Management Of Pulmonary Tuberculosis Research Articles

Keterkaitan Pengaruh Iklim Terhadap Angka Kejadian Tuberkulosis Berbasis Web Gis

Management of pulmonary tuberculosis (TB) in Bogor City is still a priority in health care. The high number of TB cases in the Lawang Gintung Health Center area in the 2017-2019 period reached 126 new cases. Where the most new cases were in the Muarasari Village with a total of 52 new cases of TB. This research method uses the spatial interpolation method to determine the distribution of climate and its association with the incidence of new cases of pulmonary TB. Through the development of spatial interpolation GIS, it is known that the pattern of distribution of cases per month in the area of ??the Public Health Center in terms of the relationship between climate and the development of new cases of TB in the area of ??the Lawang Gintung public Health center. Incidence Rate in the region public Health center Lawang Gintung per month during 2017-2019 was highest in February with an IR value of 8.7 per 10,000 people/population. The increase in the IR value in each month is accompanied by an increase in the average value of rainfall (mm²), air temperature (°C), and humidity (%). Where in January the IR value was 2.2, increasing in February to 8.7 with an average rainfall value per month of January 15.4 mm² and in February it increased to 25.3 mm². Followed by increasing the value of air temperature and humidity. Correlation of climate to the incidence of new cases of pulmonary TB in the region public Health center Lawang Gintung is known that rainfall is positive with an R² value of 0.50. Air temperature is negative where R² is 0.01 and humidity is positive with R² value is 0.17.

Chest X-rays and CT Results from Tuberculosis Screening in Healthcare Workers Using Interferon- Gamma Release Assay (IGRA)

Background: To examine the prevalence of tuberculosis (TB) in healthcare workers (HCWs) with positive chest X-ray (CXR) and computed tomography (CT) findings and to ascertain the function of imaging in the diagnosis of TB. Aims & Objectives: This study’s objectives included determining the prevalence of TB based on CXR and CT findings in healthcare professionals with positive IGRA results as well as the function of imaging in the diagnosis and management of pulmonary TB. Materials and Methods: Retrospective investigations were conducted on IGRA positive people among 1976 hospital staff who had been TB-screened using the test. CXR was positive for clustered nodular and/or linear streaky opacities in the upper lung zone. The CT results were categorised. as being active, uncertain, inactive, or typical. The class was regarded as CT-positive if it was active or undetermined. Results: In 195 patients, the IGRA was positive. 190 participants (98.95%) and 90 subjects (46.87%) had CXR and CT, respectively. There were 6 of 190 and 14 of 90 patients with CXR- and CT-positive findings, respectively. 9 and 5 of the 14 CT-positive individuals had active and indeterminate TB results, respectively. All 14 CT-positive participants had negative microbiological reactions for TB. Nine CT-positive people were given empirical anti-TB drugs, and 5 of these 14 subjects tested negative for pulmonary TB on the CXR. Conclusion: CT helped diagnose asymptomatic TB in IGRA-positive HCWs.

A Descriptive Study to Assess the Knowledge and Practice of Self-care regarding Transmission, Prevention and Management of Pulmonary Tuberculosis among Staff Nurses Working at SMHS Hospital Srinagar with a view to Develop an Information Booklet

Introduction: Pulmonary tuberculosis is a highly contagious disease with a high fatality rate. The goal of this study was to analyse staff nurses’ knowledge and self-care practices related to pulmonary tuberculosis transmission, prevention, and management.Methodology: Staff nurses at SMHS Hospital in Srinagar were assessed for their knowledge and practice of self-care regarding transmission, prevention, and management of pulmonary tuberculosis using a quantitative research approach. We used a non-probability handy sampling strategy.A panel of experts validated the provided tool (structured knowledge questionnaire) and intervention (structured practise checklist). The data was analysed using descriptive and inferential statistics.Results: The study found that 53.3 percent of staff nurses had strong knowledge, with the area of signs, symptoms, and diagnosis having the most knowledge. The knowledge score and demographic variables like professional qualification and working experience, as well as the self-care practice score and demographic variables like age and professional qualification, had a significant relationship. When it came to transmission, prevention, and management of pulmonary tuberculosis, the highest number of staff nurses practised mediocre self-care. A substantial positive association was discovered between knowledge and practice scores related to pulmonary TB self-care among staff nurses.Conclusion: People can die from pulmonary TB. As a result, it is critical for staff nurses to have appropriate expertise in this field so that they can provide adequate assistance to the people

Impact of a computer system as a triage tool in the management of pulmonary tuberculosis in a HIV reference center in Brazil.

