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Sir, I have Extra pulmonary TB, means lympnode at my neck, I am taking the Forecox 150 mg single tablet per day. My weight is 72 kg, is that right dose for me or how much dose should I take of that tablet can you please suggest me?

DM (Pulmonary & Critical care medicine), DNB ( Respiratory Diseases/Pulmonary Medicine), MD (Tuberculosis & Respiratory Diseases), MBBS
Pulmonologist, Delhi
Hi. Forecox contains four drugs in combination with different dosages. I guess it can't be 150 only .considering your weight 72 you require 3 tablets of forecox daily with serial liver function test monitoring. Treatment with TB medicines should not be under dosed. Consult chest physician. Thanks.
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How HIV & TB Are Related?

MBBS, MD - Dermatology
HIV Specialist, Mumbai
How HIV & TB  Are Related?
Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously. Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated.

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A subclinical phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.
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I Had seizure. The brain MRI reveals either TB or cysteriosis. Many doctors assumed it to be cysteriosis and told it is in dying stage. I was advised by doctor to take lacosam50 mg twice daily and steroid omnacortil 20 mg twice daily. But when I sleep I start snoring loudly and feel twitching. I wake up and then go to sleep. This happens whole night. I hardly sleep. Doctor added next plus at night. But it is the same problem. I tried sleeping sideways but of no help. Am I taking right dosage of medicine.

DM (Pulmonary & Critical care medicine), DNB ( Respiratory Diseases/Pulmonary Medicine), MD (Tuberculosis & Respiratory Diseases), MBBS
Pulmonologist, Delhi
Consult chest physician or ENT specialist for your complaints. You might have sleep disordered breathing like Obstructive sleep apnea. Taking sleeping pills only is not the solution. Rule out any cause. Thanks.
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Hypoxia - Causes, Symptoms & Treatment Of It!

MBBS, MD
General Physician, Lucknow
Hypoxia - Causes, Symptoms & Treatment Of It!
Oxygen is integral and fundamental to the efficient functioning of your body. It is the substance that produces energy in the body, through the process of cellular respiration. In it, consumed food is broken down and the energy is supplied to the blood and cells. Moreover, less than adequate levels of oxygen in the body leads to pain in muscles due to generation of excessive lactic acid. A lack of oxygen will adversely affect your vital organs, including the brain and liver. The condition is termed hypoxia and can be potentially lethal.

Causes of hypoxia:

This condition can develop due to a number of factors working alone or in combination, like:

Diseases that heavily impair the lungs, like pneumonia or bronchitis.
Pain medication that is potent enough to interfere with normal breathing.
Asthma attacks.
Pre-existing heart diseases.
Anaemia, wherein oxygen-carrying red blood cells are reduced drastically in number.



Symptoms:

These are the symptoms by which you can identify hypoxia occurrence:

Respiratory problems.
Wheezing and cough.
Lack of mental clarity.
The skin can change colour and turn anything from bluish to a deep red.
Exhaustion and a lack of energy.

The symptoms need to be acted upon very soon to prevent irreversible damage to the patient.

Treating hypoxia:

The underlying principle of all hypoxia treatment is increasing the levels of oxygen in the body. This can be achieved in multiple ways:

An artificial mask can be used for the purpose. Devices called nasal cannulae are used for the same purpose. These machines either cover the oral and nasal orifice or are inserted under the nose, and are the most widely used for oxygen provision.
Oral asthma medication can be used. Steroids are the second kind of drugs used in hypoxia treatment to combat secondary infection or lung inflammation.
You can use an inhaler for which the doses vary according to the severity of your condition.
Intravenous (IV) injections are used in cases where other methods do not work, and in the most extreme cases (where the situation is nearly lethal), a machine can be used to assist breathing.

