1. Eat more healthy food

Yes, this can be on your 2020 resolution list to stay healthy. You can start by adding healthy food items to your meal and removing too much fast food from your diet. This will help you a lot to increase your health and if you are fat or skinny by any chance then you can even come up with a diet plan to maintain your body shape.

And it is pretty easy to understand that healthy food provides good nutrients, vitamins, and minerals to your body which keeps you energetic whereas fast food just introduce your body too bad fat and unhealthy substances.

Also Read: Foods that Keep You Warm in Winter

2. Resolute to leave a bad habit

This can be a hard one because bad habits are often very hard to leave, more reason why you should resolute to leave a bad habit this new year. This can be a great step towards your health if you leave a bad habit like drinking too much alcohol or smoking or eating too much unhealthy food or any such habit which causes harm to your health. This resolution surely will test your caliber of control over your body and willpower but if you succeed then this will result in a considerable change in your good health and better lifestyle.

Also Read: Super Foods For Your Diet This Winter

3. 30 minutes daily walk

If you are too busy to join a gym or to follow an exercise plan then the best thing you can do is take a 30-minute walk in a day which will help you a lot to stay healthy. It may not sound like a big deal to take a 30 min walk but it affects your body in a good way by increasing your body activity and heart rate. It will also help your lower muscles to be in shape and habitual of walking long. This will help you improve your digestion.

Also Read: Food for thought

4. Stay away from social media

One reason for bad health in today’s world is using technology too much. We use to give a lot of our important time to social media. Yes, social media can help you to stay up to date but nowadays everyone is addicted to social media which is as bad as the addiction of alcohol or smoking. Continuous use of phones causes damage to your eyes. So, you should make a resolution this year to stay away from social media.

Also Read: Study: Increasing Protein and Dairy Intake Reduce Burden of Diabetes

5. Take proper sleep

Taking proper sleep is directly related to your health. In the past few years, we have developed a new habit of going to bed late. We used to do different things at that time that we should be giving to our sleep which is a big reason for health issues. The human body requires a good sleep to work properly and sleep is the time when our body heals itself. So, giving your body a proper sleep can increase your health and will also make you feel refreshed. Dedicating a certain hour to your body for sleep is a good resolution to make this year.

Also Read: Can Millets Be the Answer to India’s Nutritional Problems?

6. A full body checkup

Even if you are working just fine you should still arrange an appointment for a full body checkup. This will help you not only to keep a track of your health records but also to make sure that you are not in danger with any secret illness or disease. This will also help you to clear any ill thoughts about your health and also make you feel relieved that you are just fine and have nothing to worry about.

Also Read: Healthy Lives: Everyone, Everywhere

7. Daily exercise

It is common fact that daily exercise is very important and beneficial for health because exercise helps you to maintain your health in many ways like

•  controlling your weight
•  reducing risk of heart disease
•  burning RFM(reserve food material) in your body
•  Improving your mental health and mood
•  Increases your physical abilities
•  maintains your body mass index

and many more things. This is not an easy resolution to follow but this is the most effective one and this year for a change and for your better health make this resolution.
Also Read: Regular consumption of fruits cuts death risk

8. Create a timetable

One of the most common resolutions many people come up with is to create a time table for their daily activities. Creating a timetable means organizing your task and giving each task a specific time which will help you to keep track on your health activities and never forget any of your exercise routine. Following a time table also helps you to improve your mental health and makes you more punctual and responsible. Start with making a task book or by creating a timetable for just a day and follow it, by completing small tasks you will develop a sense of achievement. Creating and following a timetable is a good resolution to follow.

Also Read: Global nutrition needs swift efforts

9. Plan outdoor activities

Committing with an outdoor activity can help you recreating your present lifestyle and improves your mental, physical, social and intellectual skills. Those who spend more time in outdoor activities become happier and tend to learn new skills. It helps to boost your creativity. You have many different things and experiences to explore when you choose to go for an outdoor activity. You can choose any activity like climbing, river rafting, playing football out of unlimited options. So, make sure you plan at least one outdoor activity this year.

Also Read: Carb reality: The truth about carbs – Are they evil or essential?

