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Abstract of articles from |
| Indian Journal of Tuberculosis | |
| reproduced with kind permission |
| Home |IJT | Links | Contact | FAQ | Forum | About | Vol 48  No 3October 2001 ISSN 0019-5707 |
ORIGINAL ARICLES
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Missed opportunities for diagnosis of pulmonary tuberculosis among rural patients seeking relief on their own under the tuberculosis programme in India A.K.Chakraborthy,M.S.Krishnamurhty,A.N.Shashidhara and Sanjay Juvekar Chest symtomatics in the community reportedly shop around, seeking relief at various health facilities, including private practitioners, before they are actually diagnosed as tuberculosis cases and put on appropriate treatment. In this investigation ,it is proposed to determine the extent of delay in diagnosis of tuberculosis, from the time the chest symptoms are recognised by a patient as significant to be noticed by him/her for seeking relief to the time actual diagnosis is made and treatment instituted. Indicators for delay in diagnosis, developed in the study could be used to determine the changes in these ,consequent upon an improved diagnostic and treatment system in a given area or between areas.
Problems in estimating the burden of pulmonary tuberculosis in India: A reviewM.S.Krishnamurthy It is generally agreed that there is a need for developing an acceptable estimate of the tuberculosis problem in India. Estimates obtained by the National Sample survey have been found to be deficient for the purpose of enabling rational allocation of resources and evaluating efficiency of anti tuberculosis programmes. The WHO commissioned a study on the subject and subsequently published a review of the global burden of tuberculosis in which the Indian situation was also considered. The Government of India also formulated a committee in 2000 to address this problem. The author reviews the estimates so far obtained. Tuberculous cervical lymphadenitis in HIV positive and negative patients-S.Rjasekaran,M.Gunasekaran,D.D.Jayakumar,D.Jeyaganesh and V.Bhanumathi Objectives: With the rising trend of extra pulmonary tuberculous conditions among HIV positive patients, study of the proportion of HIV seropositives among patients with tuberculous cervical lymphadenitis variations in clinical presentation ,diagnosis, yield of FNAC/biopsy, microbiological findings and pathological pattern of cervical lymph node in HIV positives and negatives gains importance. Methodology: In all 110 patients ,considered as tuberculous cervical lymphadenitis cases, were screened by chest radiography, tuberculin test, fine needle aspiration cytology and or histopathological examination and smear microscopy for AFB of biopsied lymph nodes. All these patients were also tested for HIV seropositivity by two different ELISA tests repeated at least twice. Results: Of the 85 confirmed tuberculosis patients ,16(18.8%) had HIV seropositivity,of whom 9(56.2%)had demonstrable AFB in FNAC/biopsied cervical lymph node specimens; Only one HIV negative patient(1.4%)had positive smear microscopy for AFB.Among the 16 HIV positive patients ,typical granuloma and or caseation were found in 10 patients(62.5%)and atypical pathological features were found in the remaining 6 patients(37.5%) Impact of initial drug resistance pattern on the maintenance phase of chemotherapy with reference to the emergence of multi drug resistance-Deepak Rosh and V.K.Kataria A study was carried out to find the pattern of initial drug resistance in fresh sputum culture positive cases of pulmonary tuberculosis with a view to guide therapy in the maintenance phase of short course chemotherapy(SCC).During the 20 month study period ,there were 667 culture positive cases. Initial drug resistance to first line antituberculosis drugs was found in 161(24.13%)cases: Single drug resistance in 142(21.3%)and poly drug resistance in 19(2.8%)cases. There was no instance of multi drug resistance(MDR)The maximum overall resistance was seen to Pyrazinamide(Z)in 44 (6.6%)cases, followed by Rifampicin(R)in 39(5.8%).Ethambutol(E)in 39(5.8%),Streptomycin(S)in 30(4.5%)and isoniazid(H)in 28(4.3%)to H or a combined67(10.3%)cases would be receiving mono-therapy in the maintenance phase. However as we follow a practice of not switching to maintenance phase until we have a satisfactory clinical, radiological and conversion response, there were only 4(0.6%)patients who had treatment failure due to development of MDR.The indiscriminate use of quinolones in the community is fast eliminating them from their role as second line antitubercular drugs. Tuberculosis of calcaneum :A case report:-B.Swain,S.Mishra,K.Patnaik,D.Patnaik and P.Dutta We report a case of calcaneal tuberculosis by a Multi-Drug Resistant(MDR)strain of M.Tuberculosis in an HIV seronegative male which is a rare occurrence Pulmonary nocardiosis mimicking pulmonary tuberculosisVishal Chopra,G.C.Ahir,Gian Chand and P.K.Jain Title7-Author7 Nocardia infections are rare among normal population.Infection mostly occurs in immuno-compromised patients. We are presenting a case of pulmonary nocardiosis in a HIV positive patient, mimicking pulmonary tuberculosis. Bilateral breast tuberculosis -U.S.Bedi and R.S.Bedi A case of bilateral breast tuberculosis is being reported because of its rare occurrence. Its pathogenesis, clinical presentation and literature have been reviewed. Right side pleural effusion and liver abscess of tuberculous origin -M.C.Dhar,S.Chaudhuri,S.Pain,U.Halder,T.J.Sau,K.Basu,D.Pal and S.R.Bagchi Tuberculous liver abscess is rare and it may mimick amoebic liver abscess, pyogenic liver abscess or tuberculous pseudo tumour. A 68 year old male ,non hypertensive non diabetic presented with features of right side pleural effusion . Ultrasonography of abdomen showed liver abscess. A positive BACTEC culture and PCR for AFB in the pus aspirated from the abscess confirmed the diagnosis of tuberculous liver abscess. Tuberculosis of tonsil with unusual presentation -K.B.Gupta,Sanjeev Tandon,T.S.Jaswal and Sunita Singh A 50 year old female with a unilateral right palatine tonsil enlargement underwent punch biopsy for the suspicion of malignancy, which proved to be tuberculosis. This case report points out that tonsillar tuberculosis still exists, and draws attention to the differential diagnosis with malignancy in an elderly patient. Extra pulmonary Tuberculosis -A retrospective study -R.Gopal,B.K.Padmavathy ,S.Vasanthy and K.Jayashree The incidence of extra pulmonary tuberculosis(EPT)is on the rise with the advent of HIV epidemic. A retrospective study of the samples from various extra pulmonary sites processed for AFB culture over a period of 2 years has been analysed. The incidence of EPT among HIV positive patients is 19.8% while among non HIV individuals it s 9.2%. The above are only abridged summaries. You may please refer the original articles for details |