It was a round day at the Orthopaedic Ward (Ward No 10) of Dhaka Medical College Hospital (DMCH). The head of Orthopaedics and Trauma Surgery Department, Professor Dr Md Amjad Hossain was performing his round at the ward.
"What is the problem?" Dr Amjad asked a teenage female patient. Mahmuda Khatun replied faintly from abdomen down the lower part of her body is paralysed with severe pain in backbone and just below her chest. She could not sleep at night due to untolerable pain and acute breathing problem.
A junior doctor showed Dr Amjad the case history including all necessary reports. He also showed him the lower part of the patient's right back attaching the backbone which swelled like a
tumour. Amjad Hossain diagnosed advanced Bone TB (tuberculosis) that would kill her fast and painfully, if not operated immediately.
"You need a surgery immediately" Amjad said. Tears rolled down the cheeks of the patient. She said quickly, "My father is a vegetable vender who earns a meagre amount a day. We haven't enough money, sir".
"Don't worry, " Dr Amjad assured. "I'll operate you for free and I'll tell the Social Welfare Department to help you with necessary requirements needed during and after the operation period. Garments worker Mahmuda could not say anything but looked at Amjad with a deep sense of gratitude.
Amjad Hossain is revered for his tireless efforts to bring health care to underprivileged people.
On weekends, Amjad and his team would drive from Dhaka deep into the countryside to perform
free health cheek-ups. Patients flocked in, some weekends they saw 300 a day at such a camp at Chirir Bandar in a remote Dinajpur village.
The 18-year-old female Bone TB patient was brought into the Orthopaedic Ward of the hospital with severe pain in backbone and below the chest accompanied by high fever. She totally lost appetite. The problem originated four years back.
Being an inhabitant of Raipur thana in Narsingdi district she visited some general practitioners but in vain. Finally she consulted with a Medicine and Cardiac specialist at a Hospital in Bhairab, Kishoreganj who also could not diagnose her disease. But he referred her to the city hospital.
Last May Amjad Hossain successfully performed the operation on Mahmuda. After recovering from the surgery, she was relieved of pain and got back her appetite.
Now paralysed Mahmuda is continuing his fight against Bone TB. "As you delayed treatment you need a long-term treatment," Dr Amjad told her.
In reply to some queries, Dr Amjad gave the following valuable information ---
About 60,000 lives are lost annually due to tuberculosis (TB) in our country and 50 percent of them are victims of muscle, bone and Joint TB.
If detected early, its treatment is safe but treatment must continue for nine months, sometimes for 18 months with no interruption for a single day.
If there is less complication and if patients get proper management with nutritious food, the survival rate is very good.
Early diagnosis, treatment and taking anti-TB drugs without interruption for a single day usually save lives of patients.
The routine blood tests, Tuberculin test, Confirmation test for TB (ECT), X- rays of the joints, Aspiration of joint fluids and C/S are the tests for Bone and Joint TB.
The tragedy is that patients often delay in seeking medical help. The delay leads to lot of complications like joint deformity, disability, paralysis of both the lower and upper limbs.
The disease can strike both the elderly and the younger people alike.
Overcrowding, poor sanitation, poverty and unhygienic conditions are the major factors of the disease.
If the patient is not treated, the disease may spread to other members of the family. If a member in a family is affected then there is a chance to spread the germs to affect the whole family. However, TB is not an inherited disease.
The possible signs of trouble is non-responding to usual treat-
ment.
According to Dr Amjad Hossain's studies, there are plenty of musculo-skeletal cases in our society involving different parts of the body. Usual complaints of patients are evening fever, weight loss, loss of appetite, apathy and unwillingness to work.
Patients must not ignore back pain. Bone TB may turn patients completely disabled leading to burden in society. Recent advancement in its treatment is the introduction of newer drugs for Multidrug Resistant TB.
Delay in treatment may lead to lots of complications like joint deformity, disability, paralysis of both the lower and upper limbs.
Consciousness about hygiene, improvement of sanitation, avoiding overcrowding, nutritious food and alleviation of poverty are the main factors in reducing the risks of TB.