Cases Of Pulmonary Tuberculosis Patients Research Articles

Erythrocyte sedimentation rate in new cases of pulmonary tuberculosis patients

Erythrocyte sedimentation rate in new cases of pulmonary tuberculosis patients

Clinical features, immunologic parameter and treatment outcome of Chinese tuberculosis patients with or without DM.

The coexistence of diabetes mellitus (DM) and pulmonary tuberculosis (PTB) poses a significant health concern globally, with their convergence presenting a considerable challenge to healthcare systems. Previous research has highlighted that comorbidities can mutually influence and exacerbate immune disorders. However, there is a paucity of data on the impact of DM on immunological features and treatment responses in the TB population in China. From January 2020 to June 2022, 264 cases of pulmonary tuberculosis patients (82 DM patients and 182 non-DM patients) hospitalized in our center were selected. 80 patients with TB with DM (TB-DM) and 80 patients with TB without DM (TB-NDM) were enrolled into the final analysis by propensity score matching for age, gender and involved lung field at a ratio of 1:1. The clinical characteristics, immunological features and treatment response were compared between the two groups. After propensity score matching, no differences in the general features such as age gender, involved lung field, the incidence of retreatment and WBC count were found between the two groups. Compared to TB-NDM group, the TB-DM group exhibited a higher positive rate of sputum smear and incidence of cavitary lesions. Immunological features analysis revealed that the TB-DM patients had higher levels of TNF-α [pg/ml; 8.56 (7.08-13.35) vs. 7.64 (6.38-10.14) p = 0.033] and IL-8 [pg/ml; 25.85 (11.63-58.40) vs. 17.56 (6.44-39.08) p = 0.003] but lower CD8+ T lymphocyte count [cells/mm3; 334.02 (249.35-420.71) VS 380.95 (291.73-471.25) p = 0.038]. However, there was no significant difference in serum IL-6 concentration and CD4+ T lymphocyte count between the two groups. After 2 months of anti-tuberculosis treatment, 39 (24.4%) cases had suboptimal treatment response, including 23 (28.7%) TB-DM patients and 16 (20%) TB-NDM patients. There was no difference in suboptimal response rate (SRR) was found between the two groups (p = 0.269). The multivariate logistic regression analysis indicated that retreatment for TB [AOR: 5.68 (95%CI: 2.01-16.08), p = 0.001], sputum smear positivity [AOR: 8.01 (95%CI: 2.62-24.50), p = 0.001] were associated with SRR in all participants, and in TB-DM group, only sputum smear positivity [AOR: 16.47 (1.75-155.12), p = 0.014] was positive with SRR. DM is a risk factor for pulmonary cavity formation and sputum smear positivity in TB population. Additionally, TB-DM patients is characterized by enhanced cytokine responses and decreased CD8+ T lymphocytes. The retreatment for TB and sputum smear positivity were associated with the occurrence of suboptimal treatment response.

Comparison of the Severity of Lung Damage on Chest X-ray Between New Drug-Resistant and Drug-Sensitive Cases of Pulmonary Tuberculosis Patients

Background: Drug-resistant (DR) pulmonary tuberculosis (TB) is often associated with morbidity and mortality compared to drug-susceptible (DS) pulmonary TB. The infectiveness and pathological destruction of DR TB and DS TB strains are still controversial. Objectives: This study aimed to compare the severity of lung damage between new cases of DR and DS pulmonary TB. Methods: This was an analytical observational study with a retrospective cross-sectional design. The sample was selected from the medical records of eligible TB patients treated at RSUD Dr. Soetomo, Surabaya (Indonesia) from January 2018 to November 2022. The severity of lung damage was assessed based on the chest X-ray. Results: A total of 319 patients, consisting of 132 new cases of DR pulmonary TB and 187 new cases of DS pulmonary TB, were recruited. The patients had a mean age of 43.64 years old, and 59.5% of them were male. The most common comorbidity was diabetes mellitus. The severity of DR pulmonary tuberculosis is higher in the mild-moderate category (51.5%), while the severity of DS pulmonary tuberculosis is higher in the severe category (77%). Conclusions: There was a difference in lung damage on chest X-ray between new cases of DR and DS pulmonary TB. The severity of DR pulmonary TB was higher in mild-moderate category, while the severity of DS pulmonary TB was higher in severe category.

