Editor Speaks

Tuberculosis is an age old disease and first spread probably 8000 years back. Killer T.B was described in India 3000 B.C. Mummified bodies of Egypt have revealed evidence of T.B of Bones and Joints. It has become a world problem because of AIDS which lowers immunity.

Most T.B infection is caused by acid-fast bacilli Mycobacterium Tuberculosis but Mycobacterium Bovis is endemic in cattle can spread by milk. Pre-historic human thought supernatural power is responsible for it. Primary T.B usually occurs in subpleural and often mid to upper jones (Ghon focus) of the lungs. It can also be extra-pulmonary e.g. Bone T.B, Gland T.B, Intestinal (ileocaecal) T.B, Meningeal T.B etc. Patients usually come with persistent cough, haemoptysis, pleural pain, spontaneous pneumothorax, lethargy, weight loss etc. Mass radiography is not used now for case findings but contact examination is important by chest X-ray, sputum examination for A.F.B and Mauntoux test where one (if no reaction 10) tuberculin unit of purified protein derivative (PPD) in 0.1ml normal saline is injected intradermally in forearm.

T.B derives its name from characteristic lesion called Tubercle (collection of inflammatory cells surrounding the organism and later progressing to cessation). In 1882 Koch first identified the organism. Sputum is stained with Ziehl-Neelsen Stain.Now a days there is direct short course treatment (DOTS) for 2 months but may require 6-9 months. Bone T.B require 9 months and Meningeal T.B require one year. However B.C.G (Bacille-Calmette-Guerin) vaccine which is dried attenuated strain of live bacteria injected intradermally (0.1ml) at arm can prevent it.

T.B affects mainly poor people in unhealthy environment. We must make people health

conscious and alleviate poverty.