[Music] hello people in this video we want to look at what calls complexes Michigan's complex is a complex of three things there are three things in this cons complex which will form this complex it is seen in primary tuberculosis that is a disease what is tuberculosis it's a disease caused by Mycobacterium tuberculosis it's a bacteria this tuberculosis there are two types primary and secondary primary means somebody who never got infected before first time he is getting infection that is primary tuberculosis mostly the seen in children so this is your after important word you have to remember mostly the scene in children here lung usually lung is affected but otherwise if they have ingested the bacteria even small in this time can get affected secondary tuberculosis is where the person is getting the infection for the second time okay so that is what it is so secondary means basically he's getting a reinfection now let us move on so you are understanding right so we are talking about war today Gonz complex so it is a lesion seen in primary tuberculosis only so you have understood what tuberculosis is you have understood what primary tuberculosis is very good now primary tuberculosis has this Gaunt's complex how will you define this cause complex it is a lesion produced or Leon Leon produced in the tissue of portal of entry wherever the bacilli has entered at that place in that tissue there will be three things a four sign a draining lymphatic vessel and lymph node three things are affected look at that here so this is the lung let us say that guy inhaled this bacteria tuberculous bacteria so here there is a for sign then draining a lymphatics and here is the lymph node to which it is reaching correct so from here to here so there are three components right so these three components together from the Gaughan's complex or the primary complex so it is what is it how will you define it gonns complex is the lesion produced at the four of entry in the dish or at the portal of entry with the full side in draining lymphatic vessel and lymph node okay if the person has inhaled the bacteria then you will see this in the nun and the lymph node that is associated will be the hilar lymph node if the person has ingested the bath and I threw food or some contamination he got it then you will see the gods complex in the small in this time and the lymph node affected will be the missing the Rick lymph node okay it will be the missing ring names mode so gongs complex you can see in both the places you can see in lung or you can see the small intestine most commonly lism now what are the components of gongs complex you only know this there are three components let us say if it is off the longer than you will see a pulmonary component right you can see here there's a gongs focus here and there is a lymphatic component and a high not lymph node component okay so look at the details of this gongs for Sai Gon suppose I or Vance focus it should be 1 to 2 centimeter solitaire area typical as pneumonia will be there usually the upper part of lower lobe is affected subdural focus see here guns focus upper part of lower loop okay then coming to the lymphatic vessel component here in lymphatic vessel component what will be you can see the lymph will contain phagocytes containing the basilic so basically in the lymph you will see phagocytes that contain the Vasiliy okay what about the lymph node component lymph node in this case is the hilar lymph node right of the lung in the lung layer in the pulmonary system the hilar lymph node will be enlarged okay in the lymph node when you observe under the microscope you will see granuloma aquellas necrosis etcetera we'll come to that okay so did you understand the three components of Gon's complex what are the three components of Gaunt's complex you have the pulmonary component the Gaughan's focus do you have the lymph decreasing component and the lymph node component okay now look at the microscopy here this is a microscopic image from our lab so you can see here that there is a gaseous necrosis this is a lymph node guys this is a lymph node tuberculous and tuberculosis lymph node this is you can see cassius necrosis here and also here so this tuba class tuberculosis lymph node okay so let us look at the details of what exactly we have to see here this is a granuloma right now in the granuloma in the center you actually have this bacilli that is the micro bacterium tuberculosis will be there around it there is cassius necrosis this is gaseous necrosis guys then you have the epithelioid cells epithelioid cells are nothing but the macrophages okay epithelial cells these epithelioid cell some sometimes they join together and they form a giant cell which is seen here this is a giant blank Hansel so all the epithelioid put together some of them they will form this giant cell liang hand giant cell okay then around all this around all this you will find four fibroblasts these are fibroblasts okay so you ought on all you saw typical Vassily cassius necrosis epithelioid cells which have joined together to form a giant cell and then around all this you have the fibroblasts so there is some fibrosis happening around spacious necrosis okay so look at the texture what will you see in the microscope you will see tuberculous granuloma you will see a granuloma then in the center of the granuloma what will you see in the center of the granuloma you will see cassius necrosis at the center of the granuloma and around the granuloma you can have fibrosis and calcification very good that's more if it is smaller this time then what is affected mesenteric lymph nodes are affected and if the mesenteric lymph nodes are enlarged it is called as babies Sint Erica these enlarged lymph nodes can rupture and can lead to tuberculin peritonitis okay so what happens if the mesenteric lymph nodes rupture it can lead to tubercle is peritonitis now let's move on fate of primary tuberculosis what can be the fate of primary tuberculosis it can heal by fibrosis or calcification it can heal if it is of this smaller design you saw that it can lead it tabes mesenteric our that is enlarged lymph nodes mesenteric lymph nodes which may rupture to lead to tuberculous peritonitis this is going to be another fate of the line primary tuberculosis in the lung it can go from one lung to the other so this will be called as the progressive primary tuberculosis it's seen in immunocompromised people like aids etc this is dissemination through bronchi okay this is scene in immuno compromised example AIDS okay then moving on to the next point here the faith of primary tuberculosis and other faiths is that by hamato genus root it can start spreading and this will lead to primary miliary tuberculosis miliary tuberculosis you can see here how the lung looks right so that's what you can see here right so that is another faith of primary tuberculosis then you have one more last one here last fate of primary tuberculosis it can eat what would have healed it can get reactivated and primary tuberculosis can become secondary to both losses that's all so that's why they say for cubic losses if you are if you are diagnosed you should take the treatment full course without leaving any tablet so they try to they try to see a dots therapy where they can directly observe whether the person was taking the medication or not because tuberculosis burden is very high on our country so that is why they had is directly observed therapy dots therapy not so now they have other ways of monitor so basically tuberculosis should they should take full treatment okay so that we are done with Ron's complex guys remember this diagram will be very easily able to write the guns complex in the exam draw this diagram also to get mouths okay that's all for now bye bye [Music]