GAMBARAN TINGKAT PENGETAHUAN KELUARGA TENTANG PENYAKIT TUBERKULOSIS PARU DI WILAYAH KERJA PUSKESMAS SUKAMERINDU KOTA BENGKULU

The increasing number of pulmonary tuberculosis patients in Indonesia is caused by a lack of public knowledge about pulmonary tuberculosis so that there are still many people who behave unhealthy. In addition, the level of family knowledge has a major influence on the health status of the family and the tuberculosis patient itself and plays an important role in the success of the prevention and prevention program for pulmonary tuberculosis. In 2021 cases of pulmonary tuberculosis patients at the Bengkulu City health office were reported to be 352 in adult patients and 33 in pediatric patients. The low success rate of pulmonary tuberculosis treatment in the city of Bengkulu is the low level of knowledge of families and tuberculosis sufferers in carrying out independent health care on a regular basis. This type of research uses a quantitative descriptive method. The purpose of this study was to describe the level of family knowledge about pulmonary tuberculosis in the Sukamerindu Public Health Center, Bengkulu City. This type of research uses a quantitative descriptive method. The research population was 37 respondents. The sampling technique used was total sampling. The research instrument used a questionnaire. The results showed that the level of family knowledge about pulmonary tuberculosis was in the good category 5%, in the sufficient category 57% and 38% in the less category. To increase public knowledge, it is necessary to provide health education and counseling about pulmonary TB.

Prevalence of Rifampicin-Resistant Mycobacterium Tuberculosis by CBNAAT in a Tertiary Care Hospital of West Bengal, India

Background: Tuberculosis (TB) remains one of the commonest infectious diseases in India, where control is difficult due to the emergence of multi-drug-resistant TB (MDR-TB). The rifampicin resistance (RR) is an important surrogate marker of MDR-TB. Aims and Objectives: The aim of this article is to determine the prevalence of RR-TB among all symptomatic presumptive TB patients by cartridge-based nucleic acid amplification test (CBNAAT) in our institution. Materials and Methods: A retrospective cross-sectional study was conducted from January 2018 to December 2020 in the Directly Observed Treatment (DOT) center of a tertiary care hospital. All presumptive cases of pulmonary TB patients coming to the DOT center were subjected to CBNAAT by GeneXpert Mycobacterium tuberculosis rifampicin (MTB/RIF) (Cepheid). Data were collected from a data-extraction sheet from registration books and analyzed using SPSS version 20. Fisher’s exact test was applied to examine the association between categorical variables and P-value less than 0.05 was considered significant. Results: A total of 6171 presumptive TB patients were included in the study. The overall prevalence of TB was 1590 (25.77%) in all age groups. The prevalence of RR-TB among all confirmed TB cases was 10.75% (171/1590) with the majority being males (130 cases). The prevalence of RR cases among new and previously treated was 3.1% and 36.34%, respectively, which were statistically significant (P < 0.05). Conclusion: We found that RR-TB is still much prevalent in our area, and it was significantly higher in previously treated cases. The CBNAAT is a good molecular assay method for rapid detection of TB and also for the detection of RR-TB.

Endovascular embolization for Rasmussen's aneurysm with massive hemoptysis: 3 case reports and literature review

This study aimed to explore the clinical features, the methods of pulmonary vascular interventional therapy, and the outcome of Rasmussen's Aneurysm (RA) with massive hemoptysis. A retrospective analysis of three cases of RA with massive hemoptysis was accomplished from the data collected through the literature review. A search through the PubMed database could retrieve information about 45 confirmed cases of pulmonary tuberculosis patients with massive hemoptysis attributed to RA. Three controls were also included in the study for unbiased statistical analysis of the data. All the 45 patients received chest CTA examination, 31 of whom (68.9%) showed RA by angiography. Lesions were mainly located in the upper lung of the patients, with an average diameter of 6.9 ± 3.9 mm. RA is classified into 4 types: 45 patients comprised 51.1% of type A (23 cases), 17.8% each respectively type B (8 cases) and type C (8 cases), and 4.4% of type D (2 cases). Two patients refused treatment whose prognoses were unknown, and another 2 died of asphyxia resulting from massive hemoptysis. A total of the forty-one patient received further treatment: 26 of them underwent pulmonary artery embolization, 7 received bronchial artery embolization, and the rest 8 received both bronchial artery and pulmonary embolization treatment. After treatment, one of the patients died of suffocation with massive hemoptysis during the surgical procedure, 38 recovered completely, and 2 showed recurrence of hemoptysis.Pulmonary vascular interventional therapy remains the preferred intervention for the remedy of RA accompanied by massive hemoptysis.

