Tuberculosis (TB) is a very common disease worldwide including India. Tuberculosis of the female genital tract is
common enough to be found in 1% of women with DUB (Sutherland 1949) and in 4% of adolescent with excessive
menstrual loss (Sutherland 1953). The commonest site of involvement is the fallopian tubes (90e100%). The next
common site is endometrium (60%). The infection is from the tubes either by lymphatics or direct spread through
continuity. Symptoms vary according to the severity site and stage of the disease. Anti tuberculosis chemotherapy is the mainstay of tt. Initially drugs are used for 2 months. These are isoniazid, rifampicin, pyrazinamide and ethambutal. Treatment is continued for another 4 months with isoniazid and rifampicin.
female Genital tuberculosis,TB-PCR, female infertility, veerendrakumar cm
female genital TB poses stiffest challenge in the diagnosis, rapid molecular techniques have helped in arriving at a definitive diagnosis in suspicious clinical setting
Gaudium IVF Clinic in Delhi - Genital Tuberculosis and InfertilityDr. Manika Khanna
Gaudium IVF Clinic in Delhi - Genital Tuberculosis and Infertility : Tuberculosis is a disease that most of the people associate with the lungs, but surprisingly it can affect other organs of the body too, including the reproductive tract.
Tuberculosis (TB) is a very common disease worldwide including India. Tuberculosis of the female genital tract is
common enough to be found in 1% of women with DUB (Sutherland 1949) and in 4% of adolescent with excessive
menstrual loss (Sutherland 1953). The commonest site of involvement is the fallopian tubes (90e100%). The next
common site is endometrium (60%). The infection is from the tubes either by lymphatics or direct spread through
continuity. Symptoms vary according to the severity site and stage of the disease. Anti tuberculosis chemotherapy is the mainstay of tt. Initially drugs are used for 2 months. These are isoniazid, rifampicin, pyrazinamide and ethambutal. Treatment is continued for another 4 months with isoniazid and rifampicin.
female Genital tuberculosis,TB-PCR, female infertility, veerendrakumar cm
female genital TB poses stiffest challenge in the diagnosis, rapid molecular techniques have helped in arriving at a definitive diagnosis in suspicious clinical setting
Gaudium IVF Clinic in Delhi - Genital Tuberculosis and InfertilityDr. Manika Khanna
Gaudium IVF Clinic in Delhi - Genital Tuberculosis and Infertility : Tuberculosis is a disease that most of the people associate with the lungs, but surprisingly it can affect other organs of the body too, including the reproductive tract.
PID and its newer concepts.This presentation is done after grouping information from a variety of textbooks,journals and of course our professors.will definitely enlighten you
Acute pelvic inflammatory disease by dr alka mukherjee dr apurva mukherjeealka mukherjee
Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.
Introduction to Sexually transmitted diseases with a concentration on certain diseases like syphilis - herpes - chancroid- gonorrhoea - chamydia - bacteria vaginosis- trichomoniasis-candidiasis- human papilloma virus
A Case of Postmenopausal Pyometra Caused By Endometrial Tuberculosisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
PID and its newer concepts.This presentation is done after grouping information from a variety of textbooks,journals and of course our professors.will definitely enlighten you
Acute pelvic inflammatory disease by dr alka mukherjee dr apurva mukherjeealka mukherjee
Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.
Introduction to Sexually transmitted diseases with a concentration on certain diseases like syphilis - herpes - chancroid- gonorrhoea - chamydia - bacteria vaginosis- trichomoniasis-candidiasis- human papilloma virus
A Case of Postmenopausal Pyometra Caused By Endometrial Tuberculosisiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Concurrent imperforate hymen and transverse vaginal septum: A rare presentati...Apollo Hospitals
A 13 year old girl not attained menarche presented as a case of acute abdomen; she had a mass per abdomen, on ultrasound diagnosed as haematometra and hematocolpus; clinically had an imperforate hymen; further evaluation by MRI revealed a high vaginal cause of obstruction which cannot be differentiated as vaginal atresia or a combination of transverse vaginal septum and imperforate hymen; operative findings showed a imperforate hymen with a patent lower vagina and a transverse vaginal septum separating upper and lower vagina; surgical correction done and drained 1000 ml of blood and post operatively patient is followed up for a month and bleeding through vagina during the next cycle is noted showing the patent vagina. This is a first case of concurrent transverse vaginal septum and imperforate hymen without any other genitourinary anomalies in literature.
Covid19 and pregnancy: There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.
