🔺CASE STUDY NO : 57 🔺PART NO : 01 🔺RAJAYAKSHMA (TUBERCULOSIS ) 🔺NIDANAM (Etiology) *Roga-sankara (Multiple diseases together) *Rasa Kshaya (Depletion of nutrition/essence) *Oja Kshaya (Immunity loss) *Vega-dharana (Suppression of natural urges) *Atikarma (Overexertion) *Mental stress *Indulgence in incompatible food habits (Viruddha Ahāra) Reference: Charaka Nidana Sthana 6/3–5, Ashtanga Hridaya Nidāna Sthāna 10,Charaka Nidana Sthana 6) 🔺 PURVAROOPAM (Premonitory Symptoms) *Svasa (breathlessness) *Kasa (cough) *Aruchi (anorexia) *Paridrava (looseness of limbs) *sula (chest pain) *Daurbalya (weakness) *Dinata (mental gloom) Reference: Charaka Nidana Sthana 6/6–7, Madhava Nidana Rajayaksma Nidana 🔺LAKSANA (Symptoms) *Kasa (Cough) *svasa (Dyspnea) *Jvara (Fever) *Arochaka (Loss of appetite) *Ratribala Kṣaya (Night sweats/weakness) *Hrdaya sula (Chest pain) *Ksaya (Emaciation) Reference: Charaka Nidana Sthana 6/8–12, Ashtanga Hridaya Nidana 10/6–9 🔺 Systemic Examination in Tuberculosis 📌General Examination *Weight loss *Pallor *Fever (usually low-grade, evening rise) *Night sweats *Lymphadenopathy (especially cervical) *Respiratory System *Inspection: Chest movements may be reduced on the affected side *Palpation: Decreased tactile fremitus (if pleural effusion) *Percussion: Dullness over areas of consolidation/cavitation *Auscultation: *Crackles (especially in upperlobes) *Amphoric breath sounds (in cavitary TB) *Bronchial breathing over consolidated areas *Other Systems (if extrapulmonary TB): *Abdomen: Hepatosplenomegaly, ascites *CNS: Signs of meningitis (neck stiffness, photophobia) *Spine: Gibbus formation, spinal tenderness (Pott’s disease) *Lymph nodes: Firm, mattednon-tender nodes with/without sinus formation 🔺Laboratory Investigations For Tuberculosis *Basic Blood Tests -CBC: Mild anemia, leukocytosis or lymphocytosis, elevated ESR *CRP: May be raised 🔺SPUTUM EXAMINATION *Sputum for AFB (Acid-Fast Bacilli): Ziehl-Neelsen stain – definitive test *GeneXpert MTB/RIF (CBNAAT): Detects TB DNA and rifampicin resistance *Sputum Culture (Lowenstein-Jensen Medium): Gold standard (time-consuming) *Radiological Imaging *Chest X-ray: *Upper lobe infiltrates, cavitation, fibrosis *Miliary TB: fine nodular pattern throughout both lungs *Pleural effusion *CT Thorax: More detailed, especially for mediastinal lymphadenopathy, miliary pattern *Tuberculin Skin Test (Mantoux Test) *Positive in latent TB infection or active TB *False positives/negatives possible *Interferon-Gamma Release Assays (IGRA) *Used in latent TB screening (e.g., Quantiferon-TB Gold) *Other Tests (for extrapulmonary TB): *CSF analysis (TB meningitis): High protein, low glucose, lymphocytic pleocytosis *Ultrasound abdomen/CT/MRI for abdominal or spinal TB *Biopsy/FNAC of lymph nodes for histopathology and AFB 🛑https://chat.whatsapp.com/KLufxKFrXwbIIAXLxXDqOB