World Tuberculosis day 2019

Testimony of a person who won a war against MDR TB…

Today I am officially a mdr tb survivor.
I am a tb warrior.
I beat TB.
I’m TB free.
Glory be to God.
Glory be to the most high.
I am a living testimony.
But my journey with TB doesnt end here.
I will continue to fight with and for those infected and affected by this deadly bacteria.
We need better and less toxic treatment!!
We need shorter regimens!!
We need better preventive methods against TB!
We need to find all the missing TB cases that are out there spreading this deadly disease.
We have a long way to go but could be easily be fast tracked if more leading figures in the world come together to fight this war against Tuberculosis.

Courtesy: instagram @stop_tuberculosis

World COPD Day 2018: Never too early, never too late

Chronic Obstructive Pulmonary Disease (COPD) is currently the 3rd leading cause of death globally & 250 MILLION people around the world are suffering from COPD.

COPD is not curable, but treatment can relief symptoms, improve quality of life & reduce risk of death. Finding cases early on is very important to prevent disease progression, and this approach may reduce the burden of disease and mortality rates in future.

The main causes of COPD are:

• Tobacco smoking
• Indoor air pollution
• Outdoor air pollution
• Occupational dusts & chemicals

Some of the Common symptoms of COPD are:

• Shortness of breath.
• A repetitive cough.
• Increased phlegm or mucus production.
• Feeling tired.
• More frequent chest infections.
• Taking longer to recover from a cold or chest infection.

World Chronic Obstructive Pulmonary Disease (#COPD) Day is organized by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in collaboration with health care professionals and COPD patient groups throughout the world. Its aim is to raise awareness about chronic obstructive pulmonary disease (COPD) and improve COPD care throughout the world

#World_COPD_Day2018

Beyond the Boundaries: Our Interventional team of Pulmonolgy

Beyond the boundaries: On 25th July, Our interventional team of Pulmonology has performed ‘Cautery and Balloon dilatation’ using rigid bronchoscopy for treating Tracheal stenosis. Proud day for us as this is the first time we have performed this procedure in the entire district of Mahbubnagar.

Our Interventional pulmonology team & Anesthesia team in Operation theatre

while performing the procedure..

Patient who underwent the procedure.. With our Professors and Post graduates..

Case Details:

A 28 year old male patient met with a road traffic accident in December 2017 and suffered from Subdural Hemorrhage & was mechanically ventilated for 8 days. He recovered from the head injury, but later developed ‘Tracheal stenosis’ as a complication of Endotracheal tube Intubation. He presented to our Pulmonology Out Patient Department with a complaint of dyspnea & hoarseness of voice.

Those marked areas are the stenosed parts of the trachea..

CT scan of the patient revealing tracheal stenosis

At SVS Hospital Mahbubnagar, Our Interventional Pulmonology team with the support of Anesthesia treated this patient by cauterizing the granulation tissue in the trachea causing stenosis by ‘Rigid bronchoscopy’ followed by ‘Balloon dilatation’ of trachea.

Pre & post procedure results..

This relieved his symptoms and he was successfully discharged from the hospital.And he is asked to visit us for regular follow up…. This is the first procedure of its kind done in Mahbubnagar district , free of cost..  Hope we do more interventions like these and save people!! My hearty thanks to everyone who helped us in achieving this .. Stay tuned!!

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Nipah Virus(NiV): Everything about this deadly virus

There has been reports of Nipah Virus outbreak in Calicut Kerala with a death toll of 14. The mortality rate has been quite high – more than 50%. So, Let’s know more about this deadly virus.

1. What is Nipah Virus?

Nipah Virus (NiV) is an emerging infectious disease which first appeared in domestic pigs in Malaysia and Singapore in 1998 and 1999.

There is evidence of Nipah infection among several species of domestic animals including dogs, cats, goats, and horses. Sheep may also be affected. However, since the initial outbreak it has primarily affected humans in different parts of the world.

The disease causes respiratory and occasionally nervous signs in pigs. It has devastating zoonotic potential. The organism which causes Nipah Virus encephalitis is an RNA virus of the family Paramyxoviridae, genus Henipavirus, and is closely related to Hendra virus. Hendra virus, formerly known as equine morbillivirus pneumonia or acute equine respiratory syndrome, is an acute, viral respiratory infection of horses and humans that has been reported in Australia.