10. Commitment towards your resolution

One of the best health resolutions is to keep committed to your resolution that you have made for your health because many people come up with different kinds of health resolutions every year but are failed to follow because of some reasons. So, you can make a resolution to stay committed to your resolution. Whenever you feel that you may leave your health resolution make sure you remember this resolution, which is to stay committed to your health resolution. This is the most important resolution to follow this new year to complete your health resolution.

Also Read: 10 EXERCISES THAT YOU CAN DO AT HOME

Every year almost 45% of the people make some kind of health resolution, but only 3% of them are able to achieve their goals rest of the people abandon their resolution. So, the most important thing is to follow and complete your resolution.
Happy and Healthy New Year

Asking about if obesity is hereditary? Then, genes aren’t the most worrisome risk of obesity. An individual’s upbringing can be, the way the family raises, the daily food intake, importance placed on physical activity and how a person would take their behaviour model, are the bigger influences on likelihood of obesity than genes. Health is not valued till sickness comes, true isn’t? Obesity is not because it runs in the family!! It is because no one runs in the family!!!

Today, more than 95% of all chronic diseases is caused by food choice. Yes,being overweight is linked to a number of health and oral health diseases, including: heart disease, high blood pressure, diabetes, cancer, gallbladder and gallstones, breathing problems, such as sleep apnea (when a person stops breathing for a short time during sleep) and asthma, oral health problems such as caries, halitosis, poor oral hygiene, periodontal disease. Symptoms for obesity include breathlessness, Increased sweating, snoring, inability to cope with sudden physical activity, feeling tired, back and joint pain, low confidence and self-esteem, and feeling isolated.

Also Read: Exclusive interview with Minister Dr Harsh Vardhan

After being aware of the risks, proper health and oral hygiene should be maintained. And why is maintaining diet an important factor? Because a poor diet may result in lack of essential nutrients and vitamins thus potentially making it more difficult for your body to fight off an infection. A diet high in fat and calories, including large quantities of processed foods or sugar, and lack of physicalactivity, leads to obesity. Those same foods can cause oral health problems including gum disease, premature tooth loss and bad breath Our body craves for what is in our bloodstream. Wheat, sugar, alcohol, coffee and de-vitalized foods are designed to be addictive. Sugar being addictive – agreed. But how does sugar affect an individual’s health and oral health? Well, consuming sugar is bad for an individual, but consuming too much has become a norm and that can cause health issues. The only type of sugar the body needs is glucose, which it can make by breaking down carbohydrates, proteins and fats. When ingested, simple sugars are converted into plaque if not removed immediately. As plaque begins to accumulate on our teeth and gums, the risk of varying forms of gum diseases such a gingivitis and periodontitis, as well as tooth decay, may become inevitable.

In 2018, a study revealed that 170 children and young people have rotten teeth removed every day, undergoing general anaesthesia. That’s an unpleasant operation that is completely avoidable; we have got a lot of evidence to show that the main cause is excessive sugar. There are also links with type 2 diabetes, usually chronic disease seen in adults, but we are seeing more and more under the age of 25 these days.

Also Read: A Right Gesture Saves Life

So, what an oral health care professional should be aware of? Dentists must be aware of how nutrition impacts general and oral health, and how dental treatment can impact patient’s nutritional status. Oral health is strongly influenced by the daily intake of food; on the other hand, oral health can also play a significant role in nutritional intake and general health status. The dental caries is also a chronic disease and may be depend on oral hygiene, high intake of sugar added to food, lifestyle factor, and host factors (salivary flow, buffer capacity and buccal microflora). Relationship between obesity and gum disease – we actually don’t know if this is a one-way or a two-way street. For example, conditions like diabetes, the relationship is bilateral. Periodontal disease will affect diabetes and diabetes will worsen periodontal disease, so that could be a possibility here. What are the other reasons of obesity affecting gums and what would be its risk factors? Because of various dietary habits and improper maintenance of oral hygiene, chronic periodontal infection is an inflammatory state that is described by a deviation in microbial environment and composition of subgingival plaque bio films and accelerated destruction of tooth supporting structures. Thus, low glycaemic diet may be beneficial to our oral health. Periodontal diseases are also influenced by various risk factors including aging, smoking, oral hygiene, socio-economic status, psycho social stress, osteopenia, osteoporosis and various systemic diseases, which signifies that periodontitis does not merely occur as a consequence of plaque deposition but is also coupled with various other host factors. Also, on examination, obese adolescents exhibited multiple carious teeth, higher plaque index, gingival inflammation, bleeding on probing and probing depth compared to normal weight subjects of similar age.