ROLE OF FIBEROPTIC BRONCHOSCOPY IN SPUTUM NEGATIVE PATIENTS

Background:Tuberculosis continues to be the one of the most common global health problems for more than a century. Fiberoptic bronchoscopy may be very useful in diagnosing cases who have no sputum or whose sputum smear is negative for Acid-Fast bacilli. The current study aims to assess the role of fiberoptic bronchoscopy in sputum smear negative under NTEP and radiologically suspected cases of pulmonary tuberculosis. Methods:This study was conducted in our institution in clinico-radiological suspected cases of pulmonary tuberculosis patients in whom two sputum smear for acid fast bacilli by Zeihl-Neelsen stain under NTEP was negative. Fiberoptic bronchoscopy was performed in all these patients and samples taken were sent for investigations. Result:Fiberoptic bronchoscopy was performed in a total of 110 patients of presumptive pulmonary tuberculosis whose sputum for AFB smear was negative. Out of 110 patients, 65.45% were male and 35.55% were female. Fever was the most common presenting symptom and was found in 93.64% patients. Radiographically, pulmonary consolidation was bilateral in 63.34% cases while was unilateral in 36.36% cases. The total yield of FOB came out to be 59.1% in which BAL for AFB smear was positive in 43.63% cases, BAL for Mtb culture was positive in 54.54% cases while, BAL for PCR was found to be positive in 59.09% cases. Conclusion:Fiberoptic bronchoscopy may be useful in rapid diagnosis and early treatment initiation thereby, reducing the risk of transmission of the disease. The findings of the study indicated that fiberoptic bronchoscopy is a useful method to diagnose the cases of sputum negative radiologically suspected symptomatic patients of tuberculosis.

Effect of Giving Cohi Fish Biscuits and Vitamin C on the Weight of Patients with Pulmonary Tuberculosis in Percut Sei Tuan District in 2019

The condition of patients with pulmonary tuberculosis (TB) with poor nutritional status will slow down the healing period. Overcoming malnutrition in pulmonary tuberculosis patients is carried out by providing supplementary food (PMT), especially those based on local food ingredients. In addition to needing additional foods rich in macro nutrients, TB sufferers also need micronutrients that can trigger increased body immunity, such as vitamin C. This study aims to see the effect of giving cohi fish biscuits and vitamin C on the weight of patients with pulmonary tuberculosis in Percut Sei Tuan District in 2019. The design of this study was a quasi experimental pretest-posttest control group design which was carried out in Percut Sei Tuan District, Deli Serdang Regency, North Sumatra starting from May-July 2019. Subjects were 52 new cases of pulmonary tuberculosis patients with malnutrition who were divided into three groups: 16 people in the first group who received 100 g/day of cohi fish biscuits, 16 people in the second group who received 100 g/day of cohi fish biscuits and 500 mg/day of vitamin C, and 20 people in the control group. The treatment was carried out for 30 days. Giving 100 grams of cohi fish biscuits contributed 583.29 kcal of calories, 15.32 grams of carbohydrates, 25.54 grams of protein and 46.65 grams of fat. Statistical test using one-way ANOVA, the results obtained were no difference in pre-test weight of patients with pulmonary TB (p=0.616), there was no difference in post-test body weight of patients with pulmonary TB (p=0.674), there was a difference in changes in patient weight. Pulmonary TB (p=0.00). There was an increase in body weight in the second group of 0.7 kg, and even though there was no increase in body weight in the first group, giving cohi fish biscuits was able to withstand the weight loss compared to the control group. The conclusion of this study is that cohi fish biscuits and vitamin C can be an alternative to PMT to increase the weight of patients with TB. Keywords: Cohi Fish Biscuits, Vitamin C, Pulmonary Tuberculosis (TB).

Effect of Case Management Nursing Service on Compliance Behavior and Quality of Life of Patients with Pulmonary Tuberculosis

Objective: To explore the effect of case management nursing service on compliance behavior and quality of life of patients with pulmonary tuberculosis. Methods: 69 cases of pulmonary tuberculosis patients in our hospital from September 2019 to August 2020 were selected as the research objects. The 69 patients were divided into study group (35 cases) and control group (34 cases). The compliance behavior, quality of life and nursing satisfaction of pulmonary tuberculosis patients were studied and analyzed. Results: The compliance rate of the control group was 82.35%, and that of the study group was 97.14%;The quality of life in the control group was [61.32 ± 7.66], which was significantly lower than that in the study group [71.12 ± 7.23];The satisfaction rate of the study group was 97.14%, which was significantly higher than 73.53% of the control group. Conclusion: In the treatment of tuberculosis patients, the use of case management nursing service can effectively improve the quality of life of patients, improve the compliance behavior of patients, and improve the treatment effect of patients, which is worthy of promotion.

