Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach Raksha Arora, VK Arora
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1Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach
2Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach
Editor VK Arora MBBS MD Vice-Chancellor Santosh University Director and Principal Santosh Medical College and Hospital Ghaziabad, Uttar Pradesh India Vice-Chairman TB Association of India Ex-Additional Director General of Health Services Government of India Director LRS Institute of Tuberculosis and Respiratory Diseases Ex-Director and Professor TB and Chest Diseases Postgraduate Institute of Medical Education and Research Puducherry, India Associate Editor Raksha Arora MBBS MD Professor Maulana Azad Medical College (MAMC) New Delhi, India
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Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2009
9788184486308
Typeset at JPBMP typesetting unit
Printed at4
To
Our parents
Shri Sardari Lal and Smt Durga Devi
Shri Mohan Lal Handa and Smt Suhag Rani
For their heavenly blessings
Our teachers
For their inspirations
Rajay Arora and Ankur Arora
For their cheerful enthusiasm
Diya and Mukul
For their unconditional support
5Contributors 7Foreword
The book Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach is fourth one in the series of practical management manuscripts dealing with the management of TB, HIV and Lung Diseases. It includes discussions about the critical issues involved in various manifestations of the diseases frequently encountered by practicing physicians and pulmonologists. The unique feature of the book is the presentation of different aspects of the diseases as experienced by the eminent practitioners in the field of Respiratory Medicine and Tuberculosis and their hands-on experience in dealing with the conditions to achieve the successful outcome. The chapters have been written in the background of their rich academic knowledge gained from day-to-day dealing with the patients.
The editors have included chapters related to the latest aspects of tuberculosis, HIV and lung diseases. Chapters on Chronic Obstructive Pulmonary Diseases (COPD), Bronchial Asthma and Constraints of their Management have also been included. Special efforts have been made to include Smoking Cessation which causes COPD and Lung Cancer.
The chapters in this book are arranged in a scientific sequence in a flow to aid easy understanding. The topics included provide relevant theoretical basis, practical management strategies as well as new advancement in the particular subject. This multi-authored book has been conceived with compilation of case oriented practical approach chapters, concisely blended with updated information to cater to the needs of the present day demand in medical curricula. The book is also equipped with the latest advances in diagnosis and management of tuberculosis in the form of annexures at the end of the book. The annexures include guidelines for various activities under Tuberculosis Control Programme of Government and also National AIDS Control Organization.
Prof VK Arora, a dynamic person with a clear vision, is a source of inspiration for young and brooding doctors in the field of tuberculosis and respiratory medicine. He is presently working as Vice-Chancellor of Santosh University and Director and Principal, Santosh Medical College and Hospital (Maharaji Education Trust), Ghaziabad. He is Vice-Chairman of the Tuberculosis Association of India. He was earlier Director, LRS Institute of Tuberculosis and Respiratory Diseases and was also holding prestigious position as Additional Director General of Health Services in the Ministry of Health and Family Welfare in Government of India. He is a well-known academician and has to his credit a number of national and international awards and citations. In his endeavor to guide and inspire the practitioners of Respiratory Medicine and Tuberculosis, he has devoted his valuable time to the preparation of this textbook with a practical approach. I congratulate him on his efforts to bring out this case-based practical approach manual for the benefit of medical fraternity.8
I do hope that the strategic guidelines as recommended by the National and International experts, included as annexures, will prove useful for exploring new areas of research and planning for prevention, control and treatment of Tuberculosis, HIV and Lung Diseases. The book deserves a place in the library of every medical college and health care providing institutes. It will also be a precious resource material for doctors in training.
SP Agarwal
Secretary General
Indian Red Cross Society
President, TAI
Formerly, Director General of Health Sciences
(Government of India)
9Preface
Tuberculosis, HIV infection and lung diseases are three burning health problems encountered among people. Though much effort is being made by Government and private health sector to tackle these problems, yet a lot needs to be done in terms of their early detection, prompt and effective treatment and overall awareness about these diseases among masses and updating the knowledge about these diseases in the health care professionals. An updated Manual on Tuberculosis, HIV and Lung Diseases: A Practical Approach is being published with this objective in mind. Written with elucidation and comprehension with latest references, it shall prove useful not only for pulmonologists and general physicians but also for program managers and postgraduate students.
I have included chapters related to the latest aspects of tuberculosis, newer drugs, TB vaccination and recent advances, i.e. on genome of tuberculosis and stem cell therapy in pulmonary diseases. Similarly, chapters related to HIV and lung diseases have been included with special reference to latest developments in recent time.
The chapters in the book have been arranged in a scientific sequence in a flow to aid easy understanding and updating the existing knowledge of readers. The case studies and reports illustrating management protocols are given to aid in understanding the applicability of knowledge imparted. Each chapter mentions the existing knowledge, its limitations, recent advances and future needs of the topics covered with latest references and case histories. Various standard guidelines and management protocols have been added in the Annexures to serve as a ready reference.
I hope this book will enlighten and educate the medical fraternity to lead a crusade against these dreaded diseases.
VK Arora
10Acknowledgements
A book of this magnitude would not have been possible but for the cooperation and hard work rendered by our contributors in preparing the chapters. My sincere thanks to all the experienced authors for their contribution in bringing out this book.
I am thankful to Dr KK Chopra, Deputy Director, New Delhi TB Center for helping me compiling and editing this book. He has spared a lot of time from his busy schedule.
My special thanks to Dr DD Arora, Dr Atam Prakash, Dr Naresh Kumar Handa, Dr Rohit Sarin and Dr Pooja for their insight and guidance. They are especially close to my heart for years as relatives. I am really indebted to them for continuously giving their encouragement and support.
My thanks are due to my family members who have stood by me during the course of compiling this book.
I am grateful to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for bringing out this book in such a good shape.