Tuberculosis

Overview

Tuberculosis (TB) - a disease that has plagued humans since the Neolithic times. This, is an age old enemy.

Two organisms cause tuberculosis -- Mycobacterium tuberculosis and Mycobacterium bovis.

The Ancient Greeks called TB "Phthisis" to reflect its wasting character.

Come the 17th and 18th Century, TB was suspected to be responsible of up to 25% of all deaths in Europe.

The 19th Century saw the bacteria that caused TB being isolated but no effective treatment was available until the mid 20th century.

Yes, TB is an age old enemy.

Causes of TB:
TB is transmitted via air droplets from infected individuals. Once inhaled, the bacterium invades the lungs and subsequently erode lung tissue.
Risk factors for TB include the following:

• HIV infection,
• low socioeconomic status,
• alcoholism,
• homelessness,
• crowded living conditions,
• diseases that weaken the immune system,
• migration from a country with a high number of cases,
• and healthcare workers.

Tuberculosis: Symptoms and Signs

TB might not surface clinically until the disease is advanced. Even then, symptoms can be vague - weight loss, mild fever, and a productive cough. Often, these symptoms are misinterpreted or misdiagnosed as other illnesses.

Any close contact with infected individuals should be referred to a doctor and tested for tuberculosis.
Tuberculosis: Diagnosis

• Chest X-ray
• Mantoux skin test, otherwise known as the tuberculin skin test (TST orPPD test).
• Sputum testing for acid-fast bacilli. This is the gold standard for TB diagnosis. 

Tuberculosis: Treatment

TB treatment is normally done on an outpatient basis. The treating doctor will prescribe several courses of medications that might last for as long as 6-9 months. It is essential that you complete your course of treatment to totally eradicate the disease.

Public health concerns should also be prioritized as exposure to other people will harm the community as a whole. Social responsibility should be observed by infected individuals. All exposed individuals to the patient should under the appropriate investigations such as a Chest X-Ray and/or the Mantoux test for farther evaluation.

Tuberculosis: Prevention

Controlling the disease in infected individuals, and controlling the disease within the community.Infected individuals should consume and complete the full course of prescribed medications while vaccinations like the Bacille Calmette-Guerin (BCG) vaccine stops the spread of TB in the community.

Tuberculosis: Prognosis

As long as the treatment protocol is observed and completed in its entirety, a normal lifestyle and lifespan is the norm.

TB is a treatable disease with the chance of total cure. Do not let it ruin your life.

Seek treatment now.

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.

Flu or Cold Symptoms?

You feel unwell. You’re coughing, your throat is sore, your nose is runny, you have a headache.

Do you have the cold or the flu?

This is important, because if you have the cold, it’ll pass. If you have the flu, and you don’t do anything about it, there’s that nasty possibility of that thing Doctors call “Progression of Disease” happening. i.e. Your “flu” might result in a Pneumonia, hospitalization, or worse.

So, what are the symptoms of the common cold?

A sore throat, which usually goes away after a day or two.
A runny nose alternating with nasal congestion and a cough by day 4 to 5.
For adults, occasionally a fever develops. For Children, fevers commonly occur.

How long do cold symptoms last?

One week. You will be contagious from Day One to Day Three. So stay at home and rest.

If, however, your symptoms do not subside by a week, you might possibly have a bacterial infection. i.e. You might need antibiotics, an allergy or a sinus infection.

What then, are the symptoms of flu?

Flu symptoms mimic the cold but are more aggressive and severe. The onset is usually more rapid and the experience intense. In severe cases, patients with the flu will experience nausea, vomitting and diarrhoea.

