Lucknow, July 24 (IANS). Starting TB (tuberculosis) treatment based only on X-rays and general symptoms can pose serious risks to patients. Many such cases are coming to light every day in the Civil Hospital of the capital, where medicines are being given to patients without confirming TB, while many genuine TB patients continue to undergo treatment for other diseases.
Experts say that for correct diagnosis of TB, sputum test with X-ray, CB-Not (CBNAAT), gene expert, CT scan and evaluation of the medical background of the patient is necessary. 46-year-old Premchand, a resident of Ahimamau in the capital, complained of persistent cough, shortness of breath and weight loss. After seeing spots in the X-ray, a private doctor started taking TB medicine. Despite taking medicine for a week, the condition did not improve.
Later, during detailed examination at Dr. Shyama Prasad Mukherjee Civil Hospital, it was revealed that he was not suffering from TB but was suffering from a lung nodule. After this the TB medicine was stopped. According to Dr. Ashutosh Dubey, senior tuberculosis specialist of Civil Hospital, not every spot visible in X-ray is the cause of TB. The X-rays of lung cancer, lump, asthma, bronchitis and TB sometimes appear similar. In about 30 percent of cases, the assessment based on X-ray alone proves to be wrong. Therefore, treatment should be started only after TB is confirmed after necessary tests.
Dr. Dubey said that every month 150 to 200 new TB patients and 2 to 3 multi-drug resistant (MDR) TB cases are reported in the Civil Hospital. Every year 15 to 17 thousand MDR TB patients are found in Uttar Pradesh. However, due to timely detection, testing and treatment, the cure rate from TB has now increased to 90 percent and the number of patients per lakh population has also come down to below 200. He said that an untreated TB patient can infect 15 other people every year. If the patient stops taking the medicine midway then MDR TB can develop. If the treatment of MDR is left incomplete, a serious condition like XDR TB can arise, the treatment of which lasts for about two years.
The tuberculosis specialist said that the TB bacteria works on Charles Darwin’s principle of ‘survival of the fittest’. Meaning to adapt oneself to the changing environment. He told that there are four types of TB bacteria. Rapid growers (fast growing), infracellular (inside the cell), cell wall (on the cell wall) and dormant group of bacilli (group of dormant bacteria). The first three types of bacteria are killed by medicines, but the medicines become ineffective on the fourth. When the body’s immunity decreases, these bacteria become active and start growing.
He said that the TB bacteria can remain active for six months in a closed, dark and moist environment, while it can survive for about a month even in sunlight. TB infection spreads in the air through infected droplets released when the patient coughs or sneezes. The risk of infection increases if you stay with a TB patient for about half an hour without a mask and proper distance. Therefore, timely treatment of TB is not only the responsibility of the patient but also the responsibility of the entire society. The doctor says that smoking and other drug abuse, malnutrition, junk food, weak immunity, diabetes, HIV, cancer, anemia and the elderly have a higher risk of TB.
The risk of TB is higher in slums due to dirt and moisture. In Uttar Pradesh, the highest number of TB cases are recorded in Agra, Firozabad, Kanpur, Varanasi, Lucknow and Prayagraj. According to experts, apart from allopathy, doctors of Ayurveda, homeopathy and Unani system also treat TB. Many times, without proper and adequate testing, TB medicines are started on patients, even though they do not have the disease. District Tuberculosis Officer Dr. AK Singhal said that if a person has symptoms like cough, fever, weight loss, loss of appetite or blood in sputum for more than two weeks, he should immediately get tested for TB in the nearest government hospital or health center.
TB patients are given Rs 1000 every month as nutritional assistance by the government. He said that timely identification, testing and regular treatment of TB patients are the most effective ways to completely eliminate this disease. Testing facility using state-of-the-art Endobronchial Ultrasound (EBUS) technology has been started at Dr. Ram Manohar Lohia Institute of Medical Sciences to identify lung related diseases.
Dr. Ajay Kumar Verma, Head of the Department of Respiratory Diseases, said that through EBUS, live pictures of the inside of the lungs are seen by inserting a thin tube through the patient’s mouth. This process does not require any incision or surgery. With the help of this technology, accurate identification of diseases related to TB, lung cancer and chest lymph nodes will be possible at the initial level.
–IANS
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