RESUMO
Pulmonary tuberculosis is a notorious disease as it can cause severe morbidity and mortality. In this case, we discuss a 75-year-old male tuberculosis patient from a rural area with no underlying comorbidities who failed to continue anti-tubercular medication after two months. The case discusses the diagnostic modalities confirming the diagnosis, sputum culture for Mycobacterium tuberculosis, imaging studies, including X-ray and CT of the chest, and laboratory parameters for identifying pulmonary mycetoma. The patient is now on anti-tubercular therapy (isoniazid, rifampicin, pyrazinamide, and ethambutol combination) and the anti-fungal drug itraconazole. Though pharmacotherapy for the treatment of mycetoma in patients with tuberculosis has a minimal role, the more appropriate treatment is surgical excision via lobectomy. As the occurrence of tuberculosis and mycetoma is a rare phenomenon, it is essential to rule out aspergillosis as both have similar presenting symptoms. Diagnosis of this co-infection can be the crucial difference between morbidity and mortality.
RESUMO
The rapid dynamics of the world bring about changes in all aspects of the life of human beings. These dynamics hence call for the need for research and development in the field of the betterment of the life of a human. Palliative care for the patient in need is a field that drastically affects human life and can provide an ethical and more humanitarian way to live. The main objective of this article is to examine the Indian system of palliative care's organizational structure, roles, and applicability in India. By reading various research articles on the internet, mainly PubMed and Google Scholar, we collected enough information on the palliative care facilities in India. After going through the research articles and thorough discussion, it comes to the knowledge that India's existing palliative care facilities are lacking behind the rest of the world. However, some states have better approaches and facilities, but overall research suggests the need for more development in the field of palliative care even more. India needs a systematic approach to improving palliative care. These improvements include increasing the workforce, better application of policies, good political support, and educating health care workers and patients requiring palliative treatment.