 |
Abstract of articles from |
| Indian Journal of Tuberculosis | |
| reproduced with kind permission |
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Vol 55 
No 2April 2008
ISSN 0019-5707 |
Original articles
- Editorial:New generation methods for drug susceptibjility testing for tubserculosis
- Survival of tuberculosis patients treated under DOTS in a rural Tuberculosis Unit(TU),south India
- A comparison of conventional and radiometric methods for the assessment of anti-tubercular activity of drugs against Mycobacterium Tuberculosis in mice and macrophage models.
- Increased yield of smear positive pulmonary TB cases by screening of patients with 2 and more months of cough ,compared to 3 and more weeks and adequacy of 2 sputum smear examinations for diagnosis
- Clinico radiological profile of new smear positive pulmonary tuberculosis cases among young adult and elderly people in tertiary care hospital at Dehadun (UttarKhand)
- Status report on RNTCP
Case reports
- Accidental Isoniazid poisoning -A report
- Psoriasiform Lupus Vulgaris Obstructing mass lesion of epiglottis
Objective:To estimate survival probabilities and identify risk factors for death of tuberculosis(TB)patients during treatment period.;
Methods: Tb patients registered during May 1999 to December 2004 from a rural TB unit(TU)with a population of 580000 in Tiruvallur district South India,formed study population.Life table and Cox's regression methods were used.
Results: Of them 3818 TB patients who were initiated on treatment,96,94 and 97% of category -I,II andIII respectively,were surviving after completion of treatment. Higher death rates were independently associated with patient's age(45 years),previous history of treatment,alcoholism and initial body weight(< 35Kg;s)ar positive culture positive' and 100% of 'smear negative culture positive' samples.from tuberculosis suspects diagnosed on the basis of other routine diagnostics and supporting clinical evidence,Seventeen samples were positive only by PCR but based on clinical parameters only 7 were considered true positives.
The sensitivity of PCR was 91.5% compared to 51% for smear microscopy and 68% for sputum culture.This was due o the fact that PCR could pick up bacterial DNA even from saliva mixed sputum specimens,which are generally not considered appropriate for microbiology. The specificity of PC(86%)was found to be lower than other than diagnostic tests mainly due to lack of a suitable gold standard to assess its efficiency. This is an important limitation in evaluation of the test.
Conclusion: The survival probability was found to be similar in all patients irrespective of categorisation.Necessary actions need to be initiated in the programme to improve body weight and abstain from alcoholism
Indian J Tuberc 2008;55:64-69:
A comparison of conventional and radiometric methods for the assessment of anti-tubercular activity of drugs against Mycobacterium Tuberculosis in mice and macrophage models.
Sarbjit Singh Jhamb,Raman Preet Singh
Background: Presently in vitro
screening of antitubercular drugs is a time consuming exercise. Therefore,it is important to develop faster methods.
Sarbjit Singh Jhamb,Raman Preet Singh
Material and Methods: Towards this end,conventional plating and radiometric Bactec methods of anti-tubercular screening were compared to determine the efficacy of anti-tubercular drugs(isoniazid and rifampicin) and morphine in Mycobacterium tuberculosis H37Rv-infected mice and macrophages
Results: A linear correlation(R2=0.95)was observed between the number of colony foorming units (CFUs) and growth index(GI)values.Bactec maethod was found to be faster and sensitive as compared to plating method.Further ,Bactec method,being aa closed system,appeared to be less susceptible to microbial contamination and poses less biohazard
Conclusion We conclude that BACTEC method can be employed for easy,precise and rapid screening of anti-tubercular compounds and morphine in mice and macrophage models Indian J Tuberc 2008;70-76:
Background: RNTCP recommends examining three sputum smears for AFB from Chest symptomatics(CS)with cough of 3 weeks and more for diagnosis of Pulmonary TB(PTB).A previous multi-centric study frm Tuberculosis Research Centre(TRC) has shown that the yield of sputum positive cases can be increased if duration of cough for screening was reduced to more than or equal 2 weeks.Other studies have shown that two smear examinations are adequate for diagnosis of smear positive PTB.To validate the above findings,a cross sectional multi-centric study was repeated in different settings in five geographical areas in India.
Methods: Three primary and secondary level health facilitieswith high out-patient attendance were selected ffrom two Tuberculosis Units(TU)in each of the 15 selected districts to screen about 10000 new adult out-patients from each state.For patients who did not volunteer history of cough,symptoms were elicited using a structured simple questionnaire.All the CSs were referred for sputum examination.
