Is it necessary to treat tuberculosis?

Before the world was ravaged by COVID-19, there was another highly infectious deadly disease — tuberculosis.
Tuberculosis is the second most deadly infectious disease in the world. It was only relinquished of its title of “most deadly infectious disease” when COVID-19 appeared. While COVID-19 is usually easy to treat, with most people not requiring any medication, tuberculosis can be fatal if not treated and treatment takes a minimum of 6 months.
According to the World Health Organization (WHO), approximately 10.6 million people fell ill with tuberculosis in 2021[1]. In Singapore alone, tuberculosis is endemic, with 1,306 new cases of active tuberculosis among Singapore residents [2].
To understand the gravity of being infected with tuberculosis, we must learn more about what it is and how it affects us.

What is tuberculosis?

Tuberculosis, commonly known as TB, is a highly infectious disease caused by a bacteria known as Mycobacterium tuberculosis. TB usually affects the lungs but can spread to other parts of the body such as the brain and spine. It is passed from person to person via respiratory droplets, but not everyone exposed to TB will develop symptoms.

There are two types of TB:

What are the symptoms of active TB?

The symptoms of active TB are as follows:

How is TB diagnosed?

TB is diagnosed in the following ways:

How is TB treated?

Both latent and active TB must be treated to prevent symptoms or the worsening of symptoms. Treatment usually involves a combination of antibiotics that must be taken over the course of 6 months to a year. After a few weeks of treatment, you will no longer be contagious — but you must continue with your treatment until the course of antibiotics is complete.
While most TB infections can be cured using antibiotics, there are some TB infections that are drug resistant. This means that the TB-causing bacteria have developed and is now resistant to certain medications. Hence a different group of medications will be used to treat it and must be taken for a much longer period of time, approximately 30 months or two and a half years.
Since TB is treated using antibiotics, the whole course of medication needs to be completed regardless of how you feel or if your symptoms are alleviated. If you do not complete the whole course of antibiotics, the TB-causing bacteria can multiply and grow back and may even become drug-resistant, making them even harder to eradicate.

What happens if TB is left untreated?

TB is not a disease that will go away on its own.
In fact, if TB is left untreated, 45% of HIV (human immunodeficiency virus) negative individuals will die, while nearly all HIV-positive individuals will die.
Furthermore, if you have untreated active TB, you can go on to infect 5-15 people at any one time as TB is easily spread when you speak, cough, sneeze, laugh, or spit, and it does not require a high concentration of bacteria to spread and infect others.

If active TB is left untreated, it could:

Although individuals with latent TB do not have any symptoms and are not contagious, it is still important to treat them because their infection can progress to active TB if their immune system weakens or if they start taking immunosuppressive drugs.

What are the possible side effects/complications of TB medications?

Some individuals may experience the following side effects from TB medications:

What should I do if I have TB?

TB is curable if you adhere strictly to your treatment regime. If you have just been diagnosed with TB, you must observe the following to keep your loved ones safe:

What can I do to reduce my risk of an active TB infection?

There are various ways in which you can reduce your risk of an active TB infection, these are:

In conclusion, treatment for TB is absolutely necessary and should be started immediately once you have tested positive. Remember to complete all medications and isolate yourself for the first two weeks of treatment. TB is curable and is no longer the death sentence it once was. Get treated and get cured!

Any questions? Leave them for me here.

References

  1. World Health Organization. (2022, October 27). Tuberculosis. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/tuberculosis
  2. Ministry of Health Singapore. (2022, March 24). Update on Tuberculosis Situation in Singapore. Retrieved from Ministry of Health Singapore: https://www.moh.gov.sg/news-highlights/details/update-on-tuberculosis-situation-in-singapore-2022

Is asthma always triggered by allergies?

Asthma is a relatively common condition. According to a National Health Survey conducted from 2016-2018, approximately 11.9%[1] of Singaporeans aged between 18-60 were affected by asthma at some point of their lives.
To better understand what asthma is, let’s first understand how our lungs work, and then we can learn about allergic asthma.

