User:Drthulasidoss

ZERO DEATH TREATMENT FOR PULMONARY AND EXTRA PULMONARY TUBERCULOSIS Once confirmed with sputum for AFB POSITIVE STATUS for pulmonary tuberculosis and histopathology examination positive for extra pulmonary tuberculosis with biopsy specimens such as TB PLEURAL effusion TB ADINITIS, TB ABDOMEN and SKELETAL TUBERCULOSIS. Then only we have to start ANTI TB treatment.

Commonly used ANTI TB DRUGS are: 1.	RIFAMPICIN 2.	INH 3.	PYRAZINAMIDE 4.	INJ STREPTOMYCIN 5.	INJ KANAMYCIN PAS THIACETAZONE CYCLOSERIN ETHIONAMIDE AND PROTHIONAMIDE AZITHROMYCIN AND CAPRIOMYCIN.

Now a day’s THIACETAZONE AND PAS are not added in the regime.

STREPTOMYCIN is ten times more potent than KANAMYCIN because the mean inhibitory concentration to suppress the growth of TB BACILLI IN STANDARD CULTURE MEDIA [LOWENSTEIN JENSEN MEDIUM] for SM is 30Mg and it is 300 Mg for KANAMYCIN [PROF MAJOR ROSS] it acts on only ALKALINE PH extra cellular.

If resistance develops to STREPTOMYCIN there is no cross resistance to KANAMYCIN.

KANAMYCIN is more Nephrotoxic than STREPTOMYCIN

Rifampicin and INH acts on both intracellular and extracellular organisms. On both acid and alkaline PH. Pyrazinamide acts only in acid PH acts on intracellular organisms and streptomycin acts only on alkaline ph acts on only extracellular organisms. New drugs like azithromycin, capreomycin, ofloxacin are included in anti tb treatment.

Any infection leads to inflammation and ends in developing disease. Same thing happens in pulmonary tuberculosis also. Infection of pulmones leads to pulmonary inflammation accompanied with pulmonary congetion and pulmonary oedema and result in pulmonary tuberculosis. The congetion and oedema leads to pulmonary hypertension that causes cough. Haemoptysis and corpulmonale are the major cause for mortality in pulmonary TB. Small dose of Diuretics depending upon Blood Pressure status of the patient will prevent the above complications. There are two factors that cause inflammation 1.	CELL MEDIATED FACTOR 2.	PLASMA MEDIATED FACTOR.

INJ PLACENTREX is the only drug which acts on both the factors that causes inflammation. By tackling inflammation the virulence of the disease is considerably reduced to the barest minimum which can be treated effectively.

TAB. FRUSAMIDE 10 TO 40 Mg orally is advised to treat pulmonary oedema and congetion which prevents Haemoptysis and Corpulmonale.

For EXTRA PULMONARY TUBERCULOSIS I am adding TAB PREDNISOLONE 1MG PER KG of body weight for 3 months with tapering doses.

I AM TREATING PULMONARY TUBERCULOSIS WITH FOLLOWING REGIMEN: 1.	RIFAMPICIN + 2.	INH + 3.	ETHAMBUTOL + 4.	PYRAZYNAMIDE daily for two months followed by RIFAMYCIN INH ETHAMBUTOL for ten months. The doses of the drugs are according to the body weight of the patient. 5.	INJ.PLACENTREX 1 AMPULE IM daily for 10 Days followed by 1 AMPULE IM alternate days for 20 Days. 6.	TAB.LASILACTONE 10 to 40 Mg orally every day. 7.	TAB.LIV 52 DS 1TAB twice a day to prevent drug induced HEPATITIS. 8.	MULTIVITAMINS. 9.	TAB LEVAMISOLE 150 Mg to boost immunity. 1 od * 10 days and 1 tab alternate days.

After 2 Months of treatment I discontinue TAB PYRAZINAMIDE and continue rest of the regime. With the above line of management i have treated about One Thousand pulmonary and extra pulmonary tuberculosis patients without any mortality from 1999 to till date.

For EXTRA PULMONARY TUBERCULOSIS I Add TAB PREDNISONE 1MG PER KG of body weight for three months with Tapering doses. When I was a MEDICAL OFFICER at TB Sanatorium, Tambaram, Chennai, INDIA (the biggest TB HOSPITAL in Asia) I conducted a study and proved TAB LIV 52 (an ayurvedic drug) prevents drug induced HEPATISIS.

By, DR. E.V. THULASIDOSS, M.B.B.S., F.C.C.P. Consultant chest physician Retd. Civil Surgeon Tamil Nadu Medical Services Regd. No. 23897 Adyar Chennai INDIA Ct No: (+91) 44 24914810