India Case Study

Tuberculosis has long been a disease that the human culture has been dealing with which entails significant morbidity and mortality worldwide. With dealing with such a horrific disease over the years, discoveries and evolution on the appropriate ways to contain, diagnose, and challengingly treat the disease has changed. One of the most concerning complications of this worldwide public health issue is the ability for it to quickly spread in high populated areas while becoming ever more resistant to forms of treatment not available in all locations around the world. This is a serious public

Now, scientists are warning signs of risks of tuberculosis and share information about bacterias and viruses. Today, when a new germ is known, they have a better chance of learning how to cure and fight it. Volunteers take the time to help in laborites in the United States, South America, Central America, and Asia. The World Health Organization reports that third of the world’s population is infected and eight million people get sick from tuberculosis that is identified to be helped by medicine from spreading the disease to

Tuberculosis is a disease of an infectious nature caused by a bacterium known as mycobacterium tuberculosis. The disease spreads through the air. People with the disease can spread it to susceptible people through coughing, sneezing, talking or spitting. It mainly affects the lungs and other parts such as the lymph nodes and kidneys can also be affected. The symptoms for TB are fatigue, coughing, night sweats, weight loss and fever. One third of the population of the world is affected with mycobacterium tuberculosis. The rate of infection is estimated to be one person per second. About 14 million people in the world are infected with active tuberculosis. Drug resistant TB has been recorded to be a serious public health hazard in many countries. Resistant strains have developed making it difficult to treat the disease. TB has caused millions of death mainly in people living with HIV/AIDS ADDIN EN.CITE Ginsberg19981447(Ginsberg, 1998)1447144717Ginsberg, Ann M.The Tuberculosis Epidemic: Scientific Challenges and OpportunitiesPublic Health Reports (1974-)Public Health Reports (1974-)128-13611321998Association of Schools of Public Health00333549http://www.jstor.org/stable/4598234( HYPERLINK l "_ENREF_3" o "Ginsberg, 1998 #1447" Ginsberg, 1998). The World Health Organization came up with the DOTS (Directly Observed, Therapy, Short course) strategy. The approach involves diagnosing cases and treating patients with drugs for about 6-8

Tuberculosis, the white plague as used to be called once upon a time is still one of the deadliest bacterial killers affecting almost all parts, all corners of the globe. Though successful anti-tubercular antibiotic regimens and effective vaccine are available for decades and being used in the battle against Koch’s bacillus, Mycobacterium tuberculosis, the causative agent of this chronic multi organ granulomatous disease, our strand in the battle continuously seems to be in the losing side. Moreover the increasing prevalence of HIV-AIDS and diabetes mellitus is being proved to be providing predisposition to tuberculosis. As witnessed by the WHO, which has estimated that, in the year 2012, 8.6 million people have developed tuberculosis and 1.3 million have died of the disease including 320000 deaths of HIV-TB co-infected people (Global tuberculosis report 2013. World Health Organization; 2013). Long term antibiotic therapy and that too associated with several side effects and discomforts have diminished patient compliance with the anti-tubercular chemotherapy. This fact in turn has raised the new deadlier MDR-TB and XDR-TB strains. The whole scenario is a matter of panic and questioning the effectiveness of anti-tubercular antibiotics, immunologic efficacy of century old BCG vaccine and all other medical advents.

The gold standard imaging modality for TMJ by which changes in disc position, morphology, and degenerative changes can be confirmed is magnetic resonance image (MRI).

During a brain MRI, a special mechanism called a head coil is placed around the patient's head to assist in producing very detailed images of the brain. The head coil does not touch the person, and the person can see through large gaps in the coil. A spine MRI is normally used to look for a herniated disk or narrowing of the spinal canal in patients with neck, arm, back, and leg pain. It is also the best examination to use to search for a recurrent disk herniation in a patient who has had prior back surgery. A bone and joint MRI can be used to check virtually all of the bones, joints, and soft tissues; it can be used to identify injured tendons, ligaments, muscles, cartilage, and bones. A MRI of the abdomen is most commonly used to look more specifically at an abnormality seen on another test, such as an ultrasound or a CT scan. The exam is usually customized to look at such organs as the liver, pancreas, or adrenal glands. For female patients, a pelvic MRI provides a more detailed look at the ovaries and uterus and is often used to follow up an abnormality seen on ultrasound. For male patients, a pelvic MRI is sometimes used to check those diagnosed with prostate cancer. Magnetic resonance angiography (MRA) depicts the blood vessels. The blood vessels in the neck and brain are often studied by MRA to look for areas of narrowing or widening. In the abdomen, the arteries supplying blood to the kidneys are also

They talk about how important the MRI is to detecting the early symptoms like inflammation in sacroiliac joints with nonradiographic axial spondyloarthritis . Where originally they were dependent on radiographic methods which were not as effective at catching the early symptoms in these joints.

