ceramah tibi mn nazrul 05 mac 2009
TRANSCRIPT
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PENGENALAN TIBIPENGENALAN TIBI
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BAKTERIA / TUBERCULER BACILLIBAKTERIA / TUBERCULER BACILLITuberculosis / TB disebabkan Tuberculosis / TB disebabkan oleh:-oleh:-
i. i. MycobacteriumMycobacterium tuberculosistuberculosis
ii. ii. MycobacteriumMycobacterium bovisbovis
iii.iii.MycobacteriumMycobacterium africanumafricanum
iv.iv.MycobacteriumMycobacterium mycrotimycroti
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MycobacteriumMycobacterium tuberculosistuberculosis Ciri – ciri:-Ciri – ciri:-Acid Alkohol Fast Bacilli (AFB)Acid Alkohol Fast Bacilli (AFB)Hidup bergantung sepenuhnya pada udara Hidup bergantung sepenuhnya pada udara (Obligat aerobik)(Obligat aerobik)Berbentuk batang silinder, ‘rod shape bacilli’Berbentuk batang silinder, ‘rod shape bacilli’Dinding sel tebal – lipid & lilinDinding sel tebal – lipid & lilinHydrophobic (tidak telap air) pada keadaan Hydrophobic (tidak telap air) pada keadaan biasabiasaKebal pada pembasmi kuman yang biasaKebal pada pembasmi kuman yang biasaMasih boleh aktif walaupun dipanaskan @ 60°c, Masih boleh aktif walaupun dipanaskan @ 60°c, 20 minit20 minitDisebarkan melalui udara daripada pesakit TBDisebarkan melalui udara daripada pesakit TB
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Sesuai hidup di paru-paruSesuai hidup di paru-paru
Masa generasi lambat: 12 jamMasa generasi lambat: 12 jam
Dapat hidup dlm sputum kering di antara 6-8 Dapat hidup dlm sputum kering di antara 6-8 bulanbulan
Sensitif pada sinaran langsung cahaya matahariSensitif pada sinaran langsung cahaya matahari
TANDA – TANDA PENYAKITTANDA – TANDA PENYAKIT• Batuk yang berpanjangan dan kadang2 berdarahBatuk yang berpanjangan dan kadang2 berdarah• Kurang selera makanKurang selera makan• Sakit dadaSakit dada• Deman yang berpanjanganDeman yang berpanjangan• Susut berat badanSusut berat badan
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THE BACTERIA : THE BACTERIA : Mycobacterium tuberculosis Mycobacterium tuberculosis
(Tubercle Bacilli(Tubercle Bacilli))THE BACTERIA : THE BACTERIA : Mycobacterium tuberculosis Mycobacterium tuberculosis
(Tubercle Bacilli(Tubercle Bacilli))
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Morfologi M Tuberculosis di atas Morfologi M tuberculosis di Morfologi M Tuberculosis di atas Morfologi M tuberculosis di atasatasmedia Ogawamedia Ogawa di dalam smear AFB di dalam smear AFB
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CARA DIAGNOSISCARA DIAGNOSISKlinikalKlinikalX-rayX-rayMakmal Makmal - Pengesanan - Pengesanan ~ pemeriksaan kahak ( paling ~ pemeriksaan kahak ( paling
penting penting dalam kawalan penyakit TB )dalam kawalan penyakit TB )
~ PCR~ PCR : Test In 4 Hour : Test In 4 Hour~ Bio-Cips~ Bio-Cips : Test In 1-2 Hour : Test In 1-2 Hour
- Pengasingan- Pengasingan ~ kultur : konvensional ~ kultur : konvensional : BACTEC 460TB: BACTEC 460TB : MGIT 960TB: MGIT 960TB
~ Drug susceptibility test~ Drug susceptibility test~ Gen Probe or BD Probe~ Gen Probe or BD Probe
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KEPENTINGAN PEMERIKSAAN KEPENTINGAN PEMERIKSAAN KAHAK & RKTBKKAHAK & RKTBK
Mengapa kahak diperiksa?Mengapa kahak diperiksa?– Tanda-tanda penyakitTanda-tanda penyakitKegunaan ujian ini:Kegunaan ujian ini:– Pengawasan rawatanPengawasan rawatan– DiagnosaDiagnosa
Kahak positif = berjangkitKahak positif = berjangkitTeknik ini kurang sensitif, tetapi satu-satunya Teknik ini kurang sensitif, tetapi satu-satunya kaedah terbaik & tercepat mengesan kes kaedah terbaik & tercepat mengesan kes berjangkit. (2004 – 2juta dikesan melalui berjangkit. (2004 – 2juta dikesan melalui perkhidmatan kesihatan)perkhidmatan kesihatan)
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Kaedah utama mencari kes di Malaysia / DuniaKaedah utama mencari kes di Malaysia / Dunia
