First Line Drugs For Tuberculosis

There are five drugs in first line attack against tuberculosis. The durgs differ in their mechanism of action; whether they are bactericidal i.e. kill bacteria rapidly or bacteriostatic i.e. inhibits the multiplication and growth of bacteria but do not kill them. They also differ in their action against intracellular bacilli (those mycobacteria that are in the cell), extracellular bacilli (those mycobacteria that are outside the cell) and the bacilli in the lesion itself.

No single drug is effective in treating the disease but when used in combination, they can cure the disease. Here are the first line drugs used in treatment of tuberculosis.

All except streptomycin are given orally.

Isoniazid

It is bacteriostatic for resting bacilli but kills those which divide actively.   It is active against intracellular bacilli, extracellular bacilli and bacilli at lesion. It has good penetration in cerebrospinal fluid and possesses good overall activity. Along with rifampicin, it is the main drug in treatment of tuberculosis. Read more

Xray of United Fracture Distal Femur With Condylar Plate In Situ

Distal femur fractures are also called intercondylar fractures and supracondylar fractures. Former are intra-articular injuries and often need surgical stabilization.

This is an xray of patient who was treated surgically for intercondylar fractures  with use of condylar plate as implant.

The fracture has united very well and articular congruity is very well maintained.

Lumbar Spondylosis- Xray Showing Straightening of Spine

Lumbar spondylosis is an important cause of back pain. It signifies the age related changes in the lumber spine that lead to chronic back pain. Low back pain is a common cause of morbidity.

A healthy lifestyle and fit body can produce a healthy back  and help to prevent the effect s of aging.

Straightening of lumbar spine is one of the early features of lumbar spondylosis.

The xray in the picture is of 36 years old lady who came with complaints of back pain. Her lateral view shows reduction in lordosis of lumbar spine or straightening of the spine.

Pain relieving medications and back exercises are mainstay of the treatment for this kind of back pain.

First Line Drugs For Tuberculosis Treatment – Recommended Doses

Antitubercular drugs are mainstay of treatment of tuberculosis. The major drugs used and effective are called first line drugs. Following are the first line drugs in tuberculosis

• Isoniazid
• Rifampin
• Pyrazinamide
• Ethambutol
• Streptomycin

These five drugs are responsible for control and containment of tubercular disease, among other factors.

The drugs are given on basis of patient weight and dosage may vary in different individuals. The dosage also differ depending on the regimen given. There are three regimen that traditionally have been used for treatment Read more

Musculoskeletal Tuberculosis – General Principles of Management

In medicine, early detection of the disease and treatment are key factors in successful management of the disease.    If osteoarticular tuberculosis is diagnosed and treated at an early stage, the large majority of patients are expected to achieve healing with near normal function.

The mainstay of treatment is multidrug antitubercular chemotherapy and

• Rest
• Traction or splint [whenever required]
• Active or assisted  exercises of the involved joint throughout the period of healing

An initial period of rest is to be followed by supervised gradual mobilization. Read more

Xray of Chip Fracture Base of Proximal Phalanx of Third Digit of Hand

Normal Synovial Fluid

Synovial fluid is a thick, stringy fluid found in the cavities of synovial joints. It reduces friction between the articular cartilage and other tissues in joints by  lubricating and cushioning them during movement.

During movement, the synovial fluid held in the cartilage is squeezed out mechanically to maintain a layer of fluid on the cartilage surface. Normal synovium contains synovial lining cells that are 1-3 cells deep. Synovium lines all intracapsular structures except the contact areas of articular cartilage. Read more

Spinal Injury – An Overview of Definitive Treatment

After initial care of the patient with spinal injury, decision is made about the definitive care. A definitive care  aims at making the injured spine stable and removing any decompression on the spinal cord.

Because not all patients would have neural injury and not all patients would have instability of the spine, the definitive treatment has a spectrum from immobilization with a collar to surgery. There are indications for each method and one treatment cannot treat all kind of injuries.

Following are the ways of treating a spinal injury

• Non operative  Treatment
• Operative treatment
• Closed reduction with or without surgery (in cervical spine only)

Read more

Xray of Undisplaced Transverse Fracture of Patella

Patella fracture is a very common injury. The xray shows a transverse undisplaced fracture of patella in 44 years old man. The fracture of patella is usually not visible in anteropsterior view. The fracture was treated in a cylinder cast.

Undisplaced fractures of patella are usually amenable to non operative treatment.

Musculoskeletal Tuberculosis – An Overview of Burden, Clinical Presentation and Investigations

Tuberculosis is  one of the major killer infections with  2.2 million new cases of TB occurring every year and 40% of them occur in South East Asia.  India, Indonesia, Bangladesh, Thailand, and Myanmar account for 95% of the cases occurring in South East Asia.

With adventof HIV infections the tuberculosis is showing  resurgence. Moreover, due to globalization of the populations, frequent travels, there are higher chances of spread of the disease from non endemic to endemic countries. An endemic country is the one where the disease is constantly present to greater or lesser extent.

Musculoskeletal tuberculosis (Tuberculosis of bone and joints) is also common and responsible majorly for the morbidity, disability and rarley death.

The disease is found more in children, adolescents and young adults, than in the elderly. Read more

Next Page »