Much has been said and shown about tuberculosis (TB) with several films
having shown people constantly coughing and being diagnosed with the
condition. It is preventable and treatable, yet the condition of
tuberculosis ( TB) continues to be a major health threat, because of
growing drug resistance and spiralling costs of treatment. That apart,
fears and stigmas around the condition are abound. The TB scenario has
only left doctors perplexed. "India is a heavy TB burden country. In
urban settings , the problem is more severe compared to rural settings
as the rate of transmission is higher due to overcrowded spaces.
Patients from lower socio- economic status cannot afford diagnostic
tests and anti- tubercular drugs, thus are diagnosed later and continue
to spread the disease. Also, improper medication (irregularities in
taking medicines by the patients or incorrect treatment regimen by
private medical practitioners), leads to emergence of drug- resistant TB
strains. Thus, worseningthe situation," says Dr BR Das, president, research and innovation, SRL
Diagnostics. Drug resistance: major threat Rising drug incidence happens
to be the biggest threat to TB control and cure. Drug resistant TB
happens when the bacteria develops resistance to the most commonly used
drugs in the first line of treatment regimen, leading to multidrug-
resistant TB ( MDR- TB) and in extreme cases, extensively drug resistant
TB ( XDR TB), where the bacteria fail to respond to even second line
drugs," says Dr Chandan Kedawat, internal medicine specialist, PSRI
Hospital. The other problem is that of patients not sticking to their
drug regimen. " They end up discontinuing it because they feel better
within a few weeks whereas the medicines should be taken for six
months," points out Dr Kedawat. Poor drug regulation TB control has also
become a challenge because of poor drug regulation and spiralling
treatment costs. " Poor drug regulation has fuelled drug resistant TB,
along with lack of discipline when it comes to TB regimen. There is no
accountability, when it comes to adhering to proper diagnostic and
treatment rules," says Dr Swati Sharma, New Delhi based internal
medicine specialist. According to experts, lack of drug regulation has
made even basic treatment of drug- sensitive TB difficult to monitor. "
There are so many different formulations of TB drugs sold across and
absolutely no monitoring," adds Dr Sharma.
Irrational prescription and indiscriminate use of non- WHO recommended
drug regimens has become a huge problem. " It is the patients who suffer
the consequences of poor regulation of TB drug formulations in India.
An increasing number of our patients are being diagnosed with drug
resistant TB ( DR- TB). We encounter a spectrum of resistance patterns
which range from mono- drugresistant TB all the way through to
extensively drug- resistant TB ( XDR TB)," says Dr Simon Janes, medical
coordinator, Médecins Sans Frontières ( MSF) India.
Hence other diagnostic tests need to be performed to consider
initiating antitubercular treatment. There are also other conditions,
symptoms of which are familiar to TB. " Conditions like amyloidosis and
sarcoidosis, have symptoms similar to TB too. And often it is too before
the correct diagnosis happens," says Dr Kedawat.
Say TB, and the first thing that might strike you is a cloudy chest X-
ray. But there are several other forms of TB which affect other organs
of the body like that of skin, intenstinal, lymph nodemusculoskeletal,
central nervous system, gastrointestinal, skin, pericardial, among
others.
Way forward
Apart from systemic policy changes, there is much that can be achieved
by individual efforts, which are as simple as sticking to your medicine
regimen beginning with the first line of treatment.
" It is important to follow proper guidelines, avoid using anti TB
medication for any other purpose other then TB, stick to total duration
of care as treatment being of longer duration there is the tendency to
default which leads to treatment failure and building up of resistance,"
says Dr Mansoor.
While most of us are exposed to TB during our lifetime, those with low
immunity are more likely to contract it. So one of the ways to keep it
off you and combat this condition when it strikes, is to build your
immunity; gradually and naturally.
Dance of health
Ever had hormones like oxytocin, glucagon or thyroid strike a mudra and
introduce themselves to you? Or have someone represent the rhythm and
balance that different organs and hormones strike in order to keep you
going like a well-oiled machine? Just one misstep or imbalance could
cause this machine to come to a crashing halt. This is exactly what Dr
Jayanthy Ramesh tried to present through his Kuchipudi dance ballet on
the eve of World Health Day. Organised by Sai Institute of
Endrocrinology in association with Cisne for Arts, this dance ballet
presented various health issues in a creative manner. The blend of
medical science and Kuchipudi dance was conceptualised and scripted by
Dr Jayanthy Ramesh, a practising endocrinologist. "Though it is a
Kuchipudi dance ballet, it was a way to express the importance of
hormones in the body, lifestyle ailments and create awareness about
health issues. I basically wanted to use a platform to drive home the
point to the common man in a language understands," he says, adding , "Each hormone has a specific action and
there is pulse style release, rhythmic action, amplitude, target action
etc. Endocrinology is a dynamic equilibrium. Dance too has similar
factors - pace, rhythm, action. That is why we thought of blending the
two." The entire dance ballet was choreographed by Kuchipudi exponent
Bhagavathula Sethuram, who also heads the department of dance at Telugu
University. "I've been training under Guruji for some time now and after
I penned the script he choreographed the ballet. This was no mean feat
given that he had to express various hormones, their functions and
lifestyle ailments through dance. I don't think anyone else could have
choreographed the ballet as beautifully as he has," says the doctor, who
also performed a portion of the ballet. Thirteen of Sethuram's students
also performed the ballet. Vocal support was lent by Mantha Srinivas, a
software employee. The ballet, which began with an ode to India, a
country of cultural and religious diversity, soon progressed to
introducing the various hormones in the human body and their importance
before moving on to throw light upon the various lifestyle ailments like
obesity, diabetes and cardiac issues that plague young Indians. "We as a
nation are genetically predisposed to diabetes and heart ailment. But
our current lifestyle habits that involve barely any exercise and
changing dietary habits are only worsening the situation and are
responsible for even youngsters falling prey to dreaded diseases.
Through my dance I wanted to highlight these issues and create awareness
among the general public on the importance of staying fit," says Dr
Ramesh, who often has youngsters walking into his clinic with such
ailments. Dr Ramesh, who first performed this ballet in February for an
international medical conference, improvised upon the script for his
recent performance. The medical practitioner who is also interested in
poetry and creative arts says that penning the script happened in
bursts. "Inspiration can strike any time. So I didn't write the entire
script in one go. Lines would come to me while I'd interact with
patients or when watching a music performance. I would make notes on my
smartphone and then put it all together later. While I wrote the script
in Telugu, my wife Dr. Srivalli translated it into English to cater to a
wider audience," he says. Incidentally, the performance included
various audio-visual elements in the backdrop to heighten the entire
experience. Interestingly, Dr Ramesh is not a trained dancer. "I learnt
dance for a couple of years before I joined medical school out of pure
interest. But with medical school and subsequent practice, dance took a
back seat. I've attempted this performance after a gap of nearly 25
years," he grins.
Subscribe to:
Posts (Atom)