ABSTRACTBackground: The Neural Clinical Score for tuberculosis (NCS-TB) is a computer system developed to improve the triage of presumed pulmonary TB (pPTB). Methods: A study was performed with cohorts of pPTB patients cared for at a reference hospital in Northeast Brazil. Results: The NCS-TB sensitivity was 76.5% for TB diagnosis, which shortened the time from triage to smear microscopy results (3.3 to 2.5 days; p<0.001) and therapy initiation (6.7 to 4.1 days; p=0.045). Conclusions: Although the NCS-TB was not suitable as a screening tool, it was able to optimize laboratory diagnosis and shorten the time to treatment initiation.

Chest Imaging in the Diagnosis and Management of Pulmonary Tuberculosis: The Complementary Role of Thoraci Ultrasound.

Tuberculosis (TB) is a severe infectious disease that still represents a major cause of mortality and morbidity worldwide. For these reasons, clinicians and radiologists should use all the available diagnostic tools in the assessment of the disease in order to provide precise indications about starting an anti-tubercular treatment and reduce risk of TB transmission and complications especially in developing countries where the disease is still endemic. As TB mycobacteria are mainly transmitted through respiratory droplets, the pulmonary parenchyma is usually the first site of infection. As a result, chest imaging plays a central role in the diagnostic process. Thoracic ultrasound (TUS) is a portable, non-invasive, radiation-free, and cost-contained technology which could be easily available in resource-limited settings. This perspective article focuses on the potential role of TUS in the diagnosis and management of patients with pulmonary TB. Unfortunately, there are still insufficient evidence and too contrasting data to judge TUS as an appropriate diagnostic method for the screening of the disease. Despite this, TUS may have a useful role in identifying pleural and anterior pericardial effusions or in the identification of abscesses of the anterior chest wall and paraspinal collections in low- and middle-income settings. In addition, TUS seems to have a milestone role in guiding minimally invasive interventional procedures, such as placement of chest tubes, drainage of loculated collections, thoracentesis and pericardiocentesis, and percutaneous biopsy of subpleural pulmonary consolidations or pleural plaques.

Effectiveness of Intensive Health Education on Tuberculosis Awareness, Attitude and Practice on Pulmonary Tuberculosis among Patients with Pulmonary Tuberculosis