To Differentiate between the Two …

Symptoms	Cold	Flu
Fever	Occasional, if present, usually mild.	Common, and lasts 3 to 4 days.
Headache	Occasional.	Common.
General Aches, Pains	Slight.	Severe.
Fatigue, Weakness	Sometimes.	Common, and can last 2 to 3 weeks.
Extreme Exhaustion	Never.	Commonly experienced with onset of illness.
Stuffy Nose	Common.	Sometimes.
Sneezing	Usual.	Sometimes.
Sore Throat	Common.	Sometimes.
Chest Discomfort, Cough	Mild to moderate; hacking cough.	Common; can become severe.
Complications	Sinus congestion; middle ear infection.	Sinusitis, bronchitis, ear infection, pneumonia; can be life-threatening.
Prevention	Wash hands often; avoid close contact with anyone with a cold.	Wash hands often; avoid close contact with anyone who has flu symptoms; get the annual flu vaccine.
Treatment	Decongestants; pain reliever/fever reducer medicines. If symptoms persist, see your doctor.	Medical Review recommended.

When do I call the doctor with flu or cold symptoms?

Call your doctor if you have any of the following severe symptoms:

• Persistent fever lasting more than three days
• Painful swallowing secondary to a sore throat
• Persistent coughing
• Persistent congestion and headaches

In some cases, you may need immediate medical attention. Call your doctor if you experience any of the following:

• Severe chest pain
• Severe headache
• Shortness of breath
• Dizziness
• Confusion
• Persistent vomiting

In children, additional signs of an emergency are:

• Difficulty breathing or rapid breathing
• Bluish skin color
• Not drinking enough fluids
• Lethargy and failure to interact normally
• Extreme irritability or distress
• Symptoms that were improving and then suddenly worsen
• Fever with a rash

How to prevent flu or cold symptoms?

• Handwashing. 
• Rub the hands with warm soapy water for at least 20 seconds before rinsing.
• In addition, get a flu vaccine to prevent seasonal influenza. 
• Antiviral medicine may also help prevent flu if you have been exposed to someone with flu symptoms.

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.

Is There A Need For Doctors to make Home Visits?

Let’s be honest with ourselves.

In today's environment, the regular person is busy, strapped for time, works long hours, and yeah, has family commitments.

In fact, the regular person is likely to be so busy that when the ugly spectre of illness strikes, putting things down and setting them aside is a challenge in itself.

“If Mohamed cannot go to the Mountain, The Mountain must go to Mohamed”

Medical Services at Home

This painful time challenge is often observed in families with elderly patients or family members who are bed-bound that require adhoc, short, or long term medical and nursing care. Deterioration in patient's health often means a whole day of waiting at the hospital due to long queues and of course, the omnipresent issue of bed availability.

“Murphy’s Law: Whatever can go Wrong will go Wrong.”

CMY Medical's services aim to complement hospital services by providing quality healthcare to patients in the comfort of their home. This is especially valuable to the elderly who are not keen to go to the hospital, and to patients who are bed-bound and/or patients with restricted mobility.

24 hour housecall doctors and nursing services visit the patient at home. Allowing patients to rest with ease and comfort at home while waiting for the medical team offers much relief to both the patient and family since there is no need for travel.

The other benefit of housecall services is the doctor's ability to make better assessment of the patient's living environment. This complements the doctor's diagnosis and will allow him to make more appropriate recommendations. This is a big advantage over consultation in a clinic or hospital.

Care-givers and helpers can also be taught how to perform certain tasks on-site to care for patient and themselves.

CMY Medical cares not just for patients, but also their care-givers.

At Work

On the other hand, housecall services also caters to busy working executives. In Singapore's competitive, fast paced and highly stressed working environment, people undergo tremendous amount of stress and get little rest.

It is not uncommon for one to suddenly feel unwell in the workplace on the day of an important meeting. The Housecall doctor will go to you.

Summary

Housecall services benefit people from all walks of life - from busy executives to elderly and bed-bound patients at home.

From ad hoc services to long term care, short term treatments to preventative care, from palliative care to chronic conditions, families can be assured that your loved ones are in good hands even when you cannot be home.

The Doctor, is in the House.

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.