1) The TB issue is huge in India because
1. TB can invade every organ system with a bewildering array of manifestations --> requires great diagnostic skills.
2. Dx methods like microscopy and even PCR often fail in case of paucibacillary disease.
3. Serology = useless
1. TB can invade every organ system with a bewildering array of manifestations --> requires great diagnostic skills.
2. Dx methods like microscopy and even PCR often fail in case of paucibacillary disease.
3. Serology = useless
2)
4. The interaction between the TB bacillus and the immune system is complex.
Why some people can contain it within granuloma and why it spreads hematogenously in others --> this is not well known.
Research is less focused here since TB is not a First World problem.
4. The interaction between the TB bacillus and the immune system is complex.
Why some people can contain it within granuloma and why it spreads hematogenously in others --> this is not well known.
Research is less focused here since TB is not a First World problem.
3)
5. ATD is hepatotoxic (among others) and relies on the same 1st line drugs since the 1950s --> HIV appeared in 1981 but we already have more drugs than we can handle. PLHIV are now dying of ASCVD, like the gen popn!
Why?
Because HIV was a 1st world problem.
5. ATD is hepatotoxic (among others) and relies on the same 1st line drugs since the 1950s --> HIV appeared in 1981 but we already have more drugs than we can handle. PLHIV are now dying of ASCVD, like the gen popn!
Why?
Because HIV was a 1st world problem.
4) Patient compliance is less of an issue if you allow the NTEP to handle treatment.
Socioeconomic status is a major but not the only determinant of TB.
Even rich people can get it, especially in the era of biologic therapy.
Socioeconomic status is a major but not the only determinant of TB.
Even rich people can get it, especially in the era of biologic therapy.
5) The epidemiology of disease changes all the time.
Don't let your cognition be biased by what you have read in Park years earlier.
Things are not always what they seem!
Don't let your cognition be biased by what you have read in Park years earlier.
Things are not always what they seem!
@nihardesai7
@anujtiwari11
@drdevrad
@Dr_samz
@freezethawed
All clinicians are welcome to provide their opinion!
#MedTwitter
#Tuberculosis
@anujtiwari11
@drdevrad
@Dr_samz
@freezethawed
All clinicians are welcome to provide their opinion!
#MedTwitter
#Tuberculosis
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