Tuberculosis is an infectious disease which spreads from one person to another which has a devastating impact on the economic well-being of the individual, their families, and the entire community. The effective engagement of all health care providers especially nursing personnel, play an important role to scale up and commensurate to their presence to achieve universal access to tuberculosis care. Majority of times, the nursing personnel were the first person to be contacted, to take care of the patients with tuberculosis. The aim of the study is to evaluate the effectiveness of intensive health education on Pulmonary tuberculosis among patients with newly diagnosed Pulmonary tuberculosis from the four primary health centres as Mettupalayam, Lawspet, Reddiarpalayam and Mudaliarpet under RNTCP (April 2017-February 2018), in Puducherry. The objectives of the study is to assess the tuberculosis awareness, attitude and practice of the subjects among the experimental and control group before and after the intervention, to evaluate the effectiveness of intensive health education and to find out the association between the pretest level of tuberculosis awareness, attitude and practice of the subjects with selected demographic variables. Pre experimental study was adopted. For the purpose of this study, a total of 126 subjects of newly diagnosed pulmonary tuberculosis were under RNTCP(October 2016 to February 2018) selected from the four primary health centres by using cluster stage sampling technique. The investigator explained the purpose of the study to the subjects. The pretest was conducted by using the interview method for all the subjects following that implementation of nursing strategies as intensive health education on health promotion and management of pulmonary tuberculosis, distribution of self-instructional module. Continuous follow up of the subjects every week till 2 months and the posttest-I was conducted by using the same questionnaire after 2 months i.e. end of the intensive phase and again posttest-II was conducted by using the same questionnaire after 6 months i.e. at the end of the continuous phase. The findings of the study as out of 126 subjects, the mean score of tuberculosis awareness score was 9.04±3.65 in the experimental group and 8.32±3.13 of them in the control group. The mean score of attitude towards tuberculosis was 28.38±4.60 and 29.72±5.05 of them in the control group. The mean level of tuberculosis awareness score in the experimental group was 9.04 during pretest and increased to 19.13 in posttest I and further increased to 21.57 in posttest II. But in the control group, the mean tuberculosis awareness score was 8.32 during the pretest and increased to 14.50 in posttest I and 14.84 in posttest II which indicated that there was an increase in the level of tuberculosis awareness score from pretest to posttest II in the experimental group which was significant at p&lt;0.001 level. The mean attitude score in the experimental group was 28.38 during the pretest and increased to 46.80 in posttest I and 57.41 in posttest II and in the control group 29.72 during the pretest and increased to 29.19 in posttest I and 32.24 in posttest II which indicated there was increase in the level of attitude score which was statistically significant at p&lt;0.001 level. The mean practice score in the experimental group was 13.97 during pretest and increased to 20.51 in posttest I and 24.51 in posttest II and in control group 13.51 during the pretest and increased to 18.69 in posttest I and 17.53 in posttest II. The mean values clearly indicated that there was an increase in the practice score which was statistically significant at p&lt;0.001 level. The increased level of Knowledge, attitude and practice score which confirmed that the intervention was much effective in the experimental group when compared to the control group. The Kruskal-Wallis test revealed that there was a significant association between the tuberculosis awareness score of the subjects with selected demographic variables such as the source of information heard about DOTS was statistically significant at p&lt;0.05 level, attitude score of the subjects with selected demographic variable as a marital status which was significant at p&lt;0.05 level than other variables and the practice score of the subjects with gender which was highly significant at p&lt;0.05 level. They concluded that the treatment outcome of the subjects under RNTCP was cured and the cure rate is 100% both in the experimental group and in the control group. Nursing strategies as intensive health education, self-care module along with anti tuberculosis drugs were found to be more effective in improving the tuberculosis awareness, attitude, practice of the subjects in the experimental group than the control group.

Effect Of Diaphragmatic Breathing And Pocketed Lip Breathing Techniques On The Management Of Breathlessness In Patients Ineffective Respiratory Pattern Disorders With Mycobacterium Tuberculosis (Pulmonary Tuberculosis)

Tuberculosis (TB) is a contagious disease caused by the bacterium Mycobacterium Tuberculosis and can spread from one person to another through the sputum droplet air transmission of the patient. Non-pharmacological management of pulmonary tuberculosis includes bed rest, semi-fowler position, comfortable environment, personal hygiene, diaphragm breathing. The purpose of this EBN is to determine the effect of diaphragmatic breathing and pocketed lip breathing on the handling of breathlessness in patients with ineffective respiratory disorders with mycobacterium tuberculosis (pulmonary TB). The implementation strategy used the techniques of literature review obtained through the online search process. The search was conducted via Google Scholar. Pursed lip breathing and diapragmatic breathing are effective in the management of breathlessness in patients with ineffective breathing patterns.

Management of pulmonary tuberculosis on the background of intestinal malabsorption syndrome

OBJECTIVE. To investigate the frequency of malabsorption in newly diagnosed sensitive pulmonary tuberculosis (TB) and to establish the effectiveness of treatment correction in these patients.&#x0D; MATERIALS AND METHODS. In the first stage of the study, 73 patients with new drug-susceptible TB underwent lactulose-mannitol test. Individuals with intestinal permeability index &lt;3 were selected and divided into main group which received injectable forms of isoniazid, rifampicin, ethambutol and oral pyrazinamide and control group which received standard treatment orally.&#x0D; RESULTS. Bacterial excretion stopped in 88.2 % of patients in the main group and in only 61.5 % of patients in the control group. In 46.1 % of cases in the control group treatment failure was diagnosed. The frequency of positive radiological dynamics at the end of the intensive phase of treatment was 64.7 % in the main group versus 30.8 % in the control group. The total efficacy of treatment at the end of the main course of chemotherapy was 88.2 % in the main group against 53.9 % in the control group (p &lt;0.05).&#x0D; CONCLUSIONS. Malabsorption, which requires correction of treatment, occurs in about one-fifth of patients with new TB. Usage of injectable anti-TB drugs in such patients increases the effectiveness of treatment by 34 % (p &lt;0.05).

