 |
Abstract of articles from |
| Indian Journal of Tuberculosis | |
| reproduced with kind permission |
| Home | Diagnosis | Treatment | Control | TB and HIV | Drug resistance | Ind J Tub | About |
Vol 52 
No 3Jul 2005
ISSN 0019-5707 |
Review article
Original articles
- Detection and characterization of mutations in Rifampicin resistant M.tuberculosis clinical isolates by DNA sequencing
- Bilateral lower zone shadows on chest radiograph- A clinico pathological profile
- Use of sputum induction for establishing diagnosis in suspected pulmonary tuberculosis
- Summaries of papers presented at the 59th National conference on TB & chest diseases
- Status report on RNTCP
- In this quarter the new sputum positive case detection rate is 66% with a total of 3,08,474 patients being placed on treatment
- Success rate of 86% of the new smear positive in the 1st quarter of 2005
- 97508 new smear negative cases and 40785 extra pulmonary cases were also initiated
- The number of smear positive re treatment cases in th quarter was 37947
- The extra-pulmonary TB cases accounted for 16% of all new cases in the quarter and re treatment cases for 24% of all smear positive cases in the 1st quarter 2005
Case reports
Short communication
Miscellaneous
MDR-TB Current status
Rajendra Prasad
Drug resistant tuberculosis has been reported since the early days of the introduction of chemotherapy, but recently multi-drug resistant tuberculosis (MDR-TB) has been an area of growing concern and is posing a threat to control of tuberculosis.A review of 63 surveys conducted between 1985 and 1994 suggested that primary and acquired MDR-TB was between 0-10.8% and 0-48% respectively.However the quality of these studies were variable due to the lack proper representativeness and size of population sampled,as well as lack of standardized laboratory methods in some of them.In 1994, WHO-IUATLD carried out a surveillance which concluded that the problem is global;the median prevalence of primary and acquired multi drug resistance was 1.4%(0-14.4%)and 13%(0-54.4%)respectively..A second WHO-IUATLD global project on drug surveillance carried out in 1996-1999 in 58 countries ,found that the median prevalence of primary and acquired multi-drug resistance was 1%(0-14%) and 9%(0-48%)respectively.It must be emphasized that optimal treatment of MDR-TB alone will not curb the epidemic .Efforts must be focussed on the effective use of first line drugs in every new patient so as to prevent the ultimate emergence of multi-drug resistance.The use of reserve drugs to cure multi-drug resistant tuberculosis and to reduce further transmission should be considered,but only as part of well structured programmes of tuberculosis control. Indian J Tuberc 2005;52:121-131:
Detection and characterization of mutations in Rifampicin resistant M.tuberculosis clinical isolates by DNA sequencing
P.Deepa,K.L.Therese and H.N.Mahadevan
Background:: Multiple drug resistant tuberculosis (MDR-TB)is increasing because of widespread application and results in selection of mutants resistant to other components of short course chemotherapy.Resistance to rifampicin can be considered as a surrogate marker for MDR-TB and the target gene for detection of rifampicin resistance is the rpo gene.
Aim:To detect and characterize mutations in the rpo B region of rifampicin resistant isolates of Mycobacterium tuberculosis by automated DNA sequencing. Methods: Absolute concentration method was used to determine the HIC of rifampicin for 44 M.tuberculosis isolates(21 respiratory,3 ocular,3 cerebrospinal fluid and 17 biopsies.)Automated DNA sequencing was pre formed in the ABI 310 Genetic Analyzer.
ResultsFive isolates(2 sputa and 1 each from broncho alveolar lavage,lymph node and endometrial biopsies)were rifampicin resistant with MIC greater than 128 mcg/ml.Three of the five isolates showed mutations.Two of the isolates had the common missense mutation at codon 531(Ser®Leu)the other isolate showed three insertions ad two of them did not show any mutation in the sequenced rpo B region. Conclusion:: DNA sequencing technique is a rapid,conclusive and more advantageous technique the convention susceptibility testing for detection of rifampicn resistance in terms of the risk involved and time consumption.
[Indian J Tuberc 2005;52:132-136]:
Bilateral lower zone shadows on chest radiograph- A clinico pathological profile
Background:: The initial suspected diagnosis in bilateral lower zone lung involvement made clinically can e compared and correlated with the final diagnosis obtained after percutaneous FNA cytology,BAL fluid examination and transbronchial biopsy.
