World TB Day
CME on “WORLD TB DAY” 2017 conducted by Department of Pulmonary Medicine On 19/03/2017
Organizing President:-Dr. Girija Nair Organizing Secretary:-Dr. Abhay Uppe
Dr. Shahid Patel Dr.Akanksha Das
Dr. Jayamol Ravendran Dr. Kalpita Patil
Dr. Ria Shah Dr. Aleena Mariam Mathew
Dr. Padmaraj Ankale Dr. Viral Nanda
Dr. Sarang Patil Dr. Akshay Singh
Dr. Aarti Sharma
The CME in world TB day was conducted along with IMA Nerul and IMA Nerul secretary Dr. Sangita Shrivastav and treasurer were also present. WHO consultant Dr. Jyoti Salve and District TB officer Dr. Vasant Mane also graced the occasion.
The CME was accredited with 2 points by MMC about 200 delegates had registered and attended this CME.
The CME was conducted to highlight the various challenges faced by clinicians, pathologist and the patient. Since TB affects almost all organs of the body there is involvement of all branches of medicine and surgery in its management.
The Government in keeping with the MDG(MILLENIUM DEVELOPMENT GOAL) has updated the TB control programme(RNTCP) and has incorporated various new measures for this year. There is an urgency in diagnosis of all cases of TB and offering treatment to them. Dr Jyoti Salve the WHO consultant for RAIGAD region described the new updates and protocols for diagnosis of TB patients. Also, the extended use of CB-NAAT (for identification of drug resistant cases) was detailed by her.
Dr Mane District TB Officer described in detail regarding RNTCP programme in NAVI MUMBAI. The number of detected TB cases has increased in 2016 Quarter 4 and number of MDR cases detected has also increased since DOTS plus site has been started from 2012. But notification of TB cases on NIKSHAY has to increase from private practioners he said.
Dr Rajiv Rao Professor of Pathology Department described the various diagnostic techniques for detecting tuberculosis. The newer diagnostic technique like Nucleic acid amplification Technique(CB-NAAT) was described by him. Dr Rajiv Rao also explained how genome sequencing is also expected to be done and labs are to be accredited for it shortly.
Dr.AbhayUppe described the various side effects of anti-TB treatment and how it is managed. Treatment of tuberculosis involved using at least 4 different drugs in intensive phase and 3 drugs in continuation phase treatment, and the whole duration of treatment is about 6-8 months. A close watch for side effects include liver damage, kidney and psychiatric manifestation has to be done and treated accordingly, Dr. Abhay Uppe has said.
The inauguration was done by Dr. Shyam More Medical Superintendent,Dr. Rajiv Rao, Dr. Prakash Samant, Dr. Archana Bhate and Dr.Girija Nair and Dr. AbhayUppe.
A panel discussion including experts in the field of medicine, paediatrics, orthopedics, obstetrics and gynecology, surgery and psychiatry was modulated by Dr .Girija Nair. Professor of paediatrics Dr. Kotra Shetty discussed the various presentation of paediatric TB and stressed that microbiological diagnosis of TB and stressed that microbiological diagnosis of TB has to be endeavored as far as possible. Gastric lavage for pulmonary TB in pediatrics patients is advisable ,he said.
Dr Prakash Samant Professor and Head of the Department of orthopedics described the sites of spinal TB including lumbosacral, sacral spine as commonest followed by dorsal spine. He mentioned that diagnosis included performing MRI spine and following up patients regularly after 3,6,9,12 months to check their improvement. A longer duration of ATT was advisable from 1year to 1 ½ year he said depending on the progress of the disease.
Dr Archana Bhate Professor and Head of the Department of Medicine described CNS tuberculosis and the various diagnostic challenges in managing it. Lumbar puncture picture with Lymphocytic predominance, proteins and ANA could be treated as tuberculous, though differential diagnosis has to be kept in mind she said.
Dr Girija Nair asked psychiatrist DrSwaroopBatankar how the patients with tuberculosis present with psychiatric complaints and described depression and feeling of sadness and sacred of being shunned by society as main complains. She stressed on the need to identify the psychiatric problem and counsel both patients and relatives at the earliest. Neuropsychiatric complication of of HIV-TB coinfection can also be a challenge she said. Psychiatric counseling is necessary since underlying problems can also affect the compliance to TB drugs she said.
Dr .Rishi Rajpal Professor of OBGY described that 60% of cause of infertility could be TB of genitals and diagnosis will include doing abdomen CT scan with USG and uterine biopsy.
Dr. Mahapatra Professor of Surgery Department discussed various manifestation of TB seen in surgery department most common is cervical lymph node and abdominal TB. Treatment for abdominal TB could be prolonged upto 12 months in some cases he felt. TB epididymitis is also a cause of male infertility and has to be treated he said.
The case discussion was followed by Quiz competition results and discussion. Dr Neil won the 1st prize for TB quiz competition and Dr Monika and Dr. Swaroop jointly won 2nd prize. The vote of thanks was given by Dr. Abhay Uppe and Dr. Akanksha Das.
Glimpses of the Event