmonary & extra pulmonary lesions:
Tuberculous caseous pneumonia
Fibrocaseous tuberculosis
Miliary tuberculosis
20. MILIARY TUBERCULOSIS
Extensive infection via hematogenous spread
In lung: lesions are either microscopic or small, visible
foci (2mm) of yellow white consolidation scattered
through out lung parenchyma
Miliary pulmonary disease can cause pleural
effusion, tuberculous empyema or obliterative
fibrous pleuritis.
Extra pulmonary miliary tuberculosis is most
prominent in the liver, spleen, bone marrow,
adrenals, meninges, kidneys, fallopian tubes and
epididymis but can involve any organ
23. SYMPTOMS OF TB
Most common symptom of TB
•Cough for 2 weeks or more
Other symptoms of TB are:
• Fever, especially evening rise
• Pain in the chest
• Loss of weight
• Loss of appetite
• Coughing up blood-stained
sputum
• Shortness of breath,
• Tiredness
26. Tests may include:
Chest CT scan
Chest X-ray
Tuberculin skin test (also called a PPD test)
Sputum examination and cultures
Interferon-gamma release blood test such as
the QFT-Gold test
Bronchoscopy
Thoracentesis
Biopsy of the affected tissue (rare)
27. Chest X-ray
Tuberculosis creates cavities
visible in x-rays like this one in the
patient's right upper lobe.
Abnormalities on chest
radiographs may be suggestive, but
are never diagnostic of TB.
However, chest radiographs
may be used to rule out.
29. SPUTUM EXAMINATION
Are essential to confirm TB
Best collected in morning before any meal
Sputum examination on 3 days, increase chances of detection
Sputum can be collected from laryngeal swab or bronchial
washing In small children, gastric lavage can be examined.
Smear should be prepared from thick dirty part of sputum &
stained with Ziehl-Neelson technique
30. Acid Fast Bacilli “AFB”
Smear Test
Specimen examined for acid fast bacilli by staining:
Ziehl-neelson Acid Fast
Staining
Auramine-rhodamine
Staining
31. Tuberculin skin Test / Mantoux test / PPD test
Purified Protein Derivative (PPD) :
Is a concentrated filter of broth in which tubercle bacilli have
grown for 6 weeks(old).
Standard method for screening & measuring of a person’s
cellular response.
Measuring the size of induration 48-72 hours.
34. Positive Reaction
Person infected in the past or latent TB infection.
After BCG vaccination, but this may last for only 3-7 years .
Persons are retested 2 weeks later; their ppd skin test “boosted” by
the recent antigen injection. High risk of (endogenous infection)
35. Negative Reaction
Persons who have NEVER been infected, they are not
subject to that risk, though they may become infected
from an external source (exogenous infection)
36. A positive tuberculin test result signifies cell-
mediated hypersensitivity to tubercular antigens.
It does not differentiate between infection and
disease
False-negative reactions may be produced by certain
viral infections, sarcoidosis, malnutrition,
immunosuppression
False-positive reactions may also result from
infection by atypical mycobacteria
37. γ-Interferon release assays (GIRA)
Test rely on the fact that T-lymphocytes will release γ-
interferon when exposed to specific antigens.
QFT-gold test measures interferon-gamma in the testee's
blood after incubating the blood with specific antigens
from m. Tuberculosis proteins
38. FIRST LINE DRUG
1. Isoniazid(H)
2. Rifampin (R)
3. Pyrazinamide (Z)
4. Ethambutol (E)
5. Streptomycin (S)
SECOND LINE DRUG
1. Thiacetazone (Tzn)
2. Paraaminosalicylic acid (PAS)
3. Ethionamide (Etm)
4. Cycloserine (Cys)
5. Kanamycine (Am)
6. Capriomycine (Cpr)
NEWER DRUG
1. Ciprofloxacin
2. Ofloxacine
3. Clarithromycine
4. Azithromycine
5. Rifabutine
6. Bedaquiline(Recently)
ANTI-TUBERCULAR DRUG
39. ANTI-TUBERCULAR DRUGS
Medication Drug action Dose(Thrice a
week)***
Dose in
children(mg/kg)
Isoniazid Bactericidal 600 mg 10-15
Rifampicin Bactericidal 450 mg* 10
Pyrazinamide Bactericidal 1500 mg 30-35
Ethambutol Bacteriostatic 1200 mg 20-25
Streptomycin Bactericidal 0.75 g** 15
* Patients who weigh 60 kg or more at the start of treatment
are given an extra 150mg dose of Rifampicin
** Patients over 50 years of age are given 0.5g of streptomycin
*** Adult patients weighing <30kg receive drugs in patients-
wise from the weight band suggested for pediatric patients
42. RIFAMPICIN (R)-Rifamycine
Action
Bactericidal for mycobacteria; also effective against most Gram-positive
and many Gram-negative bacteria.
Mechanism of Action
Binds to the β subunit of DNA-dependent RNA polymerase (rpoB) .
Inhibit RNA synthesis
Dose
10 mg/kg (600 mg),OD
Oral
44. PYRAZINAMIDE (Z)-Nicotinamide analogue
Action
Bactericidal for actively dividing intracellular mycobacteria.
Main effect occur in first few months.