Also Read: Minds of Medalists behind their Medals

An obese patient, whose lungs are often not large enough to lift heavy chest walls, can have trouble during breathing, especially when active. Also, during sleep the person might breathe through his/her mouth instead of nose, thus jaw is forced into an unnatural position for a longer period of time. This can lead to teeth grinding and development of an overbite, over jet or spacing between the anterior teeth.How can we, as dentists, help the obese patients? Dentists should include the evaluation of BMI in routine patient examination and eventually refer obese periodontal adolescents for weight reduction interventions like diet therapy, behavioural therapy, pharmacotherapy, so that they can have better control over periodontal inflammation.What are the practical considerations in dentistry? It can be difficult carrying out dental care for an obese patient: the maximum lifting weight for modern dental chair is approximately 140kg (23 stones). The position of anatomical landmarks may be less obvious if surrounded by fatty tissue, the landmarks for placement of an inferior alveolar nerve block can be impossible to palpate through excess soft tissue. It may be impossible to palpate cervical lymph nodes in a large neck. Also due to constant secretion of saliva, the mouth and teeth are rinsed and kept free off food debris and foreign particles, thus excess of buccal pad of fat hinders with self-cleansing action in the mouth. Because of lack of saliva present in the mouth, it can lead to dry mouth. Sip water frequently throughout the day and use alcohol-free antiseptic mouthwash daily for cure. A normal sized mirror is unsafe for retraction of soft tissues: a ‘lax’ tongue retractor can be useful.What is the alternative to conventional dental chair? Refer the patient to the hospital environment where the patient may be treated on an operating table or trolley. Another possible solution for obese patients is a custom-made chair such as DIACO dental chair. What is the difficulty faced during conscious sedation? When thinking about conscious sedation for obese patients, the potential difficulties in airway management and intravenous cannulation should be considered. The provision of inhalation sedation with nitrous oxide during which oxygen levels are maintained at or above 30% may be more appropriate. If intravenous sedation with midazolam is proposed, the overall benefit to the patient must be carefully weighed up against the increased likelihood of significant respiratory depression and the difficulties in managing a respiratory complication. New research suggests that the health of your mouth mirrors the condition of your body as a whole. A healthy smile can surely transform our visual appearance and the positivity of our mind-set.

‘Eat every two hours, sleep eight hours, have plenty of water and pray to keep calm. Most importantly, carry a smile on your face.’

About the author

Dr. Vishaj S. Maru is a dental surgeon. She studied dentistry at the D.Y. Patil School of Dentistry. She does clinical practice in Mumbai with a keen interest in academia and clinical dentistry.

Although all grains, cereals as well as millets, mostly comprise of starch (~60-65%), however the concentrations of protein,dietary fiber and minerals greatly vary among them. Wheat grains are composed of 70% starch, while rice is 90%. Protein ranges from 13—15% in wheat but is essentially lowest in rice among all available cereals. The fiber content, as well as the minerals composition of both the privileged grains, is also poor. Considering the modern-days edentary lifestyle, the amount of refined carbohydrates we consume without much physical activity is taking a toll on our health, as is evident by rising malnutrition numbers.

Moreover, the sudden release of glucose into the blood stream causes“energy crash” soon after a starchy meal. Thus, we need grains with higher dietary fiber and resistant starch. These slowly digestible nutritional elements provide satiety feeling for a longer period of time,and help prevent constipation by accelerating food movement through the gastrointestinal tract.They also bind to toxins and remove them from the gut, thereby protecting the colon mucosa from cancers. Dietary fibers also reduce serum LDL-cholesterol levels, by binding to cholesterol generated bile salts thereby hindering their re-absorption in the colon.