Nipah Virus infection, also known as Nipah Virus encephalitis, was first isolated and described in 1999. The name, Nipah, is derived from the village in Malaysia where the person from whom the virus was first isolated succumbed to the disease.

2. Where is the disease found?

There have been Nipah Virus infection outbreaks in pigs Malaysia and Singapore, and human disease in Malaysia, Singapore, India, and Bangladesh. Evidence of the virus without clinical disease has also been found in fruit bats in Cambodia, Thailand and Madagascar.

3. How is Nipah transmitted and spread?

Fruit bats, also known as‘flying foxes,’ of the genus Pteropus are natural reservoir hosts of the Nipah and Hendra viruses. The virus is present in bat urine and potentially, bat feces, saliva, and birthing fluids. Perhaps as a result of deforestation programmes, the Malaysian pig farms where the disease first originated had fruit trees which attracted the bats from the tropical forest, thus exposing domestic pigs to bat urine and feces. It is thought that these excretions and secretions initiated the infection in pigs which was then followed by a rapid spread through intensively reared pigs. Furthermore, transmission between farms may be due to fomites – or carrying the virus on clothing, equipment, boots, vehicles, etc.

The virus is present in bat urine and potentially, bat feces, saliva, and birthing fluids.

4. What is the public health risk associated with this disease?

Nipah Virus is a zoonotic disease. Transmission to humans in Malaysia and Singapore has almost always been from direct, contact with the excretions or secretions of infected pigs. Reports from outbreaks in Bangladesh suggest transmission from bats without an intermediate host by drinking raw palm sap contaminated with bat excrement, or climbing trees coated in bat excrement. In Bangladesh and India, there have been reports of possible human-to-human transmission of the disease so precautions are necessary for hospital workers caring for infected patients.

Precautions should also be taken when submitting and handling laboratory samples, as well as in slaughterhouses. Typically the human infection presents as an encephalitic syndrome marked by fever, headache, drowsiness, disorientation, mental confusion, coma, and potentially death. During the outbreak in Malaysia, up to 50% of clinically apparent human cases died. There is no specific treatment for Nipah Virus. Supportive care is the general treatment for this disease.

5. What are the clinical signs of Nipah Virus?

Nipah Virus in pigs affects the respiratory and nervous systems. It is known as porcine respiratory and neurologic syndrome, porcine respiratory and encephalitic syndrome (PRES), and barking pig syndrome (BPS). It is a highly contagious disease in pigs; however the clinical signs vary depending on the age and the individual animal’s response to the virus. In general, mortality (death due to the disease) is low except in piglets. However, morbidity (illness from the disease) is high in all age groups. Most pigs develop a febrile respiratory disease with a severe cough and difficulty breathing. While the respiratory signs predominate, encephalitis has been described, particularly in sows and boars, with nervous signs including twitching, trembling, muscle fasciculation, spasms, muscle weakness, convulsions, and death. Some animals, however, remain asymptomatic. Natural infection of dogs with NiV causes a distemper like syndrome with a high mortality (death) rate.

6. How is the disease diagnosed?

The disease is difficult to diagnose based on clinical signs alone, however confirmation can be made through prescribed laboratory tests (OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals).

7. What is being done to prevent or control this disease?

Prevention and control measures focus on immediate eradication by mass culling of infected and in-contact pigs and on antibody surveillance of high risk farms to prevent future outbreaks. After culling, the burial sites are disinfected with chlorinated lime. It is also recommended to use sodium hypochlorite (bleach) to disinfect the contaminated areas and equipment. Other important control measures have been a ban on transporting pigs within the countries affected, a temporary ban on pig production in the regions affected, as well as improvement of biosecurity practices. Education and use of personal protective equipment (PPE) by persons exposed to potentially infected pigs is highly recommended. Also, improved hygiene at pig operations is suggested.

One of the most important biosecurity measures for affected areas is to decrease the likelihood of the bat reservoir coming into contact with pig product ion facilities. Research into development of vaccines has been ongoing in Australia and France.

Precautions to be taken:

1. Be highly suspicious about any fever with respiratory symptoms of 2 or 3 days suddenly showing signs of encephalitis

2. Ensure you wear a mask during any interaction with patients in OPD / wards. Usual surgical mask is enough, but don’t use it for too long. Change mask!!

3. Proper hand washing and hand hygiene is very important. Ensure there’s no laxity in this…

Stay tuned for more updates…

Source: WHO, Google, NDTV etc.,