Profile of Adenosine Deaminase (ADA) Level in Active Pulmonary Tuberculosis Patients

Background: Pulmonary tuberculosis (TB) has a risk of increasing the transmission of infection and death may occur if diagnosis is delayed due to limited testing. Faster, more accurate, inexpensive new methods with easy-to-obtain samples, such as serum levels of Adenosine deaminase (ADA), need to be applied. This study aims to compare serum ADA levels in new cases of pulmonary TB patients and in healthy individuals, and to examine the potential of serum ADA to diagnose pulmonary TB. Methods: This study was an observational analytic study conducted at the Outpatient Clinic of TB/TB-MDR-DOTS, Dr. Soetomo Hospital, Surabaya, Indonesia, from August to December 2019. The subjects were new cases of pulmonary TB patients and healthy individuals. Serum ADA levels were analyzed using the enzymatic colorimetric method, using Erba XL 600. Results: A total of 60 patients were divided into 34 new cases of pulmonary TB patients and 26 healthy individuals. Serum ADA levels in new cases of pulmonary TB patients were significantly higher compared to those in healthy individuals (P<0.001). The cut-off value of serum ADA levels was 11.4 U/L with a sensitivity of 85.3% and specificity of 84.6%. Conclusion: ADA serum levels are increased in patients with new cases of pulmonary TB. ADA serum can be used to assist the diagnosis of tuberculosis.

Clinical metagenomic sequencing for diagnosis of pulmonary tuberculosis

The aim of this study is to investigate the clinical usefulness of metagenomic Next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples to discriminate pulmonary tuberculosis (PTB) from Non-TB community-acquired pneumonia (CAP) in PTB suspects. We investigate the performance of mNGS on BALF samples from 110 PTB suspects, in comparison with conventional microbiological testing (solid media culture, acid-fast bacilli staining (AFS), Xpert) of BALF or sputum samples and final clinical diagnosis. We finally clinically diagnosed 48 cases of pulmonary tuberculosis patients and 62 cases of non-tuberculosis patients. Comparing to the final clinical diagnosis, mNGS produced a sensitivity of 47.92%, which was similar to that of Xpert (45.83%) and culture (46.81%), but much higher than that of AFS (29.17%) for TB diagnosis in BALF samples. Apart from detecting Mycobacterium tuberculosis, mNGS also identified mixed infections in PTB patients, including 3 fungal cases and 1 bacteria case. Meanwhile, mNGS efficiently identified 14 of 22 (63.63%) cases of non-tuberculous mycobacteria (NTM), 7 cases of fungi, 1 case of viral infection, and other common bacterial pathogens in Non-PTB group. Finally, mNGS identified 67.23% infection cases within 3 days, while the conventional methods identified 49.58% infection cases for over 90 days. Our data show that mNGS of BALF represents a potentially effective tool for the rapid diagnosis of PTB suspects.

To assess clinical profile of oral glucose tolerance in pulmonary tuberculosis patient

Introduction: Tuberculosis (T.B), which is one of the oldest disease known to affect human and is likely to have existed in pre hominids, is a major cause of death worldwide. This disease is caused by bacteria of the mycobacterium tuberculosis complex and usually affects the lungs, although other organs are involved in upto one- third of cases. Diabetes Mellitus (D.M.) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.Subject and Methods: In this study 75 newly diagnosed cases of pulmonary tuberculosis patients were evaluated. A cross section of both male and female diagnosed case of pulmonary tuberculosis attending the outdoor and indoor of various department were taken into study. A detailed history, clinical examination and relevant investigations were performed. Collected data were analysed by using appropriate software.Result: This study of 75 cases showed overall incidence of impaired glucose tolerance as 17.33% in patients with pulmonary tuberculosis. Among 82.67% patients GTT was normal (Fasting 126mg/dl and 2hours >200 mg/dl) was diagnosed.Conclusion: This study showed no statistically significant association of sex, age and chest X-ray findings in patients with pulmonary tuberculosis and diabetes mellitus.

