- Tuberculosis infection can occur in either a latent or active form. Latent TB does not cause symptoms but can reactivate later, while active TB makes people sick and contagious.
- One quarter of the world's population has latent TB infection, with most cases occurring in Asia and Africa. New infections and deaths from TB have decreased since 2000.
- TB is spread through airborne droplets when infected people cough, sneeze or speak. The infectious dose is very small.
it is an acute highly contagious /infectious diseases caused by a varicella zoster virus. chicken pox is usually a mild self limiting illness and most healthy children recover with no complication.
Anyone who has had chickenpox in the past may develop shingles, you can only get shingles if you have previously had chicken pox as it is a recurrence or reactivation of the varicella zoster virus.it is not possible to develop shingles from exposure to a person with chickenpox it is possible however to develop chickenpox as a result of exposure to a person with shingles second attacks of chickenpox are rare but do occur.
describing the case definitions, prevalence,modes of transmission,clinical features and presentations,treatment and prevention as a whole of common infectious diseases- small pox,chicken pox, measles, rubella
it is an acute highly contagious /infectious diseases caused by a varicella zoster virus. chicken pox is usually a mild self limiting illness and most healthy children recover with no complication.
Anyone who has had chickenpox in the past may develop shingles, you can only get shingles if you have previously had chicken pox as it is a recurrence or reactivation of the varicella zoster virus.it is not possible to develop shingles from exposure to a person with chickenpox it is possible however to develop chickenpox as a result of exposure to a person with shingles second attacks of chickenpox are rare but do occur.
describing the case definitions, prevalence,modes of transmission,clinical features and presentations,treatment and prevention as a whole of common infectious diseases- small pox,chicken pox, measles, rubella
Intro to TB
epidemiology of TB
Structure of Mycobacterium TB
pathogenesis of TB
Immunosuppression by Mycobacterium TB
types of TB
Clinical manifestation
Diagnosis
Treatment
Update on Tuberculosis Transmission, Parthenogenesis and Epidemiology by Mul...mulusew andualem
This pdf contains vital updated evidences on the current status of TB epidemiology,, transmission, and parthenogenesis. It is a summary note by reviewing various literature on TB. I think, it is crucial to TB officers, students and researchers at d/t levels and locations to have update and take action.
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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Tuberculosis
1.
2. A TB infection doesn’t always mean a person will
get sick. There are two forms of the disease:
• Latent TB: Patient will have the bacteria in the
body, but the immune system keeps them from
spreading. Patient don’t have any symptoms, and
he is not contagious. But the infection is still alive
and can one day become active. If he is at high risk
for re-activation -- for instance, if the patient have
HIV, an infection in the past 2 years, the chest X-
ray is unusual, or the immune system is weakened
-- the doctor will give the patient medications to
prevent active TB.
3. • Active TB. The bacteria multiply and make
the patent sick. Patient can spread the
disease to others. Ninety percent of active
cases in adults come from a latent TB
infection.
A latent or active TB infection can also
be drug-resistant, meaning certain
medications don’t work against the bacteria.
4. One quarter of the world's population was thought
to have latent infection with TB. New infections
occur in about 1% of the population each year. In
2018, there were more than 10 million cases of
active TB, resulting in 1.5 million deaths and
making it the number one cause of death from an
infectious disease at that time. Most TB cases
occurred in the regions of South-East Asia (44%),
Africa (24%) and the Western Pacific (18%), with
more than 50% of cases being diagnosed in eight
countries: India (27%), China (9%), Indonesia (8%),
the Philippines (6%), Pakistan (6%), Nigeria (4%)
and Bangladesh (4%). The number of new cases
each year has decreased since 2000.
5. When people with active pulmonary TB
cough, sneeze, speak, sing, or spit, they
expel infectious aerosol droplets 0.5 to
5.0 µm in diameter. A single sneeze can
release up to 40,000 droplets. Each one of
these droplets may transmit the disease,
since the infectious dose of tuberculosis is
very small (the inhalation of fewer than 10
bacteria may cause an infection).
6. When a person breathes in TB bacteria, the
bacteria can settle in the lungs and begin to grow.
From there, they can move through the blood to
other parts of the body, such as the kidney, spine,
and brain.
TB disease in the lungs or throat can be infectious.
This means that the bacteria can be spread to other
people. TB in other parts of the body, such as the
kidney or spine, is usually not infectious.
People with TB disease are most likely to spread it
to people they spend time with every day. This
includes family members, friends, and coworkers or
schoolmates.
7. Pulmonary (90% of the active cases)
• Chest pain
• Prolonged cough producing sputum
• Hemoptysis in small amounts
• In rare cases, the infection may erode into
the pulmonary artery or a Rasmussen's
aneurysm (inflammatory pseudo-aneurysmal
dilatation of a branch of pulmonary artery
adjacent to a tuberculous cavity), resulting in
massive bleeding.
• Scarring in the upper lobes of the lungs.
8. Extra-pulmonary & General (15-20% of active
cases)
• Pain in affected area
• Fever
• Chills
• Night sweats
• Loss of appetite
• Weight loss
• Fatigue.
