Female genital tuberculosis (FGTB) is an important cause of significant morbidity and infertility.
Gold-standard diagnosis by demonstration of acid fast bacilli on microscopy or culture or detection of epithelioid granuloma on histopathology of endometrial or peritoneal biopsy is positive in only small percentage of cases due to its paucibacillary nature. Use of gene Xpert on endometrial or peritoneal biopsy has improved sensitivity of diagnosis. Composite reference standard (CRS) is a significant landmark in its diagnosis in which combination of factors like AFB on microscopy or culture, positive gene Xpert, epithelioid granuloma on endometrial or peritoneal biopsy, demonstration of definite or probable findings of FGTB on laparoscopy or hysteroscopy. There have been many advances and changes in management of FGTB recently. The program is now called National Tuberculosis Elimination Program (NTEP), and categorization of TB has been stopped. Now, patients are divided into drug-sensitive FGTB for which rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) are given orally daily for 2 months followed by three drugs (rifampicin, isoniazid and ethambutol (RHE) orally daily for next 4 months. Multi-drug-resistant FGTB is treated with shorter MDR TB regimen of 9–11 months or longer MDR TB regimen of 18–20 months with reserved drugs. In vitro fertilization and embryo transfer have good results for blocked tubes and receptive endometrium, while surrogacy or adoption is advised for severe grades of Asherman’s syndrome.
The first case of COVID-19 (coronavirus disease) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was notified to the World Health Organization (WHO) on December 31, 2019, from Wuhan, Hubei Province of the People's Republic of China. 1 The disease especially pneumonia quickly spread to other provinces of China and overseas. 2 At early stage, most patients (49%-66%) had the contact history with Huanan Seafood Market where various kinds of living wild animals including poultry, bats, and marmots were on sale. 2 It is currently speculated that the outbreak of COVID-19 in Wuhan is associated with wild animals especially bats as the whole genome sequence of SARS-CoV-2 has 96.2%-98.7% identity to bat's coronavirus. 2 Pangolins were the most probable intermediate hosts as sublineages of SARS-CoV-2 were found in their organs. 2
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