Aim:: To study diseases presenting with bilateral lower zone shadow on chest radiograph and compare the initial clinical diagnosis to the final diagnosis.
Methods 56 patients were studied by routine haematological,sputum and pleural fluid examination along with PCNA and TBNA cytology,bronchial aspirate/BAL fluid examination and transbronchial biopsy after a detailed clinical history and thorough physical examination
Results Initially suspected diagnosis include tuberculosis in 32.1% cases,pneumonia in 30.4%,malignancy in 10.7% pulmonary oedema in 5.4% bronchiectasis in 8.9%,ILD in 7.1%,TPE in 3.6% and bilateral hydatid disease of lung in 1.7% of cases.The final diagnosis revealed tuberculosis in 25.0% cases,pneumonia in 23.2%,malignancy in 16.1% bronchiectasis in 8.9% pulmonary oedema and ILD in 7.1% each,sarcoidosis and TPE in 3.6% each while pulmonary candidiasis,pulmonary alveolar proteinosis and bilateral hydatid disease of the lung 1.7% case each respectively.
Conclusion Majority of cases can be diagnosed by a detailed clinical profile along with a chest radiograph.However,FNAC and fiberoptic bronchoscopy are of high value for pathological and microbiological confirmation of the diagnosis and provides a significant yield. [Indian J Tuberc 2005;52:137-142]:
Use of sputum induction for establishing diagnosis in suspected pulmonary tuberculosis K.B.Gupta and Seema Garg
Setting: Department of TB and chest diseases Pt. B.D.Sharma PGIMS Rohtak
Aim: The study was undertaken to find out the yield in the diagnosis of the smear negative pulmonary tuberculosis by sputum induction with hypertonic saline.
Methodology&Nbsp;Five ml hypertonic saline was administered through ultrasonic nebuliser for a maximum of 30 minutes. Results: 100 patients suspected of pulmonary tuberculosis either smear negative with spontaneous sputum or having inadequate/no sputum were studied.97 patients produced adequate amount of sputum after hypertonic saline induction.38 were found positive for AFB on sputum microscopy after induction
Conclusions Hypertonic saline induction produces better quality and adequate sputum,thereby increasing yield of smear positive pulmonary tuberculosis.
[Indian J Tuberc 2005;52:143-146]:
Tubercular osteomyelitis of mandible K.B.Gupta,M.Manchanda,S.P.S.Yadav and A.Mittal
Tubercular osteomyelitis of mandible is an extremely rare condition,particularly in comparison to pyogenic infections and neoplastic diseases involving the mandible.We report a case of tubercular osteomyelitis of mandible in an old chronic smoker woman initially suspected of neoplasia,proved later on as primary tubercular osteomyelitis in absence of a primary focus.
[Indian J Tuberc 2005;52:147-150]:
Tubercular osteomyelitis of Zygomatic bone
A.Chakravarty,Rajiv Dhawan,J.K.Sahni and T.B.Shashidhar
A case of tubercular osteomyelitis of the zygomatic bone in a child is presented here because of its rarity and clinical interest. A high index of suspicion should be kept in mind to reach the diagnosis. [Indian J Tuberc 2005;52:151-152]:
Failure to initiate treatment for tuberculosis patients diagnosed in a community survey and at health facilities under a DOTS programme in a district of South India
P.G.Gopi,V.Chandrasekaran,R.Subramani and P.R.Narayanan
We studied the proportion and fate of tuberculosis patients who were not initiated on treatment(initial defaulters in Tiruvallur district Tamiladu where DOTSS strategy was implemented.These patients were visited to find out the reason for default.Treatment was not initiated in 57(23.5%) of the 243 sputum positive cases diagnosed a community survey and 156(14.9%)of 1049 patients diagnosed in health facility.Men were more likely not to have treatment initiated.The common reasons stated for initial default were unwilling unwillingness ,symptoms being mild.,personal reasons and dissatisfaction.There is an urgent need to improve the patient's perception of treatment and strengthen the health systems capabilities to reduce the initial default<
[Indian J Tuberc 2005;52:153-155]:
Created on ... August 16, 2005