Changes of serum adenosine deaminase level in new cases of pulmonary tuberculosis before and after intensive phase treatment.

Background and Objectives:Tuberculosis (TB) continues to be a public health crisis with an estimated 10 million people developing TB disease in 2017. Adenosine deaminase (ADA) level in serum and pleural fluid as a biomarker may be used to diagnose pulmonary TB (PTB), but it is not always easy to obtain those samples at the end of treatment. This study was conducted to analyze the changes of serum ADA level in the new case of PTB patients with acid-fast bacilli (AFB) smear-positive sputum and sputum conversion status as treatment monitoring in PTB patients.Materials and Methods:This was a prospective observational analytic study conducted in Dr. Soetomo General Hospital, Surabaya, from January 2018 to May 2018. Participants were all new cases of PTB patients with AFB smear-positive sputum, and a positive rapid molecular test for Mycobacterium tuberculosis. Blood serums were taken at the same time on the 1st day of TB treatment and also taken at the end of intensive phase treatment to analyze the changes of serum ADA level.Results:There were 26 TB patients and 26 healthy control people. Serum ADA level at the beginning of TB treatment was higher than the level at the end of intensive phase treatment. There was a significant difference between serum ADA level before and after the intensive phase of TB treatment (P < 0.001).Conclusions:The examination of serum ADA levels can be used to evaluate the PTB treatment response.

Fungal isolates findings of sputum samples in new and previously treated cases of pulmonary tuberculosis in dr. soetomo hospital surabaya, Indonesia.

Fungal infections generally occur in immunosuppressive patients. Long-term tuberculosis (TB) treatment facilitates the occurrence of fungal infections, such as long-term antibiotics administration which is immunosuppressive agents and increases the opportunity of infections. Other factors may be correlated with fungal infection such as age, sex, malnutrition, smoking, diabetes mellitus, lung lesion severity, and the presence of multidrug-resistant TB. This study aims to identify and analyze the proportion of fungal isolates findings in the sputum of new and previously treated cases of pulmonary TB patients. This was an observational analytic study with a cross-sectional design of all pulmonary TB patients who were hospitalized in Dr. Soetomo Hospital Surabaya. Sputum samples were inoculated on Sabouraud's dextrose agar medium. The growth of visible colonies was identified by Lactophenol Cotton Blue staining using direct microscopy. Fungal isolates were found in 148/193 (77%) pulmonary TB patients. Candida species was found 99% among 148 fungal positive culture. Candida albicans was the most common found fungal species (54.05%), followed by Candida sp (26.35%), Candida glabrata (10.13%), Candida krusei (5.4%), and Candida tropicalis (1.35%). Previously treated cases, sex, malnutrition, and smoking were variables correlated with fungal isolates finding with P value of 0.015, 0.006, 0.010, and <0.001, respectively. The proportion of fungal positive cultures in previously treated cases was higher than in new cases. C. albicans was the most common fungal species both in previously treated cases and new cases of pulmonary TB.

Diagnostic Yield of Bronchoalveolar lavage Xpert MTB/RIF Assay (Gene Xpert ® in Sputum Smear Negative Pulmonary Tuberculosis Patients – A One Year Cross Sectional Study

Introduction: Tuberculosis remains a major public health issue and is one of the top ten causes of death worldwide. Seven countries worldwide account for 64% of the total incidence and India leading the count. Only about 50-60% of the cases are sputum smear positive, while rest are sputum scare or smear negative cases. Since December 2010, WHO has recommended the use of Xpert MTB/RIF assay due to its high-quality performance, as compared to microscopy in the diagnosis of tuberculosis. The present study was done to evaluate the early diagnosis of sputum smear negative pulmonary tuberculosis patients using Xpert MTB/RIF assay test in broncho-alveolar fluid and to evaluate prevalence of rifampicin resistance in these patients.&#x0D; Methods: This was a one year cross section study conducted in a tertiary care hospital. A total of 143 suspected cases of pulmonary tuberculosis patients who were sputum smear negative were included in the study. All patients underwent bronchoscopy and the BAL specimen was subjected for Xpert MTB/RIF assay, smear by ZN staining and AFB Culture using MGIT 960 medium. The sensitivity and specificity of the Xpert MTB/RIF assay was compared to AFB culture which is considered as the gold standard method for diagnosing TB was calculated.&#x0D; Results: Majority of the patients were males (74.83%) and under the age group of 30 years (26.57%). Out of 143 suspected, the final diagnosis of PTB was done in 93 patients. Out of 93 cases of PTB, 87(93.5%) patients were Xpert MTB/RIF assay positive, 80(86.0%) were AFB culture positive and 39(41.9%) patients were AFB smear positive. The sensitivity and specificity of BAL Xpert MTB/RIF assay was 92.5% and 79.37% respectively (p &lt;0.0001).&#x0D; Conclusion: The Xpert MTB/RIF assay is more sensitive and specific than smear microscopy for the diagnosis of PTB in sputum smear negative on specimens obtained from broncho-alveolar lavage (BAL).

