Tuberculosis is an infectious disease caused by the bacillus named Mycobacterium tuberculosis. This bacillus contains in the air and enters into the body through respiration. Bacillus of tuberculosis contains in most of the human body but all are not affected by this bacillus because of strong immunity power. Mainly this bacillus affects the lung. Besides this it may affect other organs such as kidney, bones and ovary.
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| Main sites of extrapulmonary tuberculosis |
Symptoms:
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| symptoms of pulmonary tuberculosis |
- Cough and sputum:
The most common symptom of tuberculosis is cough with sputum. It is the earliest indication. Sometimes purulent sputum is observed in young adult caused by the unhealthy state of nose and throat or due to over smoking etc. In older people chronic bronchitis is very common.
- Haemoptysis (bleeding from the lung):
In this case sputum varies from streak to bright color. The appearance of the blood in the phlegm is almost the sign of tuberculosis of the lungs.
- Pain:
Tuberculosis of the lungs in early stage is painless. But there is occurred an attack of pleurisy (inflammation of the lining membranes of the lung and inner surface of the chest wall) can cause pain.
- Dyspnoea:
Formation of scar tissue in lung may cause dyspnoea. In some cases fluid will fill up the space between the lung and the chest wall without causing any pain but it can cause difficulty in breathing.
- Influences on general health:
- Malaise (feeling of tiredness) is common for month.
- Wight loss:
In a young adult loss weight in a rapid is common.
- Night sweating:
This is common at the beginning. It occurs during fever in unconsciousness condition.
- Fever:
Sometimes body temperature is raised without the patient being aware of anything unusual.
- Anemia
- Digestive problem
- Fistula
Treatment:
Sanatorium treatment
The patient should be taught that his main object is to become well as soon as he or she can but not to worry about returning home.
This treatment includes rest of mind and body, exercise, fresh air and sunlight, routine and discipline and correct feeding. Sometimes these all are not possible in home treatment so you can choose sanatorium treatment.
Fresh air and sunlight :
Patient should spend many hours in the open air and windows must be widely opened for fresh air and sunlight.
Routine, discipline and education:
In sanatorium treatment physical training, strict routine and education are must be followed.
Food:
Three good meals should be taken. And keep in mind that food should be properly chewed. They should maintain a normal healthy weight by food.
Exercise:
Exercise should start after disappearing general symptoms.
Exercise is very important to cure tuberculosis because in this time patient needs to maintain a cheerful attitude of mind which is necessary for successful treatment. Exercise is necessary for muscular system especially of the heart muscle. Exercise start with ordinary action such as washing, eating, talking and writing. After this, walking exercise should be started.
Drug treatment
Sometimes taking of tonic helps to improve the condition of the patient. Cod liver oil is the best remedy for the patient.
Some medicines like Rifampicin, isoniazid, pyrazinamide and ethambutol are drugs which used in the treatment of tuberculosis. These drugs are given free through Government hospitals and health centres.
In 1997 in the tuberculosis control programme ‘Dots’ (Directly Observed Treatment Short Course) method are accepted to cure tuberculosis. This method is very effective for curing tuberculosis.
Hygiene:
- One should always be in the habit of deep breathing.
- Room should be kept clean and dust removed.
- Patient should carry a receptacle for spitting.
- Patient should never swallow his phlegm as he or she can thus infect his or her own intestine.
- one should always use handkerchief in front of the mouth during coughing
- Room should contain simple furniture as it can be cleaned easily
- Patient should not sleep with others he or she should sleep in another room.
- Patient’s utensils should be boiled.
- Washing hands frequently is very important.
Dietary management:
Principle of diet:
A high calorie, high protein, high vitamin and minerals, plenty of fluid diet is recommended. Diet should be soft.
- Energy:
High calorie diet is prescribed. Patient should be given 2500 – 3000 calorie. Patient should be given 10 % extra calorie on the basis of his normal requirement.
- Protein:
80 – 120 gm protein is required for tuberculosis patient.
- Vitamins:
Vitamins A, B6 and C are needed. To fulfill the requirement of vitamin A, liver and vitamin A rich foods should be included.
For the requirement of vitamin C, orange juice can be taken.
For vitamin B6, cereals and pulses can be eaten in a soft form.
To fulfill the demand of vitamins patient can be taken a multimineral tablet every day.
- Minerals:
For tuberculosis of lung, lesion is occurred so calcium is required. For this reason patient should intake 1 liter milk per day. Calcium, phosphorus rich foods should be taken. Bleeding is common with cough so iron is required.
General guidelines:
- Patient’s food should be soft and digestive.
- Oily, high fibre and spicy foods should be avoided.
- In chronic stage high calorie, plenty of fluid and soft food should be given. As the patient progresses high calorie normal food can be given.
- Initially small quantities of fluid diet should be given once in 3 hours. When fever comes down fluid should be given once in four hours.
- With milk 3 to 4 eggs per day can be consumed.
- Smoking must be stopped.
- Cinnamon oil can be used to heal cough.
- Bleeding from the lungs is treated by putting the patient on bed at once. When bleeding stops the patient should rest on bed for some days.
- In case of pregnant woman doctor may say for abortion.
- If lactating woman is affected or the infant is affected, breast feeding should be stopped.
- Hygiene should be maintained.
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