AN ASSESSMENT OF PLEUROPULMONARY POST-TUBERCULOSIS PATIENTS IN A TEACHING HOSPITAL IN EAST INDIA (original) (raw)
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Pleural Tuberculosis and its Treatment Outcomes
Tropical Journal of Pharmaceutical Research, 2013
Purpose: To evaluate the incidence, treatment and clinical outcomes of tuberculosis pleuritis at a hospital in the state of Penang, Malaysia. Methods: A retrospective study was conducted in Hospital of Penang, Malaysia. Patient records were reviewed retrospectively to identify patients with confirmed diagnosis of tuberculous pleuritis from January 2006 to December 2008. Chest x-ray (CXR) and pleural biopsy were carried out on all patients. Directly observed therapy (DOT) was given to all patients. Data were analyzed using SPSS version 16. Results: Of 1548 tuberculosis cases, 80 (5.2 %) patients had tuberculous pleuritis. The mean age of the patients was 35.4 ± 12.87 years, with a male to female ratio of 3.4:1. Ethnically, a plurality (n = 30, 37.7 %) of cases among tuberculosis pleuritis patients were Chinese, followed by Malay (31.2 %). Out of the 80 patients with tuberculous pleuritis, 10 (12.5 %) also had diabetes mellitus, and 8 (10.0 %) HIV/AIDS. Fever, cough, chest pain and shortness of breathing were the most frequently reported symptoms. Treatment success rate was 1.558 times higher among TB group than pleuritis TB group (Odds ratio, 95 % CI, p = 0.025). Conclusion: The incidence of TB pleuritis was gender-and race-related, with DM and HIV the most commonly reported risk factors. Treatment success rate was higher among pulmonary TB group than in those with TB pleuritis (extra pulmonary TB).
Evaluation of Pulmonary Status of Post-Tuberculosis Patients with Spirometry and Chest X-Ray
International Journal of Experimental Research and Review, 2024
In 2022, 7.5 million new cases of tuberculosis were reported worldwide. Mycobacterium tuberculosis results in tuberculosis, an infectious disease mostly affecting the lungs. However, many completely treated post-tubercular patients experience persistent changes in lung anatomy (bronchial and parenchymal structure), Increasing their risk of lung complications and early death. These changes affect the airway's size, leading to higher resistance and decreased airflow. Our study aimed to assess the overall clinical status and lung function of treated post tuberculosis patients using spirometry. The study constituted patients over the age of 18 who presented to the Outpatient department of the Pulmonary Medicine Department, Chettinad Hospital and research institute, Kelambakkam, after receiving complete treatment and being certified cured. Convenience sampling technique was used, 87 patients participated in this trial. The Institutional Ethical Committee approved the study, which lasted 18 months. A proforma was used to collect a complete socio-demographic history and clinical history, particularly in terms of pulmonary symptomatology, and information about previous anti-tb treatment. Each of these patients had chest radiography, smear microscopy, and lung function testing. Mean age was 44.1± 15.2 years, mean BMI was 22.27 ± 3.66 kg/m2. There were 66.2% men and 33.8% females. 42% employed and 52% literate. In the current study, 41(53.25%) of the individuals reported dyspnea and 22(28.57%) had dry cough, cough with expectoration 12(15.58%), Fever 8(10.4%), Haemoptysis 7(9%), chest pain 2(2.6%). Following Post tuberculosis treatment, 38(44%) had normal chest radiographs, 31(35.6%) of the patients had fibrosis/Fibrotic strand, 8(9.1%) had consolidation, 5(5.7%) had ectatic changes, 3(3.4%) had fibrocavity, 1(1%) had calcification and cicatricial collapse. In the current study, we found that 31(40.25%) had normal spirometry followed by 23(29.87%) had mixed pattern and 12(15.6%) had restrictive pattern findings, 11(14.28%) had obstructive pattern findings. In spite of appropriate suggestions, the majority of post-tb pulmonary impairment individuals suffer in quiet or undergo poor medical care. As a result, comprehensive recommendations for patient follow-up following tuberculosis treatment are required in order to monitor lung function and provide appropriate care to improve quality of life.
