Ahmedabad: Ahmedabad-based pharma major Cadila Pharmaceuticals was declared one of the ‘Best Record Holders’ amongst 100 record holders across the world for its campaign initiative towards the ‘end the global epidemic -TB’ by worldkings.org. Cadila initiated a public awareness campaign in the ‘Fight Against (TB) Tuberculosis’ on ‘World Tuberculosis Day’ last year on March 24. During this campaign, wherein Cadila Team collected around 7215 messages from doctors across the country. The company took this humble initiative as part of its contribution to enhancing awareness towards the ‘end the global epidemic -TB’.

Worldkings organized the 4th World Record Holders Meet in Delhi recently where Cadila was announced as one of the ‘Best Record Holders’ amongst 100 record holders across the world.  World Records Union (Worldkings) is the first union of national and regional records organizations in the world. Worldkings was founded by 25 business partners and initial members in 2013, India Book of Records is also a member. Participants must go through an exhaustive process of the evaluation set by Worldkings.

Encouraged by the worldwide recognition for the unique initiative taken up by the team Cadila, Jawad Zia CEO – of domestic business, Cadila Pharmaceuticals Ltd said “We at Cadila Pharmaceuticals always look for innovation and new ways to serve the masses through the most affordable qualitative drugs. Fight against Tuberculosis is our commitment, and we are happy that doctors across the country supported our social media campaign in spreading awareness about TB. This recognition strengthens our efforts in the right direction to fight and eradicate tuberculosis.”

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In another rare instance, Medeor Hospital, Manesar at Gurugram – a dedicated covid-19 hospital  successfully treats a 27 year-old Covid positive male diagnosed with latent pulmonary tuberculosis. The patient was discharged after 10 day COVID treatment ongoing ATT (Anti Tubercular Treatment) with a regular follow-up on telemedicine. The patient who was totally asymptomatic a week before, tested positive for corona virus infection and complained of symptoms like fever, breathlessness, blood in sputum (haemoptysis) and chest pain. His CT chest and other tests were found to be normal except for the sputum that revealed tubercular bacilli indicating active tuberculosis in the lungs.

Sharing his opinion about this case, Dr. Sanjay Gupta, Senior Consultant and HOD, Internal Medicine, Medeor Hospital Manesar says, “Clinically COVID-19 and Tuberculosis may show overlapping symptoms such as cough, fever and difficulty breathing with haemoptysis (Bloody Sputum). Both the diseases primarily attack lungs and both biological agents transmit mainly via close contacts. However, the incubation period from exposure to disease in tuberculosis is longer, with often a slow onset. Hence patients of Covid-19 if detected with a bloody sputum, must be investigated for pulmonary tuberculosis.”

He further added, “In this case, we started the treatment of the patient as per the WHO guidelines on Tuberculosis with on-going Covid-19 management. Limited literature is available explaining the progress of latent pulmonary tuberculosis to an active disease in presence of the Covid-19 infection; but our medical team was able to successfully tackle with the situation and provide necessary treatment. This case has insights on how Covid-19 infection may aggravate a latent or an occult tubercular infection, but more studies and cases are needed to understand the role played by SARS-CoV-2 in the progression of tubercular infection.”

TB pathogeh may vause severe COVID-19 pneumonia:

The WHO has issued an information note urging the continuity of essential services for people with tuberculosis during the pandemic. It is socioeconomic development and poverty that drive tuberculosis rates globally, thus fighting tuberculosis in the context of COVID-19 demands that we address social determinants as well as clinical care. Therefore, for COVID 19 patients with suggestive symptoms (like haemoptysis) clinical workup and testing for possibility of latent tuberculosis can benefit in fighting both the diseases.

The COVID-19 pandemic is likely to be the defining global health crisis of our generation. It is likely to have catastrophic effects on tuberculosis, another global pandemic. Tuberculosis has long been the world’s leading infectious killer, until on April 1^st, 2020 when COVID-19 overtook tuberculosis as the infectious disease killing the most people per day. It is no coincidence that the areas of the world predicted to be most affected by the social and economic consequences of COVID-19 are also the areas with the highest tuberculosis burden.

Risk factors associated with COVID-19 is always a concern for patients as well as doctors because the medical resources and timely attention can be given for those at highest risk of severe COVID-19 complications. Infection with Mycobacterium tuberculosis (MTB), the pathogen that causes TB and latently infects ~25% of the global population, may be a risk factor for SARS-CoV-2 infection and severe COVID-19 pneumonia.

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Ignoring TB can spread to bones and affect spinal cord. Complication can have serious consequences, if not treated on time. According to medical statistics, around 10-15 per cent of the total TB patients in India suffer from bone TB and the numbers are constantly increasing.

While extra-pulmonary Tuberculosis, being a lesser-known complication can have serious consequences, if not treated on time. TB has always been related to be a pulmonary disease, but in fact if left untreated, it can spread to various parts of the body and the most common site being the spinal cord.

The symptoms of extra-pulmonary TB being similar to that of arthritis in its nascent stages, it often goes misdiagnosed for the latter. While bone TB can attack any site in the body, the usual victims are the weight bearing joints like hands, wrist, elbows and the spine. The increased bacterial activity causes severe pain in the affected parts that patient need to understand the urgency of intervention.

The type of pain too depends on the exact location of the tuberculosis and in order to distinguish it from arthritic pain, patients should observe the nature of pain. For instance, most of the arthritic patients experience relief at night whereas those suffering from bone TB have elevated discomfort while lying down flat.

According to medical statistics, around 10-15 per cent of the total TB patients in India suffer from bone TB and the numbers are constantly increasing. India is home to about one lakh people who suffer from osteoarticular tuberculosis which leads to limb shortening in growing children and full body paralysis in a few cases. 

Usually diagnosis can be made with radiology tests like X-ray, CT scan or MRI, other lab tests on fluid aspirates from the affected joints may be done for confirmation. Spinal TB usually affects the middle part of the spinal cord known as the thoracic, leads to constant and unbearable back pain along with stiffness. In severe and chronic cases, abscesses develop in the affected joints. Timely treatment can prevent the spread of the bacteria to other parts of the vertebrae and discs. Spinal TB is severe because if not detected and treated in time, the disease can cause severe paralysis which may take years to get cured.

Patients with bone TB are generally not contagious because the disease spreads through coughed up active virus particles unless you come in contact with a patient’s pus. Another important point to remember is that bone TB may affect the bone marrow, so timely and complete course of treatment can only cure the patients. Duration of treatment will depend on the location and severity of the infection. But unlike TB of lungs, Bone and Spine TB takes a little longer depending on the severity of infection.

The treatment for normal bone TB may last at least one year and in case of Spine TB causing paralysis treatment and recovery time depends, if paralysis is mild, moderate or severe. Patients with TB in their bones might or might not exhibit generalised signs of tuberculosis such as fever, fatigue, night sweats and unexplained weight loss.

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