Meta Analysis: Relationship of Tuberculosis Patient Contact, Density And Ventilation Area With Tuberculosis Events

Tuberculosis is one of 10 causes of death in the world. In 2018 TB sufferers in Indonesia reached 840 thousand people, the third-highest figure in the world after India and China. The purpose of this study was to analyze the relationship between contact with tuberculosis patients, occupancy density and ventilation area with tuberculosis’ incidence. This study used meta-analysis, the articles’ sources were from Google Scholar, PubMed and DOAJ published from 2011-2020. There were 12 articles that met the conditions for contact-free variables with tuberculosis patients, 12 articles of occupancy density, and 10 articles of ventilation area variable. The results were contacting with tuberculosis patients had 5.93 times more of getting tuberculosis compared to people who had no contact with tuberculosis patients, people who lived in densely populated areas were 2.41 times more getting tuberculosis compared to people living in occupancy that is not crowded, people who live in dwellings with a non-standard ventilation area were 2.14 times more getting tuberculosis when compared to people who live in an area where the ventilation area meets the standard. The conclusion of this study is tuberculosis patient contact, occupancy density, and ventilation area with the incidence of tuberculosis have a significant relationship.

Study of extrapulmonary tuberculosis in tertiary care hospital children with reference to cartridge based nucleic acid amplification test

Background: Tuberculosis is an infectious disease cause by the mycobacterium tuberculosis which typically involve lung but can affect other site called extrapulmonary tuberculosis (EPTB). In EPTB lymph node tuberculosis is most common and most severe is tuberculous meningitis. Cartridge based nucleic acid amplification test (CBNAAT) have high sensitivity and perform both respiratory and non-respiratory specimen. The aim of this retrospective study is to find out the proportion of extra pulmonary tuberculosis in hospitalized patient and determine the association of CBNAAT in diagnosis EPTB and Rifampicin resistance.Methods: This is the retrospective observational study done at Civil Hospital Ahmedabad in between October 2017 to October 2019 among the admitted patient age 1 month to 12 year diagnosed cases of EPTB according to RNTCP guidelines. Data collection done by medical records as indoor case sheets and investigation data from laboratory department.Results: Incidence of EPTB among the hospitalized children is 1.95% and among total tuberculosis patient is 42.48%. Among 191 suspected EPTB cases 59 confirmed indicate sensitivity of 37.3% and no false positive cases indicate 100% positive predictive value. Sensitivity of CBNAAT was highest in gastric aspirate followed by CSF in present study.Conclusions: Tuberculosis is more common in male child less than 5-year-old with frequent risk factor is rural residential area, lower socioeconomic class and contact with active cases. In my study is CNS tuberculosis is most common. In my study mortality is higher among 1-to-5-year age group with co morbid condition are SAM and septicemia.

A Rare Case of Pneumoperitoneum in Pregnancy: Perforation of Tubercular ileal Ulcer

The incidence of tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of intestinal tuberculosis can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. We present a 25 year old 17 weeks primi presented with peritonitis with solitary perforation of terminal ileum with miscarriage of fetus and subsequent surgical wedge resection of ileum and ileo-ileal anastomosis. Histology revealed presence of Langerhan’s cell with caseating granulomatous inflammation. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and responded well. This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.

Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome Manifested As Multiple Central Nervous System Granulomas In Non-HIV Patient: A Case Report

Background: In addition to developed in HIV patient during highly active antiretroviral therapy, immune reconstitution inflammatory syndrome (IRIS) has also been well recognized in non-HIV immunocompromised patients induced by latent viruses, untreated microorganisms, or treating microorganisms. Mycobacteria tuberculosis is one of the most common pathogens inducing IRIS.Case presentation: Here, we report a tuberculosis patient progressed with IRIS that additional central nervous system (CNS) granuloma occurred during the anti-tuberculosis treatment (ATT) process with her pulmonary symptoms improved after quadruple anti-tuberculosis. This case highlights the need to increase the awareness of IRIS in non-HIV immunocompromised patients.Conclusions: TB-IRIS must be considered when the condition deteriorates or development of new lesions at distant sites in the course of ATT. Early identification and diagnosis help to handle timely and correctly.

Rifampicin-Induced Nephrotoxicity in a Tuberculosis Patient: Treatment Dilemma?

Acute kidney injury related to rifampin is usually a clinical diagnosis. We report a case of a man being treated for pulmonary tuberculosis with acute tubulointerstitial nephritis related to rifampicin.

Cavities Herald Persistent Sputum Positivity

Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

Tubercular Mastitis in an Elderly Female: A Rare Entity

Introduction: Tuberculosis of the breast is a rare entity, especially in elderly females. Moreover, the disease is overlooked and misdiagnosed as malignancy or pyogenic abscess. Here we report a case of an elderly female who presented with a lump in her left breast which resembled malignancy. Fine needle aspiration cytology followed by histopathological examination confirmed the diagnosis of breast tuberculosis. Patient underwent excision of the lump followed by six months of anti tubercular therapy to which she responded well. Key words: breast; mastitis; tuberculosis