Difficulties that we are still facing in confirming genital Kochs?? The ways & means of diagnosis of TB Endometrium.

Endometrial TB is a notoriously difficult diagnosis to confirm because it's very hard to grow mycobacteria in the lab

1)      Z. N. stain: -   TB culture automated smear.

2)      Modified TB culture-Middlebrook 7H9 broth

3)       TB PCR DNA: - Real time PCR. INVESTIGATIONS OF GENITAL KOCHS.

Family history / Contact with Kochs 2) Chet X-ray, 3) ) Hysteroscopy:-From endometrium- 5 things to be done 1) Slide study for Langhans Type Giant cells by -Z. N. stain: -  2)  TB culture automated smear. /modified TB culture-Middlebrook 7H9 broth 4) Delayed culture 5) PCR TB PCR DNA: - Real time PCR. ) HSG is forbidden in a case of presumed/confirmed case of genital Kochs. B) Secondly, what U has diagnosed Kochs may be misdiagnoses/ inappropriate... It is difficult to be certain about Kochs as there is no specific serum marker... PCR ---so long we trusted so much has fallen to disrepute so also TB Gold tests. C) Thirdly, it is our duty to refer to a Pulmologist and seek opinion about vomiting component along with current LFT report and H/O other medications.  D) Ask the couple to use barrier contraceptives till the course is completed E) If U have doubt do not hesitant about etiology Lap-Hysteroscopy & peritoneal/ Lymph node biopsy (histological diagnosis, Rapid culture-Bactec, Delayed culture-L-J media) will of considerable help. To confirm your initial diagnoses) In case she falls preg during the course of anti-Kochs- do not advocate TOP. G) INH is notorious to cause peripheral Neuritis - Suppl. of vit B6 will help/ameliorate. In conclusion to avert MDR Kochs it is our noble duty to motivate her to continue the ATD in consultation with Pulmologist. This is our patriotic duty. MDR Kochs-- enough is enough.

What ART specialists are interested about Endo Kochs treated? They are more interested on blood flow of endometrium too, including uterine artery RI too. In normal cases the RI is 0.60 to 0.80 & PI will be 2.22 to 3.16. If abnormalities then it is expected endometrium sub optimally supplied.

A)ABC of Mycobacteria? So many political paties –how to identify who is bad(harmful for body)  and needs Tr?. What are the types of Mycobacteria:

Mycobacteria are a diverse group of rod-shaped bacteria that include more than 100 different species. The others, which are far commoner, environmental mycobacteria; and when the TB PCR test. But quite often contaminations occur e.g. tap water, slides etc and giving a false + ve DNA –PCR +ve. AS such, it is important to discriminate between true infection and contamination. The molecular cross-reaction between the ubiquitous non-pathogenic environmental mycobacteria (which are harmless colonisers) and M tuberculosis is what creates the diagnostic dilemma.

Consensus on TB PCR!!! The TB PCR test is highly flawed, because the DNA sequence which the PCR amplifies is common to both the mycobacterium tuberculosis as well as the other species of mycobacteria.

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Mycobacteria are a diverse group of rod-shaped bacteria that include more than 100 different species. The others, which are far commoner, environmental mycobacteria; and when the TB PCR test. But quite often contaminations occur e.g. tap water, slides etc and giving a false + ve DNA –PCR +ve. AS such, it is important to discriminate between true infection and contamination. We refer to Mycobacterium tuberculosis which causes 1) tuberculosis; or Mycobacterium lepta which causes leprosy

B)Characteristics of Mico Tuberculosis? They live in the soil and water throughout the world. Because they are protected by their waxy lipid-rich cell wall, mycobacteria are resistant to disinfectants. This is why they are ubiquitous inhabitants of the hospital environment ; and frequent contaminants in hospital settings, where they are often found in the water supply and even in the solutions in which the endometrial biopsy is sent to the lab for PCR testing).

3).

Barriers in diag :_-Endometrial TB is a notoriously difficult diagnosis to confirm because it's very hard to grow mycobacteria in the lab.

The ways & means of diagnosis of TB Endometrium

In the past, to make a definitive diagnosis of genital TB, a A) positive mycobacterium culture or B) the presence of tubercles/ giant cells in the histopathology report (from an endometrial biopsy ) was required.

What about PCR ?  

Quite often people do TB PCR from DNA of tee excise sample /removed endometrium and send for