How do our lungs work, and what is asthma?

Breathing is something we do without even thinking, but the whole breathing process is intricate and complicated. When you breathe, air travels down your throat and into your lungs. Within your lungs are tiny airways known as alveoli. Once air reaches the alveoli, it transfers to the surrounding blood vessels and is transported all over your body.

However, when someone has asthma, this process gets affected negatively, at times making breathing difficult.
Asthma is a chronic inflammatory disease of the airways in the lungs. It occurs when the airways and surrounding muscles swell and tighten. This causes a significant narrowing of the airways, leading to production of mucus which also contributes to the narrowed airways, making breathing difficult. The severity of asthma varies between individuals ranging from mild irritation to life-threatening.

Types of asthma

For the purposes of this article, we will be focusing on allergic asthma.

Can allergies cause asthma?

Yes, allergic asthma, or allergy-induced asthma, is asthma that is triggered by various allergens. These can range from pollen to even cockroaches; but often allergens that cause allergic rhinitis/hay fever have been known to trigger an allergic asthma attack.

An allergic reaction is caused by an over-reaction of our immune system. The main function of the immune system is to protect our body from dangerous or harmful substances that can make us sick.

However, sometimes the immune system mistakenly identifies harmless substances such as food, dust, pollen or other everyday items as harmful. When this happens, our body overproduces immunoglobulin E (IgE), an antibody when present in excess can cause your airways to:

Worldwide, allergic asthma is responsible for 90%[1] and 50% of asthma cases in children and adults respectively.

What are the common causes of allergic asthma in Singapore?

According to Asthma Singapore [2], the common causes of allergic asthma in Singapore are:

How do I know if I have allergic asthma?

If you experience the following symptoms, you may have allergic asthma:

Symptoms that you might experience in conjunction with allergic asthma are:

Do I have asthma or just allergies?

One of the best ways to identify if you have asthma or allergies is to figure out where the reaction happens.

If you are experiencing symptoms in just your nose such as sneezing, congestion, watery nose, then chances are that you are having an allergic reaction. However, if you are experiencing symptoms in your lungs such as wheezing, chest tightness, breathlessness, then you are having an asthma attack.

Asthma attacks can vary in intensity and you must ensure that you have a treatment plan ready to help alleviate your symptoms and prevent them from escalating.
You are at a higher risk of developing allergic asthma if you:

How is allergic asthma diagnosed?

Diagnosing allergic asthma is two-fold. First, an allergy test in conducted, then further tests will be conducted to diagnose for asthma.

Allergy test

Asthma testing

If your respiratory specialist (or pulmonologist) suspects that you have asthma based on your medical history and physical examination, the following diagnostic tests will be conducted for a more accurate diagnosis:

Will allergic asthma go away?

Asthma is a chronic respiratory condition and there is no cure.
The main goal for asthma treatment is maintaining good control of your condition by reducing or minimising exposure to triggers. Continuous management and monitoring by your respiratory specialist are important.
In addition to reducing or minimising exposure to triggers, asthma can be treated with the following medications:

Allergies can be treated in the following ways:

Do you have any questions for me? Feel free to drop me a message.

References

  1. Anitha Jeyagurunathan, E. A. (2021). Asthma Prevalence and its Risk Factors Among a Multi-Ethnic Adult Population. Yale Journal of Biology and Medicine, 417-427.
  2. Asthma Singapore. (2016, April 26). Understand and manage asthma triggers. Retrieved from Asthma Singapore: https://www.asthmasingapore.com/asthma-singapore/managing-asthma/understanding-asthma-triggers.html

Smoking and lung cancer: What’s my risk?

Smoking is a lifestyle habit that has been linked to multiple diseases such as heart disease, stroke, and multiple types of cancer. According to the Singapore Cancer Society1 and the World Health Organization (WHO)2, smoking is associated with at least 6 million deaths worldwide every year. If you are a smoker or know someone who smokes, read on to find out more about how smoking is associated with lung cancer.

