Tuberculosis – Treatment, Counseling and Motivation of The Patient
Though age old stigma with tuberculosis has educed but people still have misconceptions about the disease, its contagiousness and the way it can affect others.
Clear communication is the keystone of patient diagnosis and it begins with telling the correct diagnosis and counseling the patient and family.
It is preferable to counsel the family together to begin with, to educate them and to dispel myths and to gain their support towards regular compliance by the patient. Read more
Mantoux Test In Tuberculosis
The Mantoux test is very widely used test for tuberculosis. Its interpretation however complex. It is also called tuberculin test.
Tuberculin is a glycerol extract of the tubercle bacillus. Purified protein derivative (PPD) tuberculin is a precipitate of non-species-specific molecules obtained from filtrates of sterilized, concentrated cultures.
The test is named after Charles Mantoux, a French physician who developed on the work of Koch.
Procedure
A standard dose of 5 Tuberculin units (0.1 mL) is injected intradermally and read 48 to 72 hours later. A person who has been exposed to the bacteria is expected to mount an immune response in the skin containing the bacterial proteins. Read more
Chest Xray and Computed Tomography in Tuberculosis of Lungs
Chest Xray
The radiological opacities in a chest x-ray are a result of the pathological processes taking place in the lungs. TB causes alveolar consolidation, necrosis, cavitation and fibrosis, features, which it shares with a variety of lung diseases.
TB also shares its radiological features with many other pulmonary diseases. There is no radiological feature that is absolutely typical of pulmonary TB and other diseases may mimic TB radiologically. The following features, however, when seen on a chest skiagram, suggest a diagnosis of TB: Read more
Treatment of Esophageal Variceal Bleeding
Sclerotherapy: Sclerosing agents like sodium tetradocyl sulphate and 3 percent phenol in water are injected through upper GI endoscopy, around the varices. They obliterate the blood vessels and prevent future bleeds.
It stops variceal bleed in 80 percent of patients and can be repeated if bleeding recurs. However, if there is active bleeding, sclerotherapy is hazardous and first the bleeding should be controlled by balloon tamponade. Read more
Side Effects of Drugs During Treatment of Tuberculosis
Isoniazid
Common side effects: Hepatitis, peripheral neuropathy
Uncommon side effects: Cutaneous reactions, arthralgia, drug induced lupus, optic neuritis, convulsions, mental symptoms aplastic anaemia, haemolytic anaemia agranulocytosis, gynaecomastia.
Need For Family Contact Survey In Tuberculosis
Mycobacterium tuberculosis can survive or a long time in darkness, away from sunlight.Those persons who stay indoors for prolonged periods with a patient of pulmonary TB are most likely to get infected.
A patient of tuberculosis is likely to have infected some of his own family members prior to reporting to you.
Of those infected, some may develop the disease. Read more
Investigations That Aid In Diagnosis of Pulmonary Tuberculosis
Routine blood and urine examinations in pulmonary tuberculosis are as non-specific as those of physical examination. The patient may be found to be anaemic with a normal or raised WBC count.
Erythrocyte sedimentation rate (ESR)
ESR is o a non-specific investigation which may become rapid in a large variety of clinical conditions ranging from anaemia to any chronic infectious, inflammatory or malignant disease. Read more
A Short Note On Tuberculosis
About the Disease
Tuberculosis (TB) is a contagious disease caused by mycobacterium tuberculosis. When this bacillus is stained with carbol fuchsin it appears purplish red. The bacterium retains this dye even when it is washed with acid and alcohol. That is why it is called acid fast bacillus (AFB). Mycobacterium tuberculosis can remain dormant for many years in the lung without producing disease.
The spread of infection
The patient with pulmonary TB is the source of infection to others around him, especially when his sputum contains AFB. When such a patient coughs, he expels thousands of tiny droplets around him which have AFB in them.
Transmission of infection takes place when those around him breathe this contaminated air. Direct sunlight rapidly destroys AFB, but they can survive for long periods in darkness. Thus the risk of transmission of infection is highest in those persons who stay indoors with such a patient for long periods, e.g. family contacts. Read more
List of Deformities In Rheumatoid Arthritis
Wrist
- Radial deviation
- Carpal supination
- Prominent, unstable ulnar head
- Extensor tenosynovitis
Causes of Portal Hypertension
Portal hypertension is increased portal vein pressure over the normal pressure of 5-8 mm Hg. As the portal pressure rises above 10-12 mm Hg, collateral veins between the portal and the systemic venous system dilate. Thus an attempt is made by the body to reduce the portal venous pressure.
The main sites are gastro-esophageal junction, rectum, diaphragm, left renal vein, retroperitoneum and the anterior abdominal wall via the umbilical vein. Read more