 |
Abstract of articles from |
| Indian Journal of Tuberculosis | |
| reproduced with kind permission |
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Vol 51 
No 3July 2004
ISSN 0019-5707 |
Original articles
- Annual risk of tuberculous infection in rural areas of Kota district
- Role of fine needle aspiration cytology of limp nodes in the diagnosis of cutaneous tuberculosis
- Evaluation of trisodium phosphate as a transport medium and its utility in a single step decontamination technique for the culture of M.tuberculosis
- Strategy for training under Revised National Tuberculosis control programme-Indian Perspective
Case reports
- Isolation of Mycobacterium chelonae from wound infection following laparoscopy
- Disseminated tuberculosis and skull involvement in a non compromised child
- Tuberculous epidural abscess- an unusual presentation
- Isolated tuberculous epididymo orchitis
Background: A nation wide tuberculin study was undertaken to estimate the Annual Risk of Tuberculous Infection(ARTI)in different parts of India.The study in the rural areas of Kota,one of the districts selected for the survey is described in this article.
Materials and methods: A total of 6264 children in 1-9 years of age residing in 64 clusters were registered into the study.The children were subjected to the standard tuberculin test using 1 TU PPD RT 23 with Tween 80 procured from BCG laboratory Guindy and the maximum transverse diameter of the induration was measured at about 72 hours.
Results: A total of 3157 children without BCG scar and 1520 with BCG scar was successfully test read.The prevalence of infection among children without BCG scar using the mirror image technique was estimated as 13.6% and the ARTI was computed at 2.6%.Using similar technique,the prevalence of infection among the entire study group irrespective of BCG scar was estimated as 14.9% and the ARTI computed at 2.8%. Conclusion: The findings indicate a high rate of transmission of tuberculous infection in rural areas of Kota and emphasise the need for further strengthening of tuberculosis control measures.
Background: Lymph node involvement in cutaneous tuberculosis is primarily seen in patients with Scrofuloderma.However ,patients with lupus vulgaris and TBVC sometimes present with regional lymphadenopathy.Demonstration of organism in skin biopsies in ZN stain is time consuming and often unrewarding when bacillary load is considerably low.Fine needle aspiration cytology(FNAC)is an economical ,dependable quick and cost effective tool for an early diagnosis compared to biopsy studies.
Aim: The present study was undertaken to assess the utility of FNAC of lymph nodes in diagnosis of cutaneous tuberculosis
Method: FNAC of affected lymph nodes in Scrofuloderma and lymph nodes draining the lesions in TBVC and lupus vulgaris was carried out followed by skin biopsy in 26 patients of clinically suspected cases of cutaneous tuberculosis
Observations: Smears revealed epithelioid cell granulomas over a necrotic background.AFB could not be demonstrated by ZN stain.Histopathological studies of skin biopsies revealed epithelioid cell granulomas and Langhans giant cells.Biopsies were also negative for AFB by ZN stain and culture .All the patients responded well to standard anti-tuberculous regimen.
Conclusions: FNAC of lymph nodes in cases of cutaneous tuberculosis is a useful procedure that helps in arriving at diagnosis within a reasonable time.
Background: Sputum specimens were received from various out-patient departments of a tertiary care referral hospital to acid- fast staining method and bacterial culture.
Material&Methods: A simple one step decontamintaion and concentration method was adopted before subjecting the samples to acid fast staining and culture.Trisodium phosphate ,a cheap,"soft" decontaminant-cum-liquefying agent was used to treat the sputum specimens before Ziehl-Nielsen's(ZN)acid fast staining and Lowenstein-Jensen (LJ) medium culture.The sputum samples were collected directly into trisodium phosphate containing screw capped McCartney bottles(Day-0).The bottles were vortexed and left overnight at room temperature.On the subsequent morning (Day-1),the supernatants were discarded and smears made from deposits were studied by ZN stain.
Results: A total of 30 consecutive samples ,which showed smear positivity by ZN technique ,were selected for the present study.Deposits from these smear positive cases were cultured onto duplicate slants of LJ medium and incubated at 370
(Day-1)Duplicate slants of LJ media were inoculated from each of these preserved deposits on 2nd,3rd,4th,6th and 8thdays.Culture bottles were inoculated at 370from 8 weeks and positive growths were recorded.Culture retrieval was possible from 29(96.7%)samples from deposits of Day-1 to Day-3.The culture positivity ,however dropped had dropped to 26 (89.7%),18(60%)and 6(20%)and 6(20%)from deposits of Day-4 ,Day-6 and Day-8 respectively.All the isolates were identified as M.tuberculosis and there was minimal contamination(0.83%)The culture retrieval dropped significantly only day-3. <
Conclusion: This method is therefore suitable for transportation ,preservation and decontamination of sputum samples before staining and culture ,up to 3 days after collection.This will be helpful especially for collection of sputum samples from distant places and their transportation to nearest mycobacteriology laboratory as also for sputum samples arriving late in a working day's schedule.
A Directly Observed Treatment-short course(DOTS)strategy has been the essence of global tuberculosis(TB)control programme success.Training in DOTS has resulted in the quality assurance of various services under programme.The present article discusses about a sustained need of DOTS training ,essentials of a training strategy and achievements and limitations of training programme.It gives a brief account of the role being played by key training players a national level and focuses on need t encourage both raining and research in the Revised National TB Control Programme.
D.R Gayathri Devi,D.Sridaran,V.A.Indumathi,P.R.S.Babu,M.R. Sandhya Belwadi,and A.C.V.Swamy
Indian J Tuberc 2004;51:149-151
M.chelonae is a rare cause of human infection and is difficult to diagnose unless suspected for the same.A 55 year old healthy gynaecologist,diagnosed to have right inguinal hernia ,underwent laparoscopic hernioplasty after which he showed signs of post- operative wound infection which was confirmed to be due to M.chelonae Definitive identification of this species of mycobacterium was possible by growth characteristics and biochemical tests.The organism was sensitive to Kanamycin ,Clarithromycin,Ciprofloxacin and Amikacin.However complete recovery from infection was possible after prolonged treatment with antibiotics to which the organism was sensitive
Roma Pandhi and A.J.Kanwar
Indian J Tuberc 2004;51:153-155
An unusual presentation of disseminated tuberculosis with lymphadenopathy ,cutaneous lesions and skull bone involvement in a non immuno compromised child
Anupam,Prakash,Samir Kubba,N.P.Singh ,Dheeraj garg,Anjali Pathania,Aman Makhija,Nirupama Prakash and S.K.Agarwal
Indian J Tuberc 2004;51:157-158
A 23 year old female presented clinically as a case of transverse myelitis.However MRI suggested an epidural abscess extending from T7 vertebral level to L1 vertebral level.Histopathological analysis revealed the abscess to be tuberculous in nature.Patient responded to surgical decompression and anti-tuberculous therapy.
Hetal Shah,Keyur Shah,Ramakant Dixit and Kusum.v.Shah
Indian J Tuberc 2004;51:159-162
Isolated epididymo orchitis is an unusual presentation of tuberculosis.We report a case of bilateral epididymitis with right sided orchits and scrotsl involvement due to tuberculosis in a young male patient who had infertility.The diagnosis was suspected on ultra sonography of scrotum and confirmed by histological examination of scrotal and testicular tissue biopsy.
Created on ... July 30 2004