Based on all nutritional parameters, millets are far ahead of rice and wheat. Not only are they more resistant to digestion, but also the antioxidants abundantly present in millets scavenge free radicals that cause inflammation in the body. Bajra/Pearl millet is the oldest millet used by our ancestors. It is still a part of regular meals in desert belt of the country like Rajasthan and Gujarat. It is extremely rich in iron (0.8%), zinc (0.3%),calcium (0.4%), phosphorus (0.4%), and most importantly dietary fibers. Jowar/Sorghum is rich in antioxidants, abundant in phyto chemicals such as tannins, phenolic acids, anthocyanins, polysterols, and polic osanols. They are also a good source of vitamin B complex and folate. Ragi/ Fingermillet is mostly consumed in Karnataka, followed by Andhra Pradesh, Tamil Nadu, Odisha, Maharashtra, Uttarakhand, and Goa. Ragihas the highest amount of calcium (344mg/100g)and potassium (408mg/100g), and fairly low content of fat(1.3%).

Moreover, it contains antioxidants such as phytates (0.48%), polyphenols, tannins (0.61%), trypsin inhibitory factors; and are a substantial source of dietary fibers (15—20%). They are also rich in amino acids like tryptophan, threonine, valine, isoleucine and methionine. Rajgira/Amaranth is considered a pseudo-cereal because of its starchy seeds. Its 13—15% protein aceous grain comprises of almost all the essential amino acids required by the human body,especially high content of lysine, which is basically absent in wheat and rice. It is an excellent source offolates, niacin, thiamin, pantothenic acid, vitamin B-complex, vitamin E as well as essential fatty acids. All of these alternate grains are arich source of soluble and insoluble dietary fibers, providing7—17% of daily requirement of fibers. Moreover, these grains are gluten-free, which are a great food substitute for people with celiac disease.

Consumption of millets lowers the Glycemic Index*, thus combating type-2 diabetes and obesity. Glycemic indices of wheat and rice are 65 and 70, respectively; whereas it is 54for bajra and 62 for jowar. Although these values are higher for ragi (84) and rajgira (107); but the great amounts of micro nutrients present in them compensate for their health implications. High iron content in these alternate grains may help increase hemoglobin; considerable phosphorus concentration is good for bone growth and development;magnesium controls blood pressure as well as helps reduce respiratory problems; also strong antioxidants present improve heart health. Millets possess hypo allergic properties as well; they are alkaline in nature, thus preventing the formation of acidity and ulcers in the stomach.

India is believed to be the world’s capital of diabetes. It is estimated that the diabetic population in the country will increase with an alarming rate of 26.6%, which will account for 69.9 million affected individuals by 2025 and 80 million by 2030! In fact, the prevalence of diabetes mellitus in the urban areas is 28%, whereas in the rural population it is 5%. New scientific approaches of developing genetic markers for estimation of the incidence of obesity and diabetes are being developed worldwide, with ironically a simple solution residing in our backyards, Millets! India has 5,97,464 villages and 2,50,000 Gram Panchayats.

We need to take initiatives to promote millet farming and consumption starting at the very basic level of villages. Since millets have evolved surviving drought, floods, harsh hot and cold climates, they have adapted with time and are easy to grow under varying environmental conditions. Because of such varied exposures, millets have become resistant to pests and diseases. For this reason, they are easy to grow, without pesticides and insecticides and with little caution; making the end-product“organic”. More so, adding to the food problem is another crisis, “global climate change”, which will cause severe water scarcity in our near future. The additional advantage of millets is their less irrigation demand in agriculture. To sum up,more production of these grains would mean limited water requirement; more consumption would mean decrease in health issues thus resulting in lower expense on medical bills and more availability of funds for other purposes, and extensive availability of the alternate grains for end-use would mean cost-effectiveness.

The reasons why these grains are not market-ready are very evident. Most important being the color and tastefulness. Millets contain polyphenols which cause the grains to become rancid faster than wheat and rice. Also, their nutritional utilization demands more effort in terms of processing/cooking times. Further, to increase the rate of iron absorption in the body as influenced by phytates present in these grains, processes like roasting or other alternate methods are required. In a quick-fix world of people with changed mindsets seeking instant gratification, it becomes challenging for people at large to take out time and make efforts towards their better health.