Mechanism of Action
PYRAZINAMIDE
Enter M.tuberculosis
Pyrazinoic acid (POA+)
Kill the mycobacteria
Pyrazinamidase/Nicotinamidase
Inhibit FAS
Inhibit growth mycobacteria
Go extra-
cellular
52. Goal
1. To decrease the mortality and morbidity
2. To cut down the chain of transmission of infection
until TB ceases to be a public health problem
Objectives
To achieve and maintain:
1. Cure rate of at least 90% among newly detected
smear positive (infectious) pulmonary TB cases
2. Case detection of at least 85% of the expected new smear
positive PTB cases in the community
53. Implementation
• Case finding- by passive surveillance on patient with
symptoms of
i) Persistent cough for 2weeks or more.
ii) Haemoptysis
iii) Night sweats
iv) Evening rise of temperature
v) Chest pain
In lab.-
i) Sputum collection for diagnosis
ii) Radiography
iii) Tuberculin test
54. Sputum examination is the best method to diagnose TB
Pulmonary TB diagnosis can be confirmed by sputum
examination.
Two sputum samples are collected over one/two consecutive
days
If the health facility is a DMC, spot sample is collected
immediately and the patient is given a sputum container to
collect early morning sample & brought to the lab
Diagnosis of TB
55. Alternatively the patient can be asked to collect a
morning sample and go to a DMC where a spot
sample can be taken
In case the patient is not able to reach a DMC, both
samples - morning and spot, can be collected and
transported
56. The sputum samples are subjected to microscopy
examination as early as possible
A patient is diagnosed positive if one or both the
samples is positive for bacteria
If the bacteria are not visible in any sputum sample,
the patient is negative and should be referred to a
medical officer for further evaluation
TB of other organs is diagnosed by a medical officer
57. RNTCP revised diagnostic algorithm (2009)
Note: RNTCP has
separate diagnostic
algorithm for
pediatric pulmonary
TB and common
forms of extra-
pulmonary TB
58. DOTS
Directly Observed Treatment
Short Course
Tuberculosis control strategy recommended by the World Health Organization
as the strategy that ensures cure of TB
59. Directly
observed
treatment
(DOT) is one
element of
the DOTS
strategy
An observer
watches and
helps the
patient
swallow the
tablets
Direct observation
ensures treatment for the
entire course
• with the right
drugs
• in the right doses
• at the right
intervals
Directly Observed Treatment Short Course
60. Directly Observed Treatment Short Course
There are two phases in DOTS treatment
1 Intensive Phase(IP):-
Intensive phase is of 2 to 3 months duration
Patient swallow medicine under the observation of a
health worker during IP
Medicines are taken 3 times a week on alternate
days
If the sputum is negative for bacteria after IP,
continuation phase is started
61. Directly Observed Treatment Short Course
2. Continuation Phase
• This phase is of 4 or 5 months duration
• The patient is provided with a weekly blister pack to
take home
• The medicines from the blister pack are taken on
alternate days, three times a week and in the
remaining days, Vitamin tablets are taken
• The first dose of the weekly blister pack is taken under
direct observation of the health worker
• Empty blister packs are collected to ensure that the
medicines are taken at home by the patient
62. H: Isoniazid (300 mg), R: Rifampicin (600 mg), Z: Pyrazinamide (1500 mg), E:
Ethambutol (1000 mg), S: Streptomycin (1000 mg)
1. Patients who weigh 60kg or more receive additional Rifampicin
150mg.
2.Patients who are more than 50 years old receive Streptomycin
500mg.
3. Patients who weigh less than 30kg receive drugs as per Paediatric
weight band boxes according to body weight.
Category Type of Patient Regimen Duration in months
Category I
Color of box:
RED
New Sputum Positive ,
Seriously ill sputum negative,
Seriously ill extra pulmonary,
2 (HRZE)3, 6
4 (HR)3
Category II
Color of box:
BLUE
Sputum Positive relapse,
Sputum Positive failure
Sputum Positive treatment after
default
2 (HRZES)3, 8
1 (HRZE)3
5 (HRE)3
63. ADVANTAGES
The patient is supported to successfully complete the full
course of medication
The patient is monitored closely for side effects of
medications and supported to work through the side
effects appropriately
The patient is encouraged and support.
Reduces the possibility of tuberculosis germs becoming
resistant to the medication.
64. DRUG RESISTANT TB
1. MULTIPLE DRUG RESISTANCE TB (MDR-TB)
An MDR-TB suspect who is sputum culture positive and whose
TB is due to Mycobacterium tuberculosis that are resistant in-
vitro to at least ISONIAZID AND RIFAMPICIN.
2. EXTENSIVELY DRUG RESISTANT TB (XDR–TB)
subset of MDR-TB where the bacilli, in addition to being
resistant to R and H, are also resistant to any
fluoroquinolones and any one of the second-line injectable
drugs (namely Kanamycin, Capreomycin, or Amikacin).
65. For the treatment of MDR-TB cases
STANDARDISED TREATMENT REGIMEN
6 drugs
- kanamycin
- ethionamide
- ethambutol
- ofloxacin
- pyrazinamide
- cycloserine
for 6-9 months of the INTENSIVE PHASE
67. BCG VACCINE
Protective effect against
meningitis and
disseminated TB in
children.
It does not prevent
primary infection and
does not prevent
reactivation of latent
pulmonary infection
68. ROLE OF PHYSIOTHERAPISTS
PT's should be prepared to take a thorough history and a
proper examination in order to better identify TB.
Recognize your patient's signs and symptoms
Patients may present in clinic with musculoskeletal problems
with unknown causes or arthritic pain.
A patient could also be seen in physical therapy if they have
had surgery on their back, in which case the normal
rehabilitation protocols would be followed
69. ROLE OF PHYSIOTHERAPISTS
All physical therapists should be aware of the proper
personal protective equipment (PPE) that should be
worn.
Therapists are able to provide percussion and postural
drainage to clear secretions out of the lung