What is lung cancer?

Our respiratory system is made up of organs and tissues that help us to breathe, with the lungs being the main organ involved. The lungs are two spongy organs made up of the right and left lung and are where the exchange of gases occurs.
When air is breathed in, it goes into the lungs which consist of the bronchi, bronchioles, and alveoli. The exchange of gases (oxygen and carbon dioxide) occurs here between the alveoli and the blood, for the removal of carbon dioxide and the supply of fresh oxygen.

Cancer occurs when cells in the body grow exponentially and out of control. When this originates in the lungs, it is known as lung cancer.
There are two main types of lung cancer:

The most damaging characteristic of cancer is its ability to spread or metastasize to other parts of the body, which results in high mortality rates.
There are 5 stages of lung cancer – the higher the stage, the bigger the tumour and more severe the cancer. By stage 4, the cancer has already spread to neighbouring lymph nodes or other organs such as the brain or stomach.

What are the symptoms of lung cancer?

Lung cancer does not usually cause symptoms when it is still in the early stages. If symptoms are showing, it means that the lung cancer is already in the advanced stages.
Symptoms may include:

How is smoking associated with lung cancer?

Smoking has long been associated with lung cancer and that is because cigarettes contain 7000 toxic chemicals with at least 70 known to be cancer causing. When smoke is inhaled, these chemicals enter your lungs and damage the DNA or deoxyribonucleic acids of your lung cells. Initially, your body responds by healing the damage; however, as time progresses and your smoking increases, your body will no longer be able to heal the damage, resulting in the formation of cancer cells.

These toxic chemicals also weaken your immune system making you more susceptible to infections and also reducing your body’s ability to identify, fight, and kill cancer cells. This coupled with the damaged DNA of lung cells, will result in the exponential and out of control growth and spread of cancer cells.
Smoking has also been associated with other types of cancers and diseases such as:

How common is lung cancer in smokers?

According to the Centres for Disease Control and Prevention (CDC), individuals who smoke are 15-30 times more likely to get or die from lung cancer than individuals who do not smoke3. Your risk of lung cancer increases with each day and cigarette you smoke. Studies have shown that even smoking just one cigarette a day puts you at an increased risk of lung cancer and other medical conditions.
People who quit smoking reduce their risk of lung cancer; this is also true for individuals exposed to secondhand smoke. Removing yourself from smokey situations can reduce your risk of developing lung cancer.
Although smoking is the main cause of lung cancer, there are also other causes such as:

What is the rate of lung cancer in Singapore?

The National Cancer Centre Singapore (NCCS) reported that lung cancer is the 3rd most common cancer diagnosed in both males and females in Singapore4. It has the highest rate of mortality (death) in Singapore because they are usually only discovered when symptoms start to show which is when the cancer is already in the advanced stages.

How can I reduce my risk of lung cancer?

In conclusion…

Smoking puts you at very high risk of lung cancer – not just yourself, but for your loved ones as well when they inhale your secondhand smoke.
If you are a smoker and want to screen or assess your risk for lung cancer, feel free to drop me a message and my friendly team will get in touch.

References

  1. Singapore Cancer Society. (2022). Live a smoke-free life: What you should know about smoking. Retrieved from Singapore Cancer Society: https://www.singaporecancersociety.org.sg/learn-about-cancer/cancer-basics/what-you-should-know-about-smoking.html#about-smoking
  2. World Health Organization. (2022, May 24). Tobacco. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/tobacco
  3. Centers for Disease Control and Prevention. (2022, October 25). Lung Cancer. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm
  4. National Cancer Centre Singapore. (2022, March 8). Cancer Statistics. Retrieved from National Cancer Centre Singapore: https://www.nccs.com.sg/patient-care/cancer-types/cancer-statistics