As per ICMR Guidelines Pregnant women do not appear more likely to contract the infection than the general population. However, pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally be related to more severe symptoms and this will be the same for COVID-19. Reported cases of COVID-19 pneumonia in pregnancy are milder and with good recovery.Pregnant women with heart disease are at highest risk (congenital or acquired). In other types of coronavirus infection (SARS, MERS), the risks to the mother appear to increase in particular during the last trimester of pregnancy. There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.The coronavirus epidemic increases the risk of perinatal anxiety and depression, as well as domestic violence. It is critically important that support for women and families is strengthened as far as possible; that women are asked about mental health at every contact. A small study of nine pregnant women in Wuhan, China, with confirmed COVID-19 found no evidence of the virus in their breast milk, cord blood or amniotic fluid. According to WHO, pregnant women
do not appear to be at higher risk of severe disease.
Furthermore, WHO reports that currently there is no known difference between the clinical manifestations of COVID-19 in pregnant and non-pregnant women of reproductive age
ACOG is advising caution based on the impact of other respiratory illnesses (including influenza/ SARS outbreak of 2002–2003), stating that “pregnant women should be considered an at-risk population for COVID-19
Isolated tuberculous inguinal lymphadenopathy: a diagnostic challenge KETAN VAGHOLKAR
Isolated tuberculous inguinal lymphadenopathy is a rare entity. Awareness of this as a distinct entity is important. Open biopsy is the best way for diagnosing this condition.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Tuberculosis
- Button Battery Ingestion
- Constipation
- Hirschprung's Disease
- Aspiration Pneumonia
- Generalized Lymphatic Anomaly
- Pediatric Acute Respiratory Distress
Importance of Pap Smear in Hysterectomised Patients So That Diagnosis of VAIN...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Irritable Bowel Syndrome (IBS) and Fecal Microbiota Transplant. A new hope fo...Find Good Health
IBDs including irritable bowel syndrome (ibs) or ulcerative colitis (uc) are a set of diseases developing into an epidemic. The unusual and recent rise in these kind of diseases most notably on developed countries point to a recent and area specific etiology, not a better healthcare and diagnosis.
Recent researchs are pointing to a healthier immune system and intestinal flora in undeveloped countries' population and an imbalance in our gut flora caused by excessive use of antibiotics.
For more information about health and wellbeing visit our site at:
http://findgoodhealth.org/
Streptococcus mutans in the oral cavity as a risk factor for threatened misca...komalicarol
we have found that the presence of Streptococcus mutans in the
oral cavity of a pregnant woman may be a risk factor for miscarriage. We observed that Streptococcus mutans is significantly more
widespread in the oral cavity of women with threatened abortion
than in those undergoing a healthy pregnancy.
Streptococcus Mutans in the Oral Cavity as a Risk Factor for Threatened Misca...komalicarol
we have found that the presence of Streptococcus mutans in the
oral cavity of a pregnant woman may be a risk factor for miscarriage. We observed that Streptococcus mutans is significantly more
widespread in the oral cavity of women with threatened abortion
than in those undergoing a healthy pregnancy
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Tuberculosis at Vulva and Vagina
1. Case Report
Tuberculosis at Vulva and Vagina
Pranom Buppasiri MD*,
Teerayut Temtanakitpaisan MD*, Woraluk Somboonporn MD*
* Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
A 60- year-old woman, gravid 4, para 4-0-0-4 was admitted to the Department of Obstetrics and Gynecology,
Khon Kaen University due to chronic extensive painful genital ulcer. She was treated by antiviral and antifungal regimens but
the ulcer persisted. After acid fast bacilli was found on tissue biopsy, a standard 6- month course of antituberculosis was
started. One month after treatment, the ulcer was completely cured.
Keywords: Genital ulcer, Vulvar, Vaginal tuberculosis
J Med Assoc Thai 2010; 93 (5): 613-5
Full text. e-Journal: http://www.mat.or.th/journal
Tuberculosis of the female external genitalia mass. A 2-cm left groin node was present with mild
is very rare and mostly secondary to pulmonary tenderness. Routine laboratory investigation revealed
or renal tuberculosis. The authors reported here a impaired renal function and hypercalcemia but chest
60-year-old postmenopausal woman who attended X-ray was normal. VDRL and antiHIV were negative.
a gynecology ward due to extensive ulcer at the She had not been in close contact with an indexed
vulva and vagina, a very rare case of vulvovaginal case of pulmonary tuberculosis. She had been treated
tuberculosis. with antifungal medication, antiviral regimen, and
many kinds of antibiotic but the ulcer persisted. Tissue
Case Report biopsy at ulcer was performed and acid fast bacilli
A 60-year old postmenopausal woman, were found. Sputum for acid fast bacilli was negative.