• Significant nail clubbing may also occur.
9.
10.
11. TB infection begins when the mycobacteria
reach the alveolar air sacs of the lungs, where
they invade and replicate within endosomes of
alveolar macrophages. Macrophages identify
the bacterium as foreign and attempt to
eliminate it by phagocytosis. During this
process, the bacterium is enveloped by the
macrophage and stored temporarily in a
membrane-bound vesicle called a phagosome.
The phagosome then combines with a
lysosome to create a phagolysosome.
12. The primary site of infection in the lungs, known as
the "Ghon focus", is generally located in either the
upper part of the lower lobe, or the lower part of
the upper lobe. Tuberculosis of the lungs may also
occur via infection from the blood stream. This is
known as a Simon focus and is typically found in
the top of the lung. This hematogenous
transmission can also spread infection to more
distant sites, such as peripheral lymph nodes, the
kidneys, the brain, and the bones. All parts of the
body can be affected by the disease, though for
unknown reasons it rarely affects the heart, skeletal
muscles, pancreas, or thyroid.
13.
14. Chest X-ray
Multiple sputum cultures for acid-fast
bacilli are typically part of the initial
evaluation
The Mantoux tuberculin skin test is often
used to screen people at high risk for
TB. Those who have been previously
immunized with the Bacille Calmette-Guerin
vaccine may have a false-positive test result.
15. The Mantoux test or Mendel–Mantoux test
(also known as the Mantoux screening test,
tuberculin sensitivity test, Pirquet test, or
PPD test for purified protein derivative) is a
tool for screening for tuberculosis (TB) and
for tuberculosis diagnosis.
16. In the Mantoux test, a standard dose of 5
tuberculin units (TU - 0.1 ml) is injected
intradermally on the flexor surface of the left
forearm, mid-way between elbow and wrist. The
injection should be made with a tuberculin
syringe, with the needle bevel facing upward.
Alternatively, the probe can be administered by
a needle-free jet injector. When placed
correctly, injection should produce a pale wheal
of the skin, 6 to 10 mm in diameter. The result
of the test is read after 48-96 hours but 72
hours (3rd day) is the ideal.
17. POSITIVE
The results of this test must be interpreted carefully.
The person's medical risk factors determine at
which increment (5 mm, 10 mm, or 15 mm) of
induration the result is considered positive. A
positive result indicates TB exposure.
5 mm or more is positive in
› An HIV-positive person
› Persons with recent contacts with a TB patient
› Persons with nodular or fibrotic changes on chest X-ray
consistent with old healed TB
› Patients with organ transplants, and other
immunosuppressed patients
18. 10 mm or more is positive in
› Recent arrivals (less than five years) from high-prevalence
countries
› Injection drug users
› Residents and employees of high-risk congregate settings (e.g.,
prisons, nursing homes, hospitals, homeless shelters, etc.)
› Mycobacteriology lab personnel
› Persons with clinical conditions that place them at high risk
(e.g., diabetes, prolonged corticosteroid therapy, leukemia, end-
stage renal disease, chronic malabsorption syndromes, low
body weight, etc.)
› Children less than four years of age, or children and
adolescents exposed to adults in high-risk categories
15 mm or more is positive in
› Persons with no known risk factors for TB[
19. FALSE POSITIVE
TST/PPD in a person who has received BCG
vaccine is interpreted as latent TB infection
(LTBI). Due to the test's low specificity, most
positive reactions in low-risk individuals are
false positives.A false positive result may be
caused by nontuberculous mycobacteria or
previous administration of BCG vaccine.
Vaccination with BCG may result in a false-
positive result for many years after vaccination.
20. False positives can also occur when the
injected area is touched, causing swelling
and itching. If the swelling is less than 5 mm,
it is possibly due to error by the healthcare
personnel causing inflammation to the area.
Another source of false positive results can
be allergic reaction or hypersensitivity.
21. FALSE NEGATIVE
Reaction to the PPD or tuberculin test is
suppressed by the following conditions:
Recent TB infection (less than 8–10 weeks)
Infectious mononucleosis
Live virus vaccine - The test should not be
carried out within 3 weeks of live virus
vaccination (e. g. MMR vaccine or Sabin
vaccine).
Sarcoidosis
22. Hodgkin's disease
Corticosteroid therapy/steroid use
Malnutrition
Immunological compromise
(This is because the immune system needs to
be functional to mount a response to the protein
derivative injected under the skin. A false
negative result may occur in a person who has
been recently infected with TB, but whose
immune system hasn't yet reacted to the
bacteria.)
Upper respiratory virus infection
23. Tuberculosis prevention and control efforts rely
primarily on the vaccination of infants and the
detection and appropriate treatment of active
cases. The World Health Organization (WHO)
has achieved some success with improved
treatment regimens, and a small decrease in
case numbers.
Vaccines
Tuberculosis vaccines and BCG vaccine
The only available vaccine as of 2011 is Bacillus
Calmette-Guérin (BCG). In children it decreases
the risk of getting the infection by 20% and the
risk of infection turning into active disease by
nearly 60%.