Pharmacon: Tuberculosis

Pharmacon: Tuberculosis: TB (Tuberculosis) is as dangerous as HIV and one of the leading cause of death worldwide Even though there are impressive efforts by WHO ...

Tuberculosis

TB (Tuberculosis) is as dangerous as HIV and one of the leading cause of death worldwide Even though there are impressive efforts by WHO (World Health Organization), in 2014 around 96 lakh people fell ill with TB and from that 15 lakh lost their lives. In India alone, there were around 19 lakh cases of TB reported in 2014.

TB (Tuberculosis)

TB is an infectious disease caused by pathogenic bacteria, Mycobacterium tuberculosis which affects respiratory system of human being by infecting their lungs. There can be two form of TB disease

:

a)   Latent TB: This is an asymptomatic TB (where you don’t see prominent disease symptoms) in which you are infected with bacterium, however your body’s immune system keeps a strong check and doesn’t let the TB bacteria grow. This state has no symptoms of disease and is also non-infectious. However, they are at constant risk to re-activation of disease and can fall ill

b)   Active TB: This is contagious and symptomatic state which might occur several weeks later than after first infection. At this stage, you are at risk of spreading disease via coughing and sneezing. You get symptoms like intense coughing, rapid weight loss, fever, night sweats, loss of appetite, etc.

A person with weaker immune system is more prone to catch the disease as body doesn’t fight back the TB bacterial infection. Therefore, people with HIV infection possess higher risk of developing active TB (e.g. out of 96 lakh TB cases, around 12 lakh were carrying HIV) and it is a leading cause of death in HIV-positive people. It also has been reported that people with diabetes, malnutrition and tobacco-addiction are in high risk category of developing active TB.

Diagnosis and medication

Primary diagnosis includes physical examination, skin test (tuberculin) and blood test.  Further, chest X-ray, sputum test and other blood-related advance test can also be performed to check the TB and its state. Importantly, it is also necessary to conduct drug-resistance test in order prescribe proper medication. Treatment of TB includes intensive administration of isoniazid, rifampicin, pyrazinamide and ethambutol followed by mild-administration of isoniazid and rifampicin for four months.

Although due to continuous efforts by WHO, TB incidence rate is falling at 1.5 % each year since 2000, situation still far from under control. One of the main reason which impairs the disease control is drug-resistance.

MDR-TB (Multi-drug related tuberculosis):- A big concern

The pervasive development of antibiotic resistance is a major concern in the treatment of TB. This happens because TB bacteria becomes un-responsive against multiple drugs (MDR-TB), and therefore patients cannot be treated effectively which ultimately leads to their death. According to the WHO, in 2014 around 4.8 lakh people developed TB which doesn’t respond to rifampicin and isoniazid (most powerful first-line drugs for TB treatment). Though in such cases, TB can be tackled using second line drugs (e.g. fluoroquinolones, kanamycin, amikacin), however in some cases, TB bacteria is even get resistant to these drugs and develop

XDR-TB (extensively drug-resistant tuberculosis) which puts these patients under high-risk group and they are difficult to treat.

There are several reasons which leads to such high resistance and a general awareness can help to prevent  developing such high resistance against drugs. One of the main reason is not taking the full-course of drugs. A lot of people have habit of stop taking drugs as soon as they feel slightly better, even though doctors have prescribed full-course. This allows bacteria grow again in body and slowly they become resistant against the drugs. Another reason is self-medication and wrong-doing of drug stores to prescribe drugs without even concerning doctors. This leads to the use of improper, bad quality and wrong drugs which might not be effective against the disease and which allow bacteria to become resistant to the drug.

Since TB is an infectious disease, by not taking proper and prescribed medication people not only affect themselves but also contributes in spreading such resistant forms of TB in the society. Therefore more awareness about TB and drug-resistance is required for the better treatment and stopping the spread of disease.

Dr. Sandeep Ameta, PhD,

Senior Research Scientist,

ESPCI ParisTech,

10 rue Vauquelin,

75005, Paris, France

ametasandeep@yahoo.com

sandeep.espci@yahoo.com

References:

1.        Global tuberculosis report 2015, World Health Organization (WHO) (http://www.who.int/tb/publications/global_report/en/)

2.        Centers for Disease Control and Prevention Division of Tuberculosis 
(http://www.cdc.gov/tb/topic/default.htm)

3.        Zumla et al., Current concepts Tuberculosis, 368, 2013, The New England Journal of Medicine.

4.        WHO guidelines on tuberculosis (http://www.who.int/publications/guidelines/

Tuberculosis/en/)

5.        WHO: Drug resistant TB (http://www.who.int/tb/areas-of-work/drug-resistant-tb/en/)

Cervical Cancer

Cervical Cancer is a type of cancer that starts as abnormal tissue growth around the cervix, briefly before spreading throughout the body hampering normal functioning. It can be diagnosed in early stages and detected by having cervical screenings like the pap test, or the cancer may spread in the uterus showcasing symptoms like abnormal vaginal bleeding, back pain etc.