The Changes of Interleukin 17 levels On Pulmonary Tuberculosis Patients with AFB Smear-Positive After 2 Months Anti Tuberculosis Drugs Treatment

Background: Tuberculosis still remain as a health problem in the world. No specific biomarkers can be used to monitor the rapid response to TB therapy. This study aims to assess the change of IL-17 levels in pulmonary tuberculosis patients with AFB smear-positive before and after 2 months of anti tuberculosis drugs (ATD) treatment.&#x0D; Method: Design of study is analytic observational with prospective cohort. The subject include 17 new cases of pulmonary tuberculosis patients with AFB smear-positive in Soetomo Hospital Surabaya from July - October 2016. Plasma levels of IL-17 were measured using ELISA technique before treatment and 2 months after the ATD therapy.&#x0D; Results: The mean levels of IL-17 before treatment is 3.510 pg / ml (2.087- 5.051 pg/ml). There were significantly decreament (p = 0.001

Anxiety and depression in tuberculosis patients and its influencing factors

Objective To explore the related factors of anxiety and depression in patients with tuberculosis. Methods A total of 453 cases of pulmonary tuberculosis patients who were hospitalized in this hospital from July 2016 to June 2017 were selected by stratified cluster random sampling method. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used for the questionnaire survey of anxiety and depression, and the general information questionnaire and social support rating scale (SSRS) were filled out.The mean, gross and standard scores were obtained for each purpose of SAS and SDS.Univariate and multivariate Logistic regression analysis was performed on 13 factors affecting patients' anxiety and depression, including gender, age, education, occupation, course of illness, family per capita income, medical expense payment method, marital status, residence status, adverse drug reactions, drug resistance, complications and social support. Results The total gross score of SAS for tuberculosis patients was(39.20±2.14)points, the standard score was 48 points. The total gross score of SDS for tuberculosis patients was(38.44±4.14)points, the standard score was 47 points.The differences in SAS scores of tuberculosis patients with different gender, age, marital status, family per capita income, medical payment method, social support level, drug resistance and complications were statistically significant(P<0.05). SDS scores of tuberculosis patients with different gender, age, course of disease, marital status, family income per capita, medical payment method, social support level, drug resistance and complications were statistically significant(P<0.05). Multivariate logistic regression analysis showed that the SAS scores of pulmonary tuberculosis patients were affected by gender, age, drug resistance and social support degree.The SDS scores of patients with tuberculosis were affected by gender, course of disease, drug resistance, complications and degree of social support. Conclusion There is a certain degree of anxiety and depression in patients with tuberculosis.The occurrence of anxiety is related to gender, age, drug resistance and social support.The occurrence of depression is related to gender, drug resistance, course of disease, complications and social support.Attention should be paid to the psychological status of pulmonary tuberculosis patients, and psychological counseling should be done according to different gender, age, disease and drug treatment to improve social psychological support for such patients. Key words: Tuberculosis; Pulmonary; Anxiety, depression; Factor analysis; Statistics

To Compare the Competency of Prognostic Markers- ESR, CRP against ZN Staining in Determining Pulmonary Tuberculosis Cases