The age-old adage, prevention is better than cure, holds true here when we consider the consumption of millets. Considering the overall nutritional status of our country and the environmental issues globally, it is time we approach these matters comprehensively, and expand our food baskets and minds to include more nature-friendly elements.

*Glycemic Index (GI) – It is a figure representing the relative ability of a carbohydrate to get hydrolyzed in the body, causing an increase in the level of blood glucose.

About the author

Dr. Geetika A. Batra is a cereal carbohydrate specialist with R&D experience in genetic and biochemical alterations in cereal grain digestibility and its nutritional implications. She is an active member of scientific societies,American Association of Cereal Chemistry and K. K. Nanda Foundation for the advancement of Plant Sciences. She has been awarded several prestigious international awards and scholarships (Herb R. & Marian H. Cark Scholarship, Paulden & Dorathea I. Knowles Postgraduate Scholarship, two times winner of Life & Health Sciences Conference at University of Saskatchewan, Canada); and has various international publications to her credit. She is currently working as Research Associate in Bio threat Mitigation project at CBRN Defense, DRDO.

Researchers measured insulin and C-peptide levels of 87 diabetics(67 men and 20 women). Actually, beta cells in the pancreas that make insulin also release the C-peptide-a polypeptide composing of 31 amino acids. Although C-peptide does not actually affect the blood sugar of a person, the doctors can measure its level to figure out how much insulin the person’s body is making.

What made researchers measure the C-peptide levels along with insulin levels in the diabetics under study? This is because C-peptide gets secreted at a more constant rate across time durations as compared to the insulin secretion. Also, C-peptide levels are more stable compared to the insulin levels (its half-life is nearly six times that of insulin)which facilitates testing of beta cells’ response, the study has pointed out. The results revealed that the persons included in the study had largely the features of adiposity characterised by high body fat, abdominal fat and fatty liver condition, which may not be visible from outside.

The study has concluded that nonobese (BMI below 25) and even lean (BMI below 19) Indians have high body fat, excess fat in the liver and skeletal muscles and lesser skeletal muscle mass. In particular, they have ectopic fat in the liver (non-alcoholic fatty liver disease) and pancreas (nonalcoholic pancreas disease), which may contribute to insulin resistance leading to diabetes even in young age.

Along with high body fat and visceral fat, researchers also found elevated levels of insulin and C-peptide in the 87 diabetic patients studied by them. Such patients would benefit better from pharmacotherapy using insulin sensitizers or weight loss therapy, the study noted.

Summarising the outcome of the study, Dr. Anoop Misra, chairman Fortis C-DOC who led the study, told India Science Wire: “Indians have normal weight-high body fat and low muscle mass. They are not overtly obese but have not only high body fat but fat which is located in the crucial organs of metabolism, i.e., liver and pancreas. Once this occurs, the action of the insulin hormone becomes jeopardized, and blood sugar startsincreasing.”

“Indian physicians should urge patients to lose weight even when they are in normal body mass index (BMI) category to maintain body habitus at leaner side. This could prevent diabetes in those who do not have it yet, and blood sugar levels are better managed in patients with diabetes.” he added.

Credits: India Science Wire

This is because of the singular and unique ability of the TB bacterium to hide inside the human body in a dormant state without causing the disease or revealing any outward symptoms. Such cases are classified as latent TB infections and can be revealed by diagnostic tests in healthy seemingly uninfected individuals. Studies indicate that close to 40% of the Indian population is positive for latent TB and without treatment 5%-10% of these will develop active TB at some point in their lives. Unfortunately, due to the high burden of TB in India, the detection and treatment of latent TB are not prioritized, resulting in a huge reservoir of dormant and potentially infectious bacteria primed to emerge under favorable conditions.