Boleh mengesan kes berjangkit (kahak positif)Boleh mengesan kes berjangkit (kahak positif)
Membantu menyekat penyebaran penyakitMembantu menyekat penyebaran penyakit
Banyak definasi RKTB berdasarkan hasil Banyak definasi RKTB berdasarkan hasil pemeriksaan kahak. Eg. pemeriksaan kahak. Eg. Cure infectious casesCure infectious cases
Pemeriksaan smear x 3,Pemeriksaan smear x 3,
80-83% - 1st. Specimen80-83% - 1st. Specimen
10-14% - 2nd. Specimen10-14% - 2nd. Specimen
5-8% - 3rd. Specimen5-8% - 3rd. Specimen
Smear negative does not exclude TB (tdk Smear negative does not exclude TB (tdk semestinya bukan TB)semestinya bukan TB)
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LABORATORY TECHNIQUESLABORATORY TECHNIQUES
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SPUTUM COLLECTIONSPUTUM COLLECTION
Pre –Collection CounsellingPre –Collection Counselling
Berikan penerangan kpd pesakit tentang cara & Berikan penerangan kpd pesakit tentang cara & kepentingan pengambilan sampel kahak supaya kepentingan pengambilan sampel kahak supaya pesakit yakin utk memberikan sampelpesakit yakin utk memberikan sampel
Berikan bekas kahak kepada pesakit & pastikan Berikan bekas kahak kepada pesakit & pastikan pesakit berkahak di kawasan terbuka bkn didlm pesakit berkahak di kawasan terbuka bkn didlm kawasan yang tertutupkawasan yang tertutup
Pastikan pesakit membasuh mulut dan tiada sisa Pastikan pesakit membasuh mulut dan tiada sisa makanan di dalam mulut sblm berkahak makanan di dalam mulut sblm berkahak
Sampel yg berkualiti haruslah kahak yg pekat, Sampel yg berkualiti haruslah kahak yg pekat, kekuningan, mengandungi sedikit calitan darah kekuningan, mengandungi sedikit calitan darah dan paling penting sampel itu bkn air liurdan paling penting sampel itu bkn air liur
Jumlah sampel yang sesuai adalah 5-10mlJumlah sampel yang sesuai adalah 5-10ml
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CARA-CARA BERKAHAKCARA-CARA BERKAHAK
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CARA-CARA BERKAHAK 1CARA-CARA BERKAHAK 1
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CARA-CARA BERKAHAK 2CARA-CARA BERKAHAK 2
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CARA-CARA BERKAHAK 3CARA-CARA BERKAHAK 3
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Rawatan TBRawatan TB
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FASA RAWATANFASA RAWATAN
BULAN PERTAMABULAN PERTAMA
BULAN KE 2BULAN KE 2
BULAN KE 3BULAN KE 3
BULAN KE 4BULAN KE 4
BULAN KE 5BULAN KE 5
BULAN KE 6BULAN KE 6
FASA INTENSIF
DAILY DOSES ( 2 SHRZ atau2 EHRZ atau 2 HRZ )
FASA SAMBUNGAN
DAILY / BIWEEKLY DOSES
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Jenis UbatanJenis Ubatan
Isoniazid ( H )Isoniazid ( H )
Rifampicin ( R )Rifampicin ( R )
Pyrazinamide ( Z )Pyrazinamide ( Z )
Streptomycin ( S )Streptomycin ( S )
Ethambutol ( E )Ethambutol ( E )
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TB Boleh Di Rawat SepenuhnyaTB Boleh Di Rawat Sepenuhnya..
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CONTOH-CONTOH SAMPELCONTOH-CONTOH SAMPEL
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Kahak Kahak berwarnaberwarna
kekuningankekuningan
CONTOH SAMPEL KAHAKCONTOH SAMPEL KAHAK
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CONTOH SAMPEL KAHAKCONTOH SAMPEL KAHAK
Kahak Kahak bercampurbercampur dengan darah dengan darah
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CONTOH SAMPEL KAHAKCONTOH SAMPEL KAHAK
Kahak Kahak BerdarahBerdarah
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GAMBAR-GAMBAR PESAKIT GAMBAR-GAMBAR PESAKIT TIBITIBI
PESAKIT DI WAD TIBI LELAKIPESAKIT DI WAD TIBI LELAKI
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PESAKIT DI WAD TIBI LELAKIPESAKIT DI WAD TIBI LELAKI
PESAKIT DI WAD TIBI LELAKIPESAKIT DI WAD TIBI LELAKI
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WAD LELAKI IPRWAD LELAKI IPR
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WAD LELAKI IPRWAD LELAKI IPR
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