Pulmonary Tuberculosis CT-Scan Features and Sputum Smear in Tertiary Referral Hospital

Introduction: Management of pulmonary tuberculosis (PTB) from primary and secondary health centers might affect the result of sputum acid-fast bacilli (AFB) smear and features of lung computed tomography scan (CT-scan) presented in tertiary hospitals. The study aims to investigate comparison between CT-scan features of PTB with sputum AFB smear in Wahidin Sudirohusodo Hospital as the top referral hospital in the Eastern part of Indonesia. Methods: This is a retrospective study of patients diagnosed as PTB by pulmonologist of nine months period. Patients with available CT-scan and sputum AFB smear results are included in the study. CT-scan features re-evaluated with RadiAnt DICOM viewer for standardized reading. The relationship between data obtained was analyzed with a chi-square test. Results: Sixty-one PTB patients were entered into the study. The three most common features found in CT were consolidation (93.4%) followed by Tree-in-bud (91.8%), and fibrosis calcification (85.2%). Relationship of CT features and sputum AFB smear was significant on cavity (p-value: 0.002) and pleural effusion (p-value: 0.020). However, unlike cavity (OR = 1.667), pleural effusion has opposite relationship (OR = 0.205) with sputum AFB smear. Conclusions: Pulmonary tuberculosis CT features seen in top referral hospitals can be very severe with consolidation and tree-in-buds as the most common features found in more than 90% of the cases. Feature of cavity may help radiologist to distinct highly active PTB with positive sputum AFB smear while presence of pleural effusion should raise the suspicion from pulmonologists to add further laboratory investigation.

Role of MMP 9 in the diagnosis and management of pulmonary tuberculosis and its association with nutritional status

Introductionand Aim: Etiopathogenesis of Pulmonary tuberculosis(PTB), is well established. Yet, the mechanisms by which a treatment regimen brings about remodelling of the pulmonary tissue during recovery phase is not well understood. The involvement of matrix metalloproteinase in this regard is debated, due to its dual role, either in disseminating the disease due to lung cavitation or reducing the inflammation due to recruitment of macrophages to the lung granulomas. PTB is a disease also driven by undernourishment.This study focuses on the association of nutritional status of PTB patients in restoring healthy lung tissue, monitored by blood levels of albumin, iron and MMP9, during the course of intensive treatment.&#x0D; Materials and Methods: Serum levels of MMP9, iron, Total protein and albumin were estimated in 30 PTB patients who visited the Directly Observed Treatment Short course (DOTS) Centre at Government Wenlock Hospital, Mangalore, Karnataka,India. Twenty controls were enrolled for comparative statistics. Samples were collected at baseline and after two months of DOTS treatment in case of patients.Pre-treatment and post treatment values were compared by paired t test.Student’s ‘t’ test was used for comparing parameters in controls and patients. Correlation between parameters was done by Pearson’s correlation test.&#x0D; &#x0D; Results: A significant increase was observed in serum iron (P=0.002) and total protein(P=0.01) levels post treatment but there was no significance in the levels of MMP9. Further, serum MMP9 correlatednegatively with body weight, BMI and serum total protein levels, post treatment, which was statistically significant. No other correlations were significant.&#x0D; Conclusion: We conclude that MMP9 neither seems to be a diagnostic marker nor a therapeutic target in the treatment of tuberculosis. Although serum iron appears to be a predictor of improved nutritional status post treatment, it probably may have a role in tissue remodelling independent of MMP-9.