In 2017, 10 million people were infected with TB and 1.6 million died worldwide, surpassing AIDS as the world’s leading cause of death due to an infectious disease. WHO has designated March 24t has the World TB Day to raise public awareness about TB and its deleterious effects on health, society and the economy. In 2015, it began to implement the ‘End TB Strategy’ which envisions a world free of TB with zero TB related deaths and zero incidences of the disease. In order to do this, WHO aims to support and promote a patient-centric approach to care and prevention, encourage proactive policies and support systems by involving the government and private sector healthcare and finally intensify research and innovation in the field of TB treatment, prevention, and diagnosis. The Government of India has instituted a similar strategy, the Revised National Tuberculosis Control Program (RNTCP). RNTCP involves adopting WHO guidelines of Direct Observation Therapy (DOT) to the Indian scenario and includes direct monitoring and administration of anti-TB drugs to the patient, rapid TB diagnosis and treatment, and increased partnership between public and private healthcare systems. RNTCP’s objective is to eliminate TB by 2025. The plan outlines four directives – Detect, Treat, Prevent and Build and includes a system for free and sensitive diagnostic tests for TB, screening of the high-risk population, free TB drugs for all patients, implementation of a uniform treatment regimen, increased social support and monitoring and treatment of latent TB. Finally, the plan will work towards translation of political commitment to action through strengthening support structures for surveillance, research, and innovation.

Several technological innovations have facilitated easier and improved patient monitoring, such as 99DOTS which is a low-cost solution for improving patient compliance during TB treatment. Patients using 99DOTS receive medication in specially packaged blister packs. Dispensation of a dose reveals a hidden and unique phone number that the patients can call for free and confirm that the medication has been taken. In this way, remote monitoring of patient compliance has been made possible. Several digital adherence technologies have also been developed as an electronic way to monitor medication and provide reminders. These include digital pill boxes (evriMED, Wisepill, etc.) that are given to patients with their medication inside. The digital boxes provide visual cues such as colored LED lights which turn on and remind the patient of the dose and the medicine that is due. These boxes can also record medication events in real time by logging the opening of the box for each dose, allowing for real-time monitoring of patient compliance. Pilot studies are also underway in the US for ingestible sensors that are embedded inside each pill, which transmits information that the pill was consumed upon activation inside the patient’s stomach. However, the cost of such technology is yet to be estimated and given WHO and Govt. of India goals to reduce the economic burden of TB, cost-effective ingestible sensors may remain only a distant possibility.

Also Read:
Health Of The Indian States
Healthy Lives: Everyone, Everywhere

Risk Factors for TB

Being primarily a respiratory disease, TB is disseminated by airborne infection as the bacteria is exhaled from an infected individual and inhaled by another. This often happens in poorly ventilated and over-crowded settings typically seen in cramped housing where the disease can spread like wildfire. Indeed, earlier TB was thought to be hereditary as it used to wipe out entire households. Weakening of the body’s immune system due to age, substance abuse, air pollution, diabetes, HIV infection, and malnutrition, among others, play a major role in increasing susceptibility to TB. Its spread is seen across the socio-economic strata. As Dr. Zarir Udwadia, one of the world’s leading pulmonologists puts it, “TB does not distinguish between the chauffeur driving the Mercedes and the CEO sitting at the back!”

Detection and Diagnosis of TB

One of the main challenges in the fight against TB is the very first step of diagnosis. Millions of TB cases go undetected and unrecorded all over the world due to the shortcomings of technology. Conventional TB diagnosis is performed by sputum smear microscopy, wherein the sputum of the patient is examined under a microscope for TB bacilli. However, this approach is only 36-43% sensitive which means that many cases of TB infection are missed by this method.

Sputum smear microscopy also suffers from false positives, as some non-TB bacilli may also pick up the TB specific stain. Therefore, a positive sputum smear needs to be confirmed by culturing the bacilli obtained from the sputum in the lab, which can then be tested to confirm TB. Unfortunately, growing patient strains and analyzing them requires resources and technical expertise that are not available in most of the high prevalence countries. In addition, growth-based confirmation of TB positivity takes a minimum of 21 days since the growth rate of the bacilli is extremely slow.

A third technique, which involves the detection of TB DNA using polymerase chain reaction (PCR) and named Xpert MTB/RIF promises results of sample positivity within 2 hours and is currently the gold standard in PCR based TB diagnosis. However, this system suffers from high costs per assay and the requirement for infrastructure and constant electricity, which are not available in many cases.