Background: Tuberculosis (TB) is a highly prevalent chronic infectious disease caused by Mycobacterium tuberculosis an aerobic intracellular binding bacterium (bacillus). Active TB disease can be fatal if left untreated. The disease today is considered curable and preventable. This retrospective study was undertaken to compare and analyzed the relationship between acute phase reactant proteins CRP (quantitative) and ESR in sputum smear positive for AFB patients and to evaluate their diagnostic and prognostic significance. Methods: The present prospective study was carried on a randomly selected study group comprising of 180 cases of pulmonary TB patients who were sputum smear positive for AFB and 25 normal healthy (sputum smear negative for AFB) individual were taken as control. The cases of PTB group was further categorized on the basis of recommendation of RNTCP grading system of AFB in Sputum ZN staining into four subgroups AFB – 3+, AFB – 2+, AFB –1+ and scanty. The control groups were negative for the Acid Fast bacilli in sputum. Results: In our study showed that the maximum patients seen in grade III (36.11%) followed by grade II (31.66%), grade I (19.44%) and 12.77% scanty according to RNTCP grading system of ZN staining of sputum for acid fast bacilli. The distribution of mean values of CRP, ESR in different grades of ZN staining of sputum in AFB positive patients as well as controls. CRP mean value was 55.4, 40.8 & 22.9 in grade III, grade II & grade I respectively and ESR was 48.1, 38.8 & 23 respectively in different grading significantly higher (p vol < 0.0001) in group II there were no serious adverse reactions in either group. Conclusions: Our study concluded that during the compression of values of CRP and ESR along with the grading of sputum AFB positive patients, the CRP raised more significantly as compare to ESR; with markedly raised values in all the grades of sputum AFB positive patients.

Genetic Diversity of Mycobacterium tuberculosis Complex Isolated from Patients in the Northeast of Iran by MIRU-VNTR and Spoligotyping

Background: Molecular typing techniques are reliable tools for epidemiological study of tuberculosis because of their power in detecting recent transmission and differentiating reinfection and relapses. Objectives: The present study investigated epidemiological diversity among Mycobacterium tuberculosis strains circulating in three Khorasan provinces, Iran, using 12-loci MIRU-VNTR and spoligotyping. Methods: This study was performed on 140 M. tuberculosis strains selected from the sputum of new cases of pulmonary tuberculosis patients in three Khorasan provinces, Iran. 12 loci MIRU-VNTR and Spoligotyping were performed on all isolates. Results: By MIRU-VNTR analysis, 76 distinct patterns comprising 19 clusters and 57 unique patterns were identified. Based on the results, MIRU10, MIRU26, and ETRF were highly discriminative, ETRD was poorly discriminative and other loci were designated as moderately discriminative. Spoligotyping of isolates revealed 51 distinct patterns: 26 patterns containing 33 strains (23.6%) corresponding to orphan strains and 14 patterns containing 107 strains (76.4%) corresponding to shared-types in the SITVIT2 database. Totally, 103 isolates (73.6%) were classified into 14 clusters containing 2 - 56 isolates; the remaining 37 isolates (26.4%) were unique patterns. By combining two techniques, 94 distinct patterns (15 clusters) contained 61 isolates (43.6%), and 79 unique patterns were identified. The discriminatory power (HGDI) of combination of two techniques was 0.962, which was higher than that of each technique alone. Based on the trees designed by Bionumerics software, we differentiated isolates with similar genetic patterns and grouped them together. Two great clusters were Haarlem and CAS lineage. All strains with combined drug resistance related to Beijing strains. Also, all mono drug-resistant strains related to Haarlem family; other strains were susceptible to the first-line anti-tuberculosis drugs. Also, homoplasy was observed in a number of patterns. Conclusions: In MIRU-VNTR typing method, according to the genotype of each area, the loci with high discriminatory power (such as miru10, miru26, and ETRF in Iran) are recommended to be used and the loci with poor discrimination (such as ETRD in Iran) are not.

Effect of hospital follow-up nursing on disease control and life quality of pulmonary tuberculosis patients

Objective To explore the application effect of hospital follow- up nursing of pulmonary tuberculosis patients. Methods A total of 100 cases of pulmonary tuberculosis patients were randomly divided into the observation group and the control group, the control group was only given guidance in hospital, the observation group was given followed- up nursing based on the control group, two groups were compared with compliance, disease control and quality life. Results After 3 months, the compliance of medication, diet, exercise, regular inspection in the observation were higher than those in the control group, the sputum negative conversion rate was higher than that in the control group, chest CT changes was better than that in the control group, with statistically significant(P<0.05). Life quality in the aspect of role limitations, bodily pain, general health, vitality in the observation group were higher than those in the control group, with statistically significant(P< 0.05). Conclusions Hospital follow- up nursing can improve the compliance behavior of pulmonary tuberculosis patients. It is conducive to the control the disease and improves the life quality of patients. Key words: Hospital follow-up nursing; Pulmonary tuberculosis; Disease control; Life quality