Novel therapeutic evaluation biomarkers of lipid metabolism targets in uncomplicated pulmonary tuberculosis patients

Currently, the management of pulmonary tuberculosis (TB) lacks potent medications and accurate efficacy evaluation biomarkers. In view of the fact that the host lipids are the important energy source of Mycobacterium tuberculosis (Mtb), UPLC-MS/MS based on lipid metabolism was used to monitor the plasma lipid spectrum of TB patients from the initial diagnosis to cured. The analysis showed that TB patients presented aberrant metabolism of phospholipids, glycerides, and sphingolipids. Upon the treatment, the abnormal expression of Cer (d18:1/24:0), CerP (d18:1/20:3), LPE (0:0/22:0), LPA (0:0/16:0), and LPA (0:0/18:0) in TB patients were gradually normalized, indicating that the intervention of lipid metabolism could block energy metabolism and inhibit the cell wall synthesis of Mtb. Furthermore, the increase in ceramide (Cer) levels could promote autophagosome–lysosome fusion. LPA (0:0/16:0) and LPA (0:0/18:0) had a great potential in the early diagnosis (both sensitivity and specificity were 100%) and efficacy evaluation (both sensitivity and specificity were 100%) of TB, indicating that the above lipid metabolites could be used as potential biomarkers for TB.

The role of bronchoscopy in the diagnosis and management of pediatric pulmonary tuberculosis.

Bronchoscopy is useful as a diagnostic and therapeutic procedure in children with Tuberculosis (TB) disease complicated by airway obstruction. It is needed in children when surgical intervention may be required for airway compression, when drug resistance is suspected, and to rule out an alternative diagnosis for airway obstruction. Bronchoscopy with bronchoalveolar lavage (BAL) should be performed when other, less invasive samples cannot be collected, or when they fail to provide useful diagnostic information. BAL specimens collected at bronchoscopy can be tested using molecular TB assays and mycobacterial culture.The aim of this review is to evaluate the role of bronchoscopy in the diagnosis and management of pulmonary TB in children, and, specifically, to review the role of interventional bronchoscopy.A search of electronic databases was undertaken using the online databases PubMed, Ovid MEDLINE, EMBASE, Google Advanced Scholar, and Web of Science to identify relevant literature. The search was limited to pediatrics, pulmonology, bronchoscopy, and pediatric pulmonary tuberculosis for all articles published in English on pediatric bronchoscopy between 2010 and 2020. Recent advances in pediatric bronchoscopy was included, as well as recent research on improving the diagnosis with the use of interventional bronchoscopy.The role of bronchoscopy in pediatric pulmonary tuberculosis has changed during the last decade, from a simple method of collecting samples for bacteriological conformation to an more sophisticate procedure. New methods are available for collecting samples, which includes the use of Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and also better methods of bacteriological conformation. Interventions are now possible; not only to improve the diagnostic abilities of bronchoscopy but also to diagnose, manage, and follow-up upon airway-related complications. Bronchoscopy services remain limited in resource-limited countries due to the high cost of equipment.

Genexpert rapid detection of rifampicin resistance among patients with pulmonary tuberculosis

The routine conventional phenotypic bacteriological tests available for pulmonary tuberculosis (PTB) diagnosis, such as microscopy by Ziehl Neelsen staining, and Lowenstein Jensen method of solid culture, requires a long time for revealing positivity, resulting in a delayed diagnosis. After Mycobacterium tuberculosis (MTB) genome was discovered, nucleic acid amplification techniques were developed with more rapid detection and identification of rifampicin resistance in respiratory and extra-pulmonary specimens. GeneXpert is a DNA-polymerase chain reaction technique based on NAA, which allows an accurate genotypic method for a quick diagnosis of PTB diagnosis. The aim of the study was to assess retrospectively the yield of genotypic assay GeneXpert in revealing multidrug resistant TB compare to phenotypic confirmation by solid culture. 512 patients with positive and negative smears of suspected PTB were investigated by conventional phenotypic assays. PTB diagnosis assessed by positive genotypic assay and confirmed by phenotypic conventional solid culture method was 78.12%. The yield of GeneXpert in revealing rifampicin resistance was high (n=79/512; 15.43%) with 12.5% additional resistance against isoniazid revealed by positive solid cultures and drug susceptibility test. GeneXpert assay is a very useful method for rapid detection of MTB and drug resistance, which facilitates timely diagnosis and appropriate management of pulmonary tuberculosis.

Evaluation of Peripheral Blood Parameters of Pulmonary Tuberculosis Patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: Comparative Study.