Treatment for TB

Active TB infections are treated with a standard 6-9 months treatment regimen involving four antibiotics: rifampin, isoniazid, ethambutol, and pyrazinamide for varying durations. This treatment duration is one of the longest for bacterial infectious disease, second only to the treatment of leprosy. Side effects like itching, rashes, fever, nausea, diarrhea and reddish/orange discoloration of body fluids including urine, tears, and saliva is another cause of worry which takes a physical, emotional and mental toll on the patient.

Since most infected individuals begin to feel better after a few weeks of treatment and the length and side-effects of the drug treatment are arduous, many patients stop the treatment prematurely or skip doses. Rampant patient non-compliance when it comes to the completion of anti-TB therapy is one of the main factors for the emergence of a more severe form of the disease, one which is resistant to common drugs! This is a big reason for TB reactivation and the continued prevalence of this disease even though it is completely curable in most cases.

Drug resistance in TB has been known since the first antibiotics to treat this disease were put into place. An increasingly larger repertoire of drug-resistant strains necessitated and increasingly larger arsenal of drugs to treat the disease. As of today, TB strains resistant to one of the first line of four antibiotics are called resistant strains. Strains resistant to two first-line antibiotics are called multi-drug resistant strains of TB or MDR-TB. These are treated with a second line of antibiotics, consisting of fluoroquinolones (levofloxacin, moxifloxacin, and gatifloxacin) or injectable drugs such as amikacin, kanamycin, and streptomycin. More recently, the third category of strains labeled Extensively drug-resistant- or XDR-TB has been described with resistance to a fluoroquinolone and at least one of three injectable drugs. A total of 12 drugs are approved today, each of which individually and in combination is used to treat these three categories of TB, MDR-TB, and XDR-TB. However, a little characterized fourth type of strain dubbed totally drug-resistant- or TDR-TB has been reported in India, Italy, Iran, and South Africa. These strains are completely resistant to all known anti-TB medication and given the airborne and infectious nature of the disease, are ticking time bombs of catastrophe.

Also Read:
Integrating Technologies To Better Healthcare
Medical Devices In India Witness Churning

Newer Strategies in TB Healthcare

The emergence of drug resistance, the persistently high rate of TB incidence and TB mortality and the challenges associated with patient non-compliance demand improved methods to detect TB with high accuracy, newer drugs to treat resistant forms of TB and increased awareness of the disease.

Bedaquiline and delamanid are two new drugs for TB that have shown promising results in clinical trials after nearly 40 years of failed attempts. These two drugs have received approval for use in the treatment of MDR- and XDR-TB. Additionally, a new drug combination involving bedaquiline, pretomanid and linezolid is reported to have successfully treated XDR-TB in six months with a lower mortality rate than current treatments. However, these new treatment regimens are yet to enter mainstream clinical practice, with further and larger clinical trials needed to make an accurate cost-benefit analysis of these strategies.

Looking to the Future

Although the current situation of TB in India and worldwide looks bleak, the global TB incidence is falling at a rate of 2% per year. According to WHO, this rate needs to increase to 5% to achieve the WHO Global Plan to End TB milestones of reaching 90% of all people with TB through national TB programmes, reaching at least 90% of vulnerable high-risk population through affordable treatment and achieve at least 90% success in the treatment of all people diagnosed with TB. Achieving both WHO and RNTCP milestones will require a concerted effort by policymakers, healthcare providers, TB researchers, patients, and the general public. What we need today is increased public spending on healthcare to make TB therapy affordable and accessible, improvement of research funding and infrastructure and stronger public awareness campaigns to disseminate the reality and requirements of ending TB.

Over just the past two centuries, TB is estimated to have killed 1 billion people, which is more than the number of people killed due to AIDS, cholera, influenza, plague, and smallpox combined! It is time we take the initiative and responsibility to help the millions that are suffering from this deadly disease.

About the Author

Vignesh Narayan is a scientist and science writer at the Indian Institute of Science who currently studies the molecular biology of the TB pathogen Mycobacterium tuberculosis in an attempt to understand how the bacterium senses and responds to its environment and develop new drugs and drug targets to combat the disease.