Also, it is the most common cancer  found in women, comprising up to 90% of all women's cancers. Generally it is caused by the HPV virus, which anyone can get infected by various reasons, including but not limited to: sexual contact with many individuals, use of birth control, weak immune system etc. However, not all women infected by HPV get this type of cancer. Early and effective treatment has surged the 5-year survival rate in US to 68% with a combined use of radiotherapy, chemotherapy and surgery.

Signs and Symptoms

There may not be many indications of it in early stages but once the cancer surfaces and starts to multiply in the vaginal canal, there are a handful of signs and symptoms that can be an alarming bell :

●      Abnormal vaginal bleeding

●      Mass discharge from vagina

●      Discomfort while sexual intercourse

●      Pelvic Pain

Symptoms of a rapidly growing cervical cancer may include weight loss, nausea, leg pain, swollen legs, heavy vaginal bleeding and rarely, it may also cause feces leakage from the vagina.

Causes and Prevention:

The most common cause of cervical cancer in women is HPV or the human papillomavirus, while smoking, using excessive birth control and having multiple pregnancies are also factors known to cause cervical cancer.

HPV is known to contribute to 90% of cervical cancers in the world, however it is worth being informed that not all HPV infections result in a cancer.

Out of 150-200 types of HPV known to medicine, HPV 16 and 18 cause about 75% of all the cervical cancer cases. These cases can be easily prevented by a HPV vaccine that targets the two papillomavirus classes.

Other prevention techniques aim at educating women to quit smoking, taking a balanced diet and encouraging them to practise safe sex.

Family planning can also reduce the chances of getting the cancer, as researchers found out in many studies that women who had more (7 or more) full-time pregnancies had four times the risk of developing the cancer as compared to women with no pregnancies and two-to-three times the risk when compared to women with two or more full-time pregnancies.

Treatment:

Treatment of a cancer usually depends upon the stage at which it is detected, if detected early the cancer can successfully treated. Age, health and quality of living are crucial aspects to the treatment.

There are four types of treatment to cervical cancer, they are:

●      Surgery may be performed to remove the cancerous tissues, keeping in mind patient desire to have children in the future. To ensure such conditions, fertility sparing surgeries are performed.

●      Radiation therapy weakens the cancerous cells through high-dose radiation in the vaginal cavity. They are removed through surgery afterwards.

●      Chemotherapy This type of treatment is usually used in very late stage cancer types, using medicines that target cancerous cells and weakens them.

●      Chemoradition is a mixed use of chemotherapy and radiation therapy, which is used in middle to late stage cancers.

After evaluating and detecting the type, stage and condition of the cancer, medical professional studies the case and offers a treatment option which seems more feasible than others.

Success rate is 100% for women with emergence form of cancer, but drops to 90% 5-year success rate for women with Stage 1, subsequently dropping to 75% and 30% for women with Stage 2 and Stage 3 cancer. Stage 4 cancer leaves the successful treatment rate to 15%, as the cancer has already spread in the vaginal cavity, disrupting normal cellular activity.

Anti Aging Fruits

Aging hits our mind with the pictures of wrinkles, fine lines, sagging skin, dead skin cells and sun damaged skin aging is a natural process and can be controlled up to some extent, research suggests that  the vitamins and nutrients in fruits and vegetables helps in reducing skin aging , It  is caused due to many factors such as stress, pollution, sun exposure, obesity, lack of sleep, unhealthy diet and age-related problem

Fruits are considered as a best anti-aging agents check out the best anti-aging fruits which helps in minimizing wrinkles, discoloration and other signs of aging skin

Pomegranate

Pomegranate basically act on skin collagen, it is a rich source of vital vitamins and minerals like riboflavin, phosphorus, which helps in increasing collagen level of skin consequently led to firm and elastic skin.

Apple

An apple a day keeps wrinkles away   apple contains nice enzymatic properties which helps skin to retain moisture and stay refreshed its residue can be used topically not only this apple cider vinegar is an excellent natural skin toner

Kiwi

Kiwi is very rich in Vitamin C and E, which helps in fighting with free radicals and acts as a best antioxidant fruit, which helps in reducing wrinkles and strengthen the skin by reducing the level of free radicals

Watermelon

Watermelon is a rich source of minerals, vitamins and antioxidants it comprises more than 90 % of fluids and minerals which helps skin in fighting with wrinkles and discoloration

Avocado

Avocado is considered as a best remedy for wrinkles and dull skin it comprises potassium which helps skin to be moisturized and hydrated it is also rich in Vitamin E and the B-complex which helps in rejuvenation of your skin it also contains a complex compound called glutathione which acts as an antioxidant and helps in anti-aging process

 

Papaya

Papaya is a rich source of Vitamins A, C and E it acts on a skin complexion and can be considered as natural complexion toner it helps in fighting with wrinkles and nourish skin  

Banana

Banana can be applied topically it comprises high levels of Vitamin C and B-6, which helps in reducing skin aging  and its antioxidant properties rejuvenate skin and also act as a natural moisturizer it also comprises manganese which helps in preventing premature aging

Grapes

These small fruits are a rich source of manganese and Vitamin C it helps skin from UV and its antioxidant properties fights against wrinkles and skin aging process