ABSTRACT

Tuberculosis, caused by Mycobacterium tuberculosis, remains a global public health issue. Latent TB is an airborne chronic disease; 46% of the world’s population is thought to be infected with LTB. It is most prevalent in the lungs (pulmonary TB) but can also affect other organs (extrapulmonary TB). Immunocompromised individuals, such as HIV-positive individuals, are at much greater risk for active TB.M. tuberculosis is an aerobic, non-motile rod whose high levels of lipids make it difficult to diagnose and thus avoid the immune system. It is transmitted via aerosol droplets, where the bacteria infect the lungs and can then remain in granulomas for years. One of the major obstacles to TB control is the advent of drug-resistant strains, such as multidrug-resistant TB, which are not effective when compared to the best first-line agents. Toxic treatment, lack of quality drugs, or improper medicine contribute to its growth. High levels of diagnostic variability hinder progress, and an estimated 4 million undiagnosed cases a year fuel transmission. WGS can be applied in various ways, but its use has a limited impact. A financial constraint also severely limits TB control efforts. Future strategies to combat TB will include better vaccines, new drugs and rapid point-of-care diagnostics. Controlling the disease requires focused screening practices, diagnosis intervention, adequate funding, and drug resistance, along with ethical principles of informed consent and patient agency in research and care.

Keywords: Mycobacterium tuberculosis, drug-resistant, novel drug discovery, TB preventive therapy and screening practices

ABSTRACT

Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome is a rare inherited disorder which shows autosomal dominant inheritance pattern with variable sensitivity primarily affecting the blood vessels and is characterized by abnormal formation of blood vessels in skin, mucous membranes, and organs like lungs, liver and central nervous system. It is seen to involve the long arm of chromosome 9. It affects both sexes equally and is characterized by multiple telangiectasias and Arteriovenous malformation that causes direct connections between arteries and veins which bypasses intermediate capillaries. The most marked sites where telangiectasia occurs are lips, tongue, face, nasal mucosa, oral cavity and gastrointestinal tract. The main complications of telangiectasias are easily rupture and bleeding which occurs due to the thin walls, narrow tortuous course, and in close proximity to skin surface and mucus membrane. The symptoms are obvious and are classified according to the involvement of organ which includes repeated epistaxis, gastrointestinal hemorrhage, hemoptysis, skin lesions, and sometimes leads to dreadful condition like stroke. Complications do occur in Hereditary hemorrhagic telangiectasia and those includes bleeding from various sites, reduced hemoglobin, followed by stroke, pulmonary AVM, Transient Ischemic Attack (TIA), hypovolemic shock which occurs due to severe uncontrolled bleeding, which eventually leads to cardiac failure. Present case is of 40 year old male who presented with complaints of shortness of breath, epistaxis, non-productive, yellow mucoid cough sometime associated with hemoptysis, GERD, skin thickening with finger-tip ulcers and nail changes.

Keywords: Osler-Weber-Rendu syndrome, Finger-tip ulcers