September 23, 2009

Friday night is curry night

The India Times is running a chat line covering most topics with medical aspects being by attended to by the enthusiastic Dr Aniruddha Malpani. Dr Malpani runs the Malpani Infertility Clinic which operates out of Mumbai India and is also kept busy running his blog The Patients Doctor, the "world's largest free patient education library" HELP, is a director on the Board of a Healthcare BPO Inventurus and Yos Technologies, which provides a comprehensive "Personal Healthcare System" including PHRs, Healthcare tools and applications for Preventive and Continuous Care.


Anyway "Ranjana" wrote to the tireless Dr Malpani saying;
I am a 30 years old female and have been planning a baby for the last one year but did not succeed. My husbands and my fertility tests have yielded normal results. Recently, I got an interferon gamma release assay (IGRA), which tested positive for latent Tuberculosis. My gynecologist asked me get a chest X-ray, a trans vaginal scan and other ultrasounds done, which were all normal. She asked me to go for an endometrial biopsy, which I was not willing to undergo. I have also got my fallopian tube imaging done and it is all clear and normal. Now, I have been put on anti-TB medication for six months. I have finished one month of these medicines and also got a liver test done to see if the medicines were not adversely affecting the liver and the test results were fine and within reference range. My concern is that can latent TB be a cause of infertility and will this treatment help?
Dr Malpani wasted little time in displaying his ignorance;
There is no such thing as latent TB. This is rubbish. I don't think you have TB at all! These tests are very unreliable..
After reading this I had a closer look at Dr Malpani's CV, it would appear that his awards were gained as a student and of his numerous publications only 4 are listed in PubMed (and one of those is about his Help line) Not that this matters too much, it is the misreporting of the truth that concerns me. Elsewhere Dr Malpani says
While the initial exposure to the tubercle bacillus is through the lungs (because the bacillus is inhaled), most of us can fight off the infection, as a result of which it remains silent in the body, causing no harm. However, sometimes these latent bacilli can get reactivated, and then spread throughout the body through the blood stream.
OK, so now he is saying that latent TB does exist!

At the very least Dr Malpani's advice is inconsistent and should be taken with caution.

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