Results A total of 96787 out-patients were registered.Among them 69,209(72%)were new adult out-patients.Using 2 or more weeks cough instead of 3 or more weeks as the criterion for screeninig,there was an overall increase of 58% in CS and 23% increase in the detection of smear-positive cases.Among 211 patients 210 were positive at least by one smear from the initial two specimens.Increase in the work-load if 2 smears were done for patients with cough of 2 or more weeks were 2 specimens (i.e 13 to 15)for an adult OPD of 150. Conclusion: The yield of sputum positive PTB cases can be improved by screening patients with 2 or more weeks cough and two specimens are adequate for diagnosis. Indian J Tuberc 2008;55:77-83:
Jagdish Rawat,Girish Sindhwani and Ruchi Juyal
Setting Patients of pulmonary tuberculosis(PT)attending the out and in patient department of pulmonary medicine ,Himalayan Institute of of Medical Science(HIMS),a post graduate institute and a large tertiary care center in DehraDun.
Objective To compare the clinicao radiological pattern of pulmonary tuberculosis in the young adult(18-59years)and the elderly>60years)patients.
Design: Prospective observational study of pulmonary and associated extra-pulmonary tuberculosis cases diagnosed between October 2005 to september 2006 in pulmonary medicine department of HIMS. Result Mean age of young adult and elderly patients was 35.71±5.7 Years and 68.57 ±3.30 years respectively.Elderly patients had a higher number of co-morbidities like diabetes mellitus,hypertension and malignancy.Tuberculin positivity was less among elderly patieents(36.0%)as compared to young adults(65.9%)Hemoptysis(29.5% vs 6%)Fever(95.4% vs 76%)and night sweats(54.5% vs 18%)were significantly higher in the young adult patients than the elderly.As for roengenographic abnormalities,a higher involvement of lower zone(24.0% vs 7.9%)and far advanced lesions(32.0% vs 14.7%)were seen in the elderly patients as compared to young adults.The lederly showed a higher freqency of TB related mortality(8% vs 1.1%)and associatedextra-pulmonary involvement(40%vs 7%)
Conclusion: Young adults are likely are more likely to have hemoptysis,night sweats and positive PPD response while lower lung field involvent is more common in elderly. [Indian J Tuberc 2008;55:84-90:
During rh 4th quarter 2007 over 1645983 TB suspects were examined and 200,223 sputum positive cases were diagnosed.More than 346566 TB cases were registered for treatment.,bringing the annualized total case detection rate to 123 cases per 100,000 population.The new smear positive (NSP)TB case detection rate (annualized)for the 4th quarter 2007 was 65% with a total of 136,805 new smear positive cases being registered for treatment.In addition 94,756 new smear negative cases (NSN)47,061 new extra pulmonary cases,47,656 smear positive re-treatment cases and 21,574 'others were also initiated for treatment in this quarter.The success rate amongst the new smear positive PTB cases was 86% .The sputum conversion and cure rate among the new sputum positive cases was 90% and 84% respectively.The relatively high default rate among NSP (6.1%)NSN (7.7% and retreatment cases conrinues to be an area of deep concern which the programme managers at all levels must focus upon.
R.L.Agarwal,N.C.Dwivedi,Manu Agarwal,Sachin Jain and Anand Agarwal.
Eight patients who had taken accidental overdose of isoniazid were followed in relation to its clinical manifestation,EEG changes and management. All cases survived without any residual effect. [Indian J Tuberc 2008;55:94-96]:
L.Padmavathy,L.Lakshmana Rao,N.Ethirajan and M.Dhanalakshmi
Tuberculosis is a major public health problem in both developing and developed countries. Cutaneous tuberculosis constitute a minor proportion of extra-pulmonary manifestations of tuberculosis. Lupus vulgaris(LV)is one of the clinical variants of cutaneous tuberculosis. A case of a large plaque type psoriasiform lesion of Lupus vulgaris on the thigh of 15 years duration,in an eighteen year old girl is reported. This case highlights the ignorance level among the patients and consequent failure to avail proper anti-tuberculosis treatment despite campaign in print and audio-visual media. [Indian J Tuberc 2005;55:97-99]:
Rajesh Gupta,Sajay Fotedar,Pradeep Sanwal,S.P.S.Yadav,Anupama Gupta,K.B.Gupta and Kuldip Saini
We report a case of 60 year old male difficulty in breathing as well as in swallowing.On examination,he was found to be having prolifearative growth of epiglottis and aryepiglottic fold mimicking neoplasm. So emergency tracheotomy was performed and biopsy taken. He was found to be having symptomatic miliary mottling on routine ray chest PA view. Further on HRCT,it turned out to be lesion suggesting tubercular etiology.Histopathology(Epiglottic biopsy)report confirmed the whole process as tubercular. The patient recovered promptly in due course with ant-tubercular treatment. Point remains to be seen that if we can avoid tracheostomy and its complications in such cases.
[Indian J Tuberc 2008;55:100-103]:
Created on ... 16 April, 2008