The dose for TB meningitis is dexamethasone 8 to 12 mg daily tapered off over six weeks (for those who prefer more precise dosing should refer to Thwaites et al., 2004). The dose for pericarditis is prednisolone 60 mg daily tapered off over four to eight weeks.Steroids may be of temporary benefit in pleurisy, extremely advanced TB, and TB in children:
Pleurisy: prednisolone 20 to 40 mg daily tapered off over 4 to 8 weeks
Extremely advanced TB: 40 to 60 mg daily tapered off over 4 to 8 weeks
TB in children: 2 to 5 mg/kg/day for one week, 1 mg/kg/day the next week, then tapered off over 5 weeksSteroids may be of benefit in peritonitis, miliary disease, tubercular osteomyelitis, TB osteomyelitis, laryngeal TB, lymphadenitis and genitourinary disease, but the evidence is scant and the routine use of steroids cannot be recommended. Steroid treatment in these patients should be considered on a case-by-case basis by the attending physician. The long-term impact of pleural TB on respiratory function is unknown. Therefore, such impact should be quantified first before assessing the need of further clinical trials of corticosteroids with pleural TB.Thalidomide may be of benefit in TB meningitis and has been used in cases where patients have failed to respond to steroid treatment. Non-compliance
Patients who take their TB treatment in an irregular and unreliable way are at greatly increased risk of treatment failure, relapse and the development of drug-resistant TB strains.There are variety of reasons why patients fail to take their medication.
Pallor is a pale color of the skin that can be caused by illness, emotional shock or stress, stimulant use, or anemia, and is the result of a reduced amount of oxyhaemoglobin and may also be visible as pallor of the conjunctivae of the eyes on physical examination. Pallor is more evident on the face and palms. It can develop suddenly or gradually, depending on the cause. It is not usually clinically significant unless it is accompanied by a general pallor (pale lips, tongue, palms, mouth and other regions with mucous membranes). It is distinguished from similar presentations such as hypopigmentation (lack or loss of skin pigment) or simply a fair complexion. Causes
migraine attack or headache
excess estradiol and/or estrone
osteoporosis
emotional response, due to fear, embarrassment, grief, rage
anorexia
anemia, due to blood loss, poor nutrition, or underlying disease such as sickle cell anemia
iron deficiency
vitamin B12 deficiency
shock, a medical emergency caused by illness or injury
acute compartment syndrome
frostbite
common cold
cancer
hypoglycaemia
bradycardia
panic attack
medications
ketorolac
amphetamines
ethanol
cannabis
lead poisoning
motion sickness
heart disease
Peripheral vascular disease
hypothyroidism
hypopituitarism
scurvy
tuberculosis
sleep deprivation
pheochromocytoma
squeamishness
visceral larva migrans
Orthostatic hypotension
methyldopa
loss of appetite
Space adaptation syndrome
fibromyalgia
Buergers disease
Hypovolemia

References


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