gravida 4, para 4-0-0-4 was admitted to the Department The authors failed to retrieve endometrial tissue via
of Obstetrics and Gynecology, Khon Kaen University, aspiration method. Standard antituberculosis
Thailand, complaining of a 9-month history of low grade quadruple (isoniacid, rifampicin, ethambutal, and
fever and painful ulcer at vulva and in vagina. Her last pyrazinamide) were started. After one month of
sexual activity was 1 year ago, before her husband therapy, the ulcer was completely healed (Fig. 2).
died from chronic kidney disease. She denied history
of chronic cough, abdominal pain, abnormal uterine
bleeding, or weight loss. Her underlying disease was
diabetic mellitus and hyperthyroidism, which were
both well controlled. On physical examination, the inner
sides of both labia minora had large, indurated painful
ulcers 2 x 4 cm in diameter on each site. The bases of
ulcers were shallow and granular and the edges were
ragged and undermined. The lower 2/3 of anterior
vaginal wall also had an ulcerative lesion, 3 x 4 cm in
diameter (Fig. 1). Minimal yellowish discharge was seen
in the vagina. The cervix was normal looking with a
small uterus, and there was no abnormal adnexal
Correspondence to: Buppasiri P, Department of Obstetrics and
Gynecology, Faculty of Medicine, Khon Kaen University, Thai-
land. Phone: 043-202-489, Mobile: 08-1183-1781, Fax: 043-
348-395. E-mail: bprano@kku.ac.th Fig. 1 Large vulvo-vaginal ulcer before treatment
J Med Assoc Thai Vol. 93 No. 5 2010 613
2. tissue biopsy was not done to explore the cause of
the collapsed spines. Chowdhury(1) suggested that
sputum in case of pulmonary tuberculosis, used as sex
lubricant, might also be a route of transmission. In the
present case, we could not access this history. One of
her daughters who was married and stayed at her
husband’s house was also diagnosed with pulmonary
tuberculosis six years ago. It might be that her daughter
contacted tuberculosis in her own family before
she got married. Chronic genital ulcer should be
differentiated from herpes infection in immuno-
compromised host and carcinoma of the vulva or vagina.
The final diagnoses are from tissue biopsy. Optimal
Fig. 2 Completely healed vulvo-vaginal ulcer after 1 month duration of treatment of vulvo-vaginal tuberculosis
of treatment is inconclusive. In general, a 6-month course of drug
is widely accepted although the patient clinically
improves in a short time after starting the treatment.
Discussion In conclusion, the authors reported a case of
Pulmonary tuberculosis is a common vulvovaginal tuberculosis presenting with large
infectious disease especially in developing countries chronic genital ulcer. Tuberculosis of various organs
but female genital tract tuberculosis is rarely reported. is still a common infectious disease in the developing
More often, hematogenous spread genital tract world.
tuberculosis is secondary to other sites of tuberculosis
infection, such as the lung or kidney. The highest References
incidence of genital tuberculosis occurs in child-bearing 1. Chowdhury NN. Overview of tuberculosis of
age women. The commonly affected sites of genital female genital tract. J Indian Med Assoc 1996; 94:
tract are fallopian tubes and endometrium. Common 345-6, 361.
presenting symptoms are menstrual irregularities, 2. Akhlaghi F, Hamedi AB. Postmenopausal
infertility, and chronic pelvic pain (1). Vulvar and tuberculosis of the cervix, vagina and vulva. The
vaginal tuberculosis have been rarely reported(2,3). Internet Journal of Gynecology and Obstetrics
The authors reported a case of painful tuberculosis 2004; 3: 1-4.
ulcer at the vulva and vagina, which was different 3. Manoj K, Soma M, Ajay L, Ashish A, Rakesh S,
from another study that reported a painless ulcer(4). It Paliwal RV. Tubercular sinus of labia majora: rare
might be bacteria on top of the infection. In the case report. Infect Dis Obstet Gynecol 2008; 2008:
presented case, the authors could not definitely trace 817515.
back how she got vulvar tuberculosis. Her husband 4. Tham SN, Choong HL. Primary tuberculous
died from chronic renal failure 1 year ago and suffered chancre in renal transplant patient. J Am Acad
from paraplegia due to collapsed L4-5 spine. However, Dermatol 1992; 26(2 Pt 2): 342-4.
614 J Med Assoc Thai Vol. 93 No. 5 2010