Oxygen deficiency in the body, termed hypoxia or hyperoxia in some cases, is a disease which may cause very serious complications if not remedied fast. It is caused by diseases of the respiratory pathway or the heart, and the symptoms are easy to identify. If you think you have this diseases, seek medical help immediately.
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Tuberculosis - 7 Signs That Confirm You Are Suffering From It!

MBBS, MD - Medicine, DM - Pulmonary Medicine & Critical Care Medicine
Pulmonologist, Delhi
Tuberculosis - 7 Signs That Confirm You Are Suffering From It!
Tuberculosis is an airborne communicable disease that mainly affects the lungs. However, it can attack the other organs as well. A tuberculosis infection may be clinically active. People showing symptoms of the disease are said to be suffering from a clinically active form of tuberculosis and must seek medical attention as soon as possible.

The symptoms of tuberculosis may be hard to identify as they can be attributed to other causes as well. In some cases, the symptoms may not appear until the disease has reached an advanced stage. Some of the common symptoms associated with this disease are:

Weight loss
Fever
Dry cough
Excessive sweating at night
Unexplained tiredness
Poor appetite
Chest pain
People with a weakened immune system such as those suffering from HIV or those undergoing chemotherapy have a high risk of suffering from this condition. When the disease is in its active form, tuberculosis causing bacteria multiply rapidly and attack the lungs. From here they may spread to other parts of the body, such as the lymph nodes, kidneys, bones, spine, brain and skin. When it reaches an advanced stage, the symptoms vary according to the organ affected. For example, pain in the bones indicates that the bone tissues have been affected while coughing up blood is a sign of TB of the lungs.

An x-ray and a lab analysis of your sputum can help in diagnosing tthe clinically active form of this disease.

Clinically active tuberculosis can be easily treated and cured as long as the patient undergoes the complete course of treatment. Treatment for this disease usually takes the form of oral medication that must be taken for six to nine months continuously. This is because tuberculosis causing bacteria can take a very long time to die. In some cases, multiple drugs may be prescribed to reduce resistance to the drugs. When it comes to tuberculosis it is important to continue taking medication for its full course, even if the symptoms disappear and you are feeling better.
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Tuberculosis - Signs And Symptoms You Must Not Ignore!

Fellowship In Minimal Access Surgery, M.Ch - Cardio Thoracic & Vascular Surgery
Pulmonologist, Hyderabad
Tuberculosis - Signs And Symptoms You Must Not Ignore!
Symptoms of TB
The symptoms of tuberculosis (TB), which is active might vary and depend on which part of the body is infected. Diagnosing TB just from its symptoms can be a difficult, as the symptoms are not for TB alone meaning the symptoms can be of other diseases as well. For the confirmation and diagnosis of TB one must get a test done for TB. However, the general symptoms of TB are tiredness, weakness, weight loss, loss of appetite, fever, chills and night sweats.

Symptoms of Pulmonary TB
Pulmonary TB is the TB of lungs. The symptoms of this are bad cough which might have lasted for more than 3 weeks, chest pain, blood or phlegm might occur on coughing.

Extrapulmonary TB
The TB of any body part other than pulmonary is called extrapulmonary TB. This TB does not affect the lungs with the exception being the extrapulmonary TB also known as Pleural TB.

General symtoms of extrapulmonary TB are same as general symtoms of TB.

Symptoms of Lymph Node TB
Lymph Node TB also known as lymphadenitis is basically the enlargement and the inflammation of the lymph nodes. This is a response to the infections especially in children. The symptoms of this might be painless slow growing lymph nodes. These swollen lymph nodes can be in the neck area, though they might also be present in the groin. Lymph node TB of the neck is also called as Scrofula or TB adenitis.

Symptoms of skeletal (bone and joint) TB
The common and the first symptoms are pain and depend on the area of the joint or the bone affected. Often it is marked with the loss of movement and curving of the affected bones and joints. The affected area also weakens and is prone to fractures.

Spinal TB is also called as Pott Disease or TB Spondylitis. The symptoms of this depend on the affected site and the stage of the disease. However, back pain is one of the earliest symptoms.