However, plain films were not obtained. There is no clear rationale for the indication of shoulder MRI with unequivocal objective findings and absence of plain films. In addition, there is no focal neurological deficit on the exam. There are no sensory or motor deficits noted. Medical necessity has not been established. Recommend non-certification.

On examination, there is decreased range of motion with pain with flexion/extension. There is positive tenderness

Temporomandibular disorder usually is a dysfunction involving anatomical structures like the temporomandibular joint, muscles/ligaments/tendons surrounding the joint, structures surrounding the joint such as the ears, neck, cervical spine, teeth, & face, ligaments, nerves, and blood vessels surrounding the joint, mouth, and teeth. TMJ disorder either impacts the joint itself, or the muscles responsible for occlusion and jaw mobility. When there is an imbalance within any of the structures in and around the temporomandibular joint there is a potential risk for a TMJ disorder (1). The best imaging modality for viewing the TMJ and the disc is an MRI where a normal disc will appear the same on both T1 and T2 weighted images. In cases of acute disc mobility there will be an increased signal intensity on T1 images (2). Hard tissue imaging can be used to asses osteoarthritis (3). So when there is a derangement of the muscles surrounding the joint, the disc itself, the bones forming the joints or the tendons connecting them, which can be visualized with an MRI or an X-ray and when the condition is accompanied by clinical symptoms like pain, swelling or clicking noises, we can conclude on a TMJ disorder. Pain and functional disturbances related to the TMD are a common occurance. Uyanik et al defines TMJ syndrome as a collective disorder encompassing: 1. Myofascial pain dysfunction syndrome- where there is pain at the TMJ due to various causes of increased muscle tension

MRI of the right knee dated 12/09/15 showed no evidence of meniscal, cruciate, or collateral ligament tear. There is fluid seen extending into the articular cartilage of the lateral tibial plateau compatible with chondral injury. Furthermore, there is mild chondromalacia involving the medial facet of the patella.

TM had MRI in 8/7/2013 and 2/15/2017 Today 2/15/2017 results reviewed and TM verbalized the results including Significant degenerative osteoarthrosis of the AC joint with mild subacromial subdeltoid bursitis that was seen since 8/7/2013 MRI and again on 2/15/20`17

In the current study the most frequent FFB was the fourth IM bursa (IM4/5) (20.1%) while the most frequent SM bursa was the first (16.1%) with the least frequent one of all being the third SM bursa. The same finding was reported by Bowen CJ et al (18) and Hooper L et al (24). The SM bursae are considered mostly pathological or symptomatic so their hypertrophy might cause pain or cause activity limitation. (18) Ultrasound detectable synovial hypertrophy of the MTP joints was present in 60% of the studied patients. Similar results were detected by Bowen CJ where the US detectable MTP synovial changes were present in 67.5 % of his patients. (25)There was no statistically significant correlation between the total number of FFB and CDAI.

10/7/15 MRI of the right lower extremity showed partial tear of the anterior talofibular ligament suggested with heterogenous thickened anterior tibiofibular ligament. There was also posterior tibial tenosynovitis, subcutaneous circumferential soft tissue edema most pronounced medially. There was moderate Achilles tendinosis with partial longitudinal tear/intrasubstance degeneration. There was minimal posterior calcaneal edema appreciated extending to the plantar fascial origin with plantar fascial calcaneal small spur noted. Posterior distal tibial minimal edema and cystic change was

Tuberculosis is among the fatal diseases that are spread through the air. It’s contagious, meaning that it spreads from one infected individual to another, and at times it spreads very fast. In addition to being contagious, the disease is an opportunist infection as it takes advantage of those with weak defense mechanism, and especially the ones with terminal diseases like HIV and AIDS. Tuberculosis is therefore among the major concerns for the World Health Organization due to its contagious nature (World Health Organization 1).