The profile of pleural tuberculosis patients in Turkey
Medicine Science | International Medical Journal, 2012
Tuberculosis is the leading cause of exudative pleural effusion. The present study was designed to evaluate the patient profile in a 3-year cohort of pleural tuberculosis patients. A total of 174 patients with pleural tuberculosis (mean age was 36.1 years, 64.9% were male) followed up in our clinic from 2004 to 2007 were included in this study. Data on diagnostic methods, pleural fluid findings and clinical features of patients were recorded based on retrospective evaluation of the medical records. Diagnostic thorasynthesis was performed in patients with pleural effusion. Concomitant analysis of pleural fluid and blood biochemistry (glucose, LDH, protein levels), ADA values and cytology of pleural fluid were performed. Tuberculosis patients were categorized and treated in accordance with WHO guidelines. Patients were invited to attend monthly visits for the cohort analysis after discharge. The frequency of patients below and above 35 years of age was 51.1 and 48.9%, respectively. Parenchymal lesion was evident in 22.4% of patients while pleural fluid was detected in 50.6% of patients within right hemithorax and in 47.1% within the left hemithorax. Lymphocytic fluid was detected in 98%. Mean level for ADA in the pleural fluid was 76.9 U/L. Pleural biopsy revealed granulomatous infection in 53.8% and chronic pleuritis in 46.2% of patients. There was a significant relation of age over 35 years to presence of chronic infection in pleural biopsy (OR: 3.11) and co-morbid disorder (OR: 23.53). Pleural biopsy was performed in 38.2% of patients who were younger than 35 years while in 51.7% of patients who were older than 35 years. The frequency of granulomatous infection diagnosis was significantly higher in patients younger than 35 years when compared to older patients (54.8% vs. 45.2 %; p=0.02). In our study including homogenous distribution of patients in terms of being younger and older than 35 years of age, pleural biopsy was performed more commonly in older patient in order to eliminate possible underlying malignancy. However the diagnostic power of pleural biopsy was determined to be poor. Accordingly, after elimination of other causes of the exudate development, initiation of tuberculosis treatment based on ADA and cell count results seems reasonable.
Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases
European Respiratory Journal, 1996
The aim of the present study was to investigate the epidemiological, clinical, laboratory and radiological features of patients with active pulmonary tuberculosis (TB) (with or without pleural involvement) or with pleural TB (in the absence of radiological parenchymal disease). A systematic predetermined form, including 60 items regarding the above-mentioned features, was completed for 5,480 patients. Sputum smear and culture data, radiological findings, and additional extrapulmonary involvement were evaluated in the patients with pulmonary TB (n=5,094). Epidemiological features, and other clinical and laboratory characteristics were investigated in all patients (n=5,480). TB was more common among persons aged 20-39 yrs, males, and those living in large urban centres in our region. There were 4,268 newly detected patients (78%), and 1,212 active ex-patients (22%) who had history of previous antituberculosis treatment. Additional extrapulmonary involvement was found in 455 patients (9%). Sputum samples were smear-positive in 3,916 (79%), and culture-positive in 3,748 cases (76%). Most common radiological patterns were parenchymal infiltrate in 5,017 (99%), and cavitation in 3,363 (66%). Unusual radiological patterns were also noted, i.e. lower lung field TB (LLFTB) in 317 cases (6.2%), pneumothorax in 78 cases (1.5%), and miliary pattern in 66 cases (1.3%). In conclusion, because of the more frequent occurrence in the younger age group, it is considered that the prevalence of disease is still high and that the transmission of tubercle bacilli is not decreasing in our region. The highest risk group consisted of male subjects and those living in urban centres. The high percentage of active ex-patients suggests that new control programmes for tuberculosis are required in Turkey.
Assessment of Symptomatic Post Tuberculosis Patients by Spirometry and Chest X Ray
International Journal of Contemporary Medical Research [IJCMR]
Introduction: TB is an infectious disease caused by the bacillus Mycobacterium tuberculosis which typically affects the lungs. The disease is spread by the people who are sick with active pulmonary TB. Up to half of TB survivors have some form of persistent pulmonary symptom despite microbiologic cure. The aim of the study was to assess the symptomatic post tuberculosis patients by using spirometry and chest x ray. Material and methods: The study was conducted in the Department of Respiratory Medicine, Rohilkhand Medical College and Hospital after seeking clearance from the Institutional Ethical Committee. The aim of the study was to assess the symptomatic post tuberculosis patients by using spirometry and chest x ray. The study duration was from 1 st November 2018 to 31 st October 2019 and 100 patients were enrolled in the study. Data was collected from patients who presented with symptoms within 6 months of completing their treatment for tuberculosis. Results: All the patients (post tubercular) enrolled in the study had symptoms (in some form) even after full course of antitubercular treatment and bacteriological cure and among these breathlessness was the most common presenting symptom (96%) followed by cough (58%). Maximum patients had abnormal findings on chest examination (80%). Fibrosis followed by cavitary lesions were the most common findings on chest x ray in post tuberculosis patients. Maximum patients had restriction (56%) in their spirometry followed by mixed pattern (23%). Conclusion: In patients with restriction on spirometry and having symptom of breathlessness and cough, reassurance and pulmonary rehabilitation may play a major role in relieving their symptoms whereas in patients with mixed or obstructive pattern on spirometry, bronchodilator therapy along with pulmonary rehabilitation may be helpful in relieving their symptoms post tuberculosis treatment.
Yield of Sputum Induction in the Diagnosis of Pleural Tuberculosis
American Journal of Respiratory and Critical Care Medicine, 2003
We prospectively evaluated the diagnostic yield of acid-fast bacilli We prospectively conducted this study to evaluate the smear and culture for Mycobacterium tuberculosis using sputum indiagnostic yield of acid-fast bacilli (AFB) smear and culture duction (SI) in the workup of patients with suspected pleural tuberfor M.tb in induced sputum in the workup of patients with culosis (TB) who were unable to produce sputum spontaneously. pleural TB in Rio de Janