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| Home |IJT | Links | Contact | FAQ | Forum | About | Vol 48  No 2 April 2001 ISSN 0019-5707 |
ORIGINAL ARICLES
CASE REPORTS
SHORT COMMUNICATION |
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Annual risk of tuberculosis infection in Bangalore city V.K.Chadha,P.S.Jagannatha and Shashidhar J.Savanur: There is paucity of data on the epidemiological situation of tuberculosis in big cities.Therefore a tuberculin survey was conducted to estimate the annual risk of tuberculosis infection (ARI) in Bangalore city among 6 and 7 yera old children attending 161 schools.A single stage cluster sampling design was adopted for selection of schools by random sampling,from a consolidated list of Govt-run ,Govt-aided and Private schools. Based on the frequency distribution of reaction size among 9,4340 test read children,11.1% were estimated to be infected with tubercle bacilli.The children studying in Govt-run and Govt-aided schoolswere more likely to be infected than those attending private schools.The ARI in Bangalore city wqas estimated to be 1.67%;it is higer than the recent estimates obtained from the surrounding peri urban and rural areas ,suggesting need for further improving the efficiency of case finding and treatment activities..The results further indicate that BCG vaccinated children can be included for the purpose of estimating ARI
Profile of DOT providers in private sectorblackR.Balambal The essential feature of the DOTS(Directly Observed Treatment Short Course Strategy of the Revised national TB control programme is provision for DOT providers who can ensure that treatment is taken by each patient under supervision. Normally this is made possible by requiring patients to attend the DOT centre ,as and when required ,to receive treatment in person. However a considerable proportion of patients prefer to receive treatment in the private sector, for which it has become crucial to organize a system for appointing DOT providers who can follow the RNTCP guidelines and observe drug consumption by privately treated patients. In Chennai ,a non Governmental organization ,ACT. has organized a group of 20 private practitioners who after a simple training ,have set up a system of quality microscopy for diagnosis of tuberculosis and volunteer DOT providers selected by patients/practitioners for delivering drugs to patients under direct observation, mostly in their homes. ACT also provides a trained supervisor to monitor all the aspects including DOT providers. The preliminary findings of this study suggest that it is feasible to identify medical practitioners and DOT providers in the private sector who can be simply trained and whose services can be integrated with the Governmental DOT centres under the RNTCP Psychiatric morbidity,patients'perspectives of illness and factors associated with poor medication compliance among th tuberculous in Vellore,South Indiablack-E.Manoharan,R.K.John,A.Joseph and K.S.Jacob Background:Background: Despite the availability of inexpensive and effective anti-tuberculosis medicines ,non adherence to medication by patients is the principal obstacle in the treatment of tuberculosis. Identification of factors associated with non compliance will aid in directing the limited resources to subjects prone to dropping out of treatment Aim: The study attempts to examine the factors ,including psychiatric morbidity and patients beliefs associated with non compliance with medication among patients with tuberculosis Method: Consecutive patients attending the tuberculosis clinic at a primary care centre and diagnosed to have tuberculosis were assessed using Revised Clinical Review Schedule for assessing psychiatric morbidity and the Short Explanatory model Interview to identify patients' perspectives of their illness.Socio demographic and clinical details were also obtained .The patients were reated using standard anti-tuberculosis therapy and were followed up for a period of 6 months Illness behaviour of tuberculosis undergoing DOT therapy: A case control study-S.K.Bhasin,Atul Mittal,O.P.Aggarwal and R.K.Chadha Illness behaviour questionnaire(I.B.Q),a self-report assessment was administered to 103 tuberculosis cases and a similar number of age,sex matched controls to find out the difference in illness behaviour profile of the two groups. The tuberculosis patients were receiving treatment from two DOTS centres in East Delhi and the controls were from the same locality. The tuberculosis patients exhibited features pertaining to general hypochondriasis(GH),affective inhibition(AI)and affective disturbance(AD) more than the controls and the difference between the two groups were statistically significant. However a denial problem (D) was seen more in controls compared to tuberculosis patients Estimation of serum and pleural fluid amylase and isoenzyme in cases of malignant pleural effusion:-K.B.Gupta,Veena Ghalaut,Rajesh Gupta,Sanjeev Tandon and Prem Prakash Serum and pleural fluid amylase, its isoenzyme and pleural/serum amylase ratio were estimated in 30 cases of malignant pleural effusion. The values were found to be significantly raised as compared non tuberculous and malignant pleural effusions. Salivary amylase isoenzyme was the predominant type found in all cases of malignant pleural effusion. Cut-off value for pleural fluid amylase of more than 100 SU/100ml and for pleural/serum amylase ratio of more than 1 helps in differentiating malignant from tuberculous pleural effusion Socio economic impact of parental tuberculosis on children :Geetharamani,M.Muniyandi,R.Rajeswari,R.Balasubramanian,X.Theresa and P.Venkatesan The impact of parental pulmonary tuberculosis on children was studied from a larger study of socio economic effects of the disease. The effect in children was studied in respect of 1)social,eonomic and demographic characteristics of the parents(who were patients,2)the child care functions of mothers who were patients and 3)effect on children education In all 276 children of 167 tuberculous parents were studied. The socio economic and demographic characteristics were generally the same as are commonly seen. The child caring on the part of mothers fell from 64% to 35% for rural females and from 74% to 33% for urban females:11% of children(8%rural,13% urban dropped out from school, significantly higher in families with 5 or more members and children living with both parents compared to single parent:34% of study parents could not buy school books or adequate food because of loss of income and 20% of the children were obliged to take up jobs in order to supplement income. Tuberculosis of frontal bone:A case reportblack -Shah Alam Khan,Mohd Zahid,Brijesh Sharma and Azra S Hasan Tuberculosis of frontal bone in a 13 year old girl is presented.The occurrence of tuberculous lesion in the flat bones of skull and face is extremely rare,with only 6 cases reported in the world literature. Asymptomatic aplastic anaemia in a patient receiving anti-tuberculosis treatmentblack -Anil K.Agarwal,Inder Mohan Chugh,Chandramani Panjabi,Sumati Dewan and Ashok Shah Blood dycrasias with antituberculosis drugs are known but rarely encountered and even less thought of. We describe a patient who developed pancytopenia due to aplastic anaemia of moderate severity, which was diagnosed after 7 months of therapy. This was thought to be an idiosyncratic response to Streptomycin. A 6 month clinical follow up after cessation of therapy, revealed that the blood counts continued to remain depressed ,but she was totally asymptomatic.Subsequently we were informed that the patient had an uncomplicated normal vaginal delivery 2 years after stopping therapy. Scoring method for diagnosis of tuberculosis :An evaluationblack -L.Suryanarayana and P.S.Jagnnatha Given below is webmaster's summary The scoring method for high tuberculosis prevalence regions proposed by the Task Group of the International Union of Tuberculosis and Lung diseases(IUAT&LD)was evaluated by using different diagnostic parameters on the subjects examined in an earlier survey of National Tuberculosis InstituteCertain drawbacks of the method are pointed out and suggestions are put forth to avoid overdiagnosis and improve consistency. The above are only abridged summaries.You may please refer the original articles for details |