Background and AimPulmonary tuberculosis is still among the leading cause of morbidity and mortality in Ethiopia. Different hematological abnormalities are commonly associated with pulmonary tuberculosis even though inconsistent results have been described. Hence, this study aimed to evaluate the hematological parameters of pulmonary tuberculosis patients visited St. Paul’s hospital millennium medical college, Addis Ababa, Ethiopia.MethodsFrom April to September 2018, a comparative cross-sectional study was conducted among pulmonary tuberculosis patients (n=40) and control patients (n=40). About 5 mL venous blood and 2–5 mL sputum samples were collected and examined by Cell Dyn 1800 hematology analyzer and cultured using Mycobacteria Growth Indicator Tube (BACTEC MGIT 960), respectively. Independent t-test was performed with the help of SPSS version 20 software, and p-value < 0.05 was considered as statistically significant difference.ResultsThe proportion of male to female in the pulmonary tuberculosis patients (PTB) and the control patients was 1.7 (25/15). Two-sample independent t-test revealed that the mean values of hemoglobin level (P=0.002), hematocrit (P=0.018), mean cell hemoglobin concentration (P=0.001) and relative lymphocyte percentage (P=0.036) of PTB were significantly lower than the control group. Moreover, significantly higher mean values were also observed in total white blood cell count (P=0.004), platelet count (P<0.001) and erythrocyte sedimentation rate (P<0.001). Among the hematologic abnormalities detected, thrombocytosis and anemia presented in 65% and 25% of PTB patients, respectively.ConclusionStatistically significant mean differences were observed in hemoglobin, hematocrit (HCT), MCHC, relative lymphocyte percentage, WBC, platelet count, relative neutrophil percentage and ESR values. So, the utilization of such data is important in providing preliminary information for diagnosis and management of pulmonary tuberculosis. In fact, a further large scale study is needed to substantiate this finding.

A study on prevalence of symptomatic not confirmed pulmonary tuberculosis under 5 to 15 years of age in protein energy malnutrition children in a tertiary care centre

Background: Tuberculosis (TB) and malnutrition are important causes of morbidity and mortality in children, in developing countries. Tuberculosis can be a cause of malnutrition in children and also a common cause of pneumonia in such malnourished children. In the present study ,our aim is to know the prevalence and early clinical diagnosis of symptomatic not confirmed TB, in recent challenging environment, in protein energy malnutrition children, this information would certainly help clinicians in early detection, diagnosis and management of PTB (Pulmonary Tuberculosis) in such populations ,to reduce morbidity and mortality.Methods: We prospectively investigated protein energy malnutrition children, with clinical features of tuberculosis, between 5 to 15 years of age , admitted during 18 months of study period. Clinical and demographic data of studied children were collected. Anthropometric (Height and Weight) measurement and physical examination were made. PEM (Protein energy malnutrition) children were classified according to Indian academy of pediatric classification. History of BCG vaccination and exposure to contact were inquired. Chest radiography was done for all children in our study.Results: A total of 150 protein energy malnutrition children, between 5 to 15 years, admitted over 18 months period were studied. Majority of children were female as compared to male and under 5 to 10 years of age. Out of these, symptomatic not confirmed pulmonary TB 93 (62%) and Extra pulmonary TB 18 (12%) and Non TB cases were 39 (26%). According to Grade of PEM, symptomatic not confirmed pulmonary TB cases under grade III were 45 (48.5%) and 35 (37.6%) were under grade II .Conclusions: Pulmonary tuberculosis may be a common cause of pneumonia in malnourished children and the cause of death in these population. So Its frequency and early clinical detection ,even without microbiological confirmation and supportive evidence and treatment guideline should be made by more further study. So that, it will help clinicians to treat these population to reduce morbidity and mortality.

Management of pulmonary tuberculosis in private health sector: is it according to revised national tuberculosis control programme guidelines?