Symptoms of Meningitis TB
The meningitis TB starts with classical symptoms of meningitis. It usually starts with symptoms of pains and aches, fever and vague and unwell feeling. These might last for 2-8 weeks and then the evident symptoms like headaches, seizures, vomiting and stiffness might occur.

Symptoms of Gastrointestinal or Abdominal TB
This is marked with diarrhea, abdominal pain and bleeding from rectum and anus, though the symptoms depend on the exact site.

Symptoms of TB in children
The symptoms depend on the type and site, though the common ones being weight loss, fever and cough.

My friend 36 years female, suffering from lymph node at the joint of neck / shoulder. As per FNAC test shown granulomatous lymphadenitis. Can you please tell me the cause and what is the treatment of medicine. Is it malignant.

MD - Homeopathy, BHMS
Homeopath, Vadodara
The major cause is tuberculosis infection. For medicine (treatment) You will need to consult.. It is not malignant but infectious. You can consult me at lybrate for homoeopathic treatment..
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Pulmonary Function Tests - Types And Reasons To Undergo Them!

MBBS, MD - Respiratory Medicine , Trained In Treating Sleep Disorder , Trained In Interventinal Bronchoscopy , Trained In Medical Thoracoscopy , Trained In Rigid Bronchoscopy
Pulmonologist, Delhi
Pulmonary Function Tests - Types And Reasons To Undergo Them!
Lung function is a major indicator of health since it determines the amount of Oxygen that a body is getting. Doctors resort to Pulmonary Function Tests if there is a problem with breathing or the lungs. Pulmonary tests show how the lungs are functioning. These tests measure parameters like lung capacity, lung volume, gas exchange, rate of flow, etc.

Armed with information from these tests, a doctor can decide whether a person has some issues with lungs or not. And if there s some issue, doctor will be able to easily decide the line of treatment for accelerated recovery.

Type Of Pulmonary Function Tests

There are two common types of Pulmonary Function Tests: Spirometry and Plethysmography

Spirometry Test

This test measures how much air a person can inhale and exhale, as well as how fast one can empty the lungs.
It may also be done to monitor the lung condition periodically to measure the outcome of a treatment a person may be undergoing.
In this test, a person needs to breathe into a tube. The tube is attached to a Spirometer.
Before the test, nostrils will be closed with a clip. The person will also need to create a seal around the tube, so that there is no leakage of air.
Patient will be asked to take a deep breath and then breathe out as hard as possible through the tube.
The doctor may ask the person to repeat the effort three times so that he gets consistent result.



Plethysmography Test

This measures how much air is actually in the lungs after a deep inhalation.
During the test, one needs to sit in a plastic box, wear a clip on the nostrils, wrap lips around a special mouthpiece and breathe in and out through it.

Why To Undergo Pulmonary Function Tests

Doctors may conduct Pulmonary Function Tests even on healthy people. If a person works in certain hazardous environments like graphite factory, coal mine, etc., the employer may order such tests on a regular basis. People working in such places are at risk of developing Pulmonary problems.

However, the most common condition when a doctor may advise a PFT is when someone faces health problems like:

Respiratory infections
Allergies
Breathing problem after injury
Chronic lung problems like Bronchiectasis, Asthma, Chronic Bronchitis, Emphysema, etc.
Tumors in the lungs or scarring or inflammation of the lungs

Diseases That May Precipitate The Need For A PFT

Sarcoidosis, a disease characterised by the formation of lumps of inflammatory cells around the lungs, spleen, eyes, skin, etc.
Asbestosis, a disease that results from inhalation of Asbestos particles.
Scleroderma, which causes thickening of connective tissues.

One of the Pulmonary Function Tests may be advised by a doctor for a variety of reasons. These tests do not always mean that Lungs have a problem. They are just a way to measure the parameters of working of the Lungs so that a Physician can treat a problem effectively if found.
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