Background: As private sector is dominant tuberculosis (TB) care provider in India, to realize the vision of TB free India, it is crucial that public and private sector follow uniform standard of TB care. This can be achieved when private health sector adopts TB management methodology of Revised National Tuberculosis Control Programme (RNTCP) of India. The present study was conducted to estimate whether or not TB management practices of allopathic private practitioners (PPs) conform to RNTCP guidelines by assessment of their knowledge and practice about new pulmonary TB (PTB).Methods: A cross-sectional study conducted using a semi-structured questionnaire among PPs practicing in urban areas of five of the six districts of Kumaon Division of Uttarakhand State of India between October 2013 to November 2014.Results: Of 71 PPs included in the study, almost 66% did not suspect pulmonary TB unless cough was associated with other symptoms. For diagnosis and follow up, sputum AFB microscopy alone was used by only 10% and 8.4% PPs respectively. Of the 71 PPs, 67 PPs who prescribed treatment for new PTB, used 20 diverse anti-TB regimens, and 10.5% of them included levofloxacin in the regimen.Conclusions: Majority PPs didn’t follow the RNTCP’s TB management guidelines for new PTB.

IP-10 and RANTES as biomarkers for pulmonary tuberculosis diagnosis and monitoring

ObjectiveWe aimed to determine whether IP-10 and RANTES plasma levels can be used in diagnosis and monitoring of pulmonary tuberculosis (PTB). MethodsPlasma levels of cytokines/chemokines were measured using a Bio-Plex® multiplex cytokine assay system in a cohort containing 457 clinically suspected PTB patients including a training set (n = 41)and two independent test sets A (n = 242) and B (n = 174). ResultsPlasma levels of IP-10 and RANTES were significantly higher in PTB patients than healthy controls' in both training and independent test sets (P < 0.05). Compared with other combinations, the combination of IP-10 and RANTES had the best performance with an AUC of 1.0 in training set. The performance characteristic of this model was successfully validated in independent test set A although this combination only resulted in a slightly improvement of AUC value in independent test set B. Plasma IP-10 and RANTES levels were weakly and positively correlated with blood glucose concentrations. Moreover, IP-10 levels were positively correlated with CRP and ESR in PTB patients. Furthermore, in response to therapy, both IP-10 and RANTES levels significantly decreased over the period of 6 months (P < 0.001). ConclusionsTaken together, combination of IP-10 and RANTES could be potentially used as diagnostic and monitoring biomarker in PTB management.

Assessment of Knowledge on management of Pulmonary Tuberculosis under RNTCP among graduating Interns and Postgraduate students in RIMS Imphal.

Assessment of Knowledge on management of Pulmonary Tuberculosis under RNTCP among graduating Interns and Postgraduate students in RIMS Imphal.

Treatment of Tuberculous Empyema by Intrathoracic Transposition of a Latissimus Dorsi Muscle Flap.

Treatment of Tuberculous Empyema by Intrathoracic Transposition of a Latissimus Dorsi Muscle Flap.

Factors affecting successful treatment outcomes in pulmonary tuberculosis: a single-center experience in Turkey, 2005-2011.

We aimed to describe the treatment outcomes in patients with bacteriologically confirmed pulmonary tuberculosis (PTB) and identify factors associated with successful treatment outcome. The medical charts of patients with smear and/or culture-positive PTB who were treated between 2005 and 2011 at the Kocaeli Tuberculosis Dispensary, Turkey, were reviewed. Patients were categorized as having a successful (cured or with a completed treatment) or poor (treatment default, treatment failure, death) treatment outcome. The association of demographic and clinical factors, including gender, age, education, occupation, insurance, family size, living area, smear and culture positivity, retreatment, comorbidity, drug resistance, and cavity on radiography, with the success of treatment, was evaluated by univariate and multivariate analyses. Of 738 patients (258 females, 480 males) with bacteriologically confirmed PTB, 683 (92.6%) had successful treatment outcomes. Of those with a poor outcome, 29 (3.9%) had treatment default, 18 (2.4%) died, and 8 (1.1%) had treatment failure. Young age, no previous treatment, no comorbidity, no drug resistance, and high education level were factors significantly associated with successful PTB treatment outcome (p < 0.05 for all). Treatment outcome was successful in young and educated PTB patients who had drug resistance, previous treatment history, and no comorbidities. Knowledge of the factors affecting treatment success will lead to the undertaking of specific measures in the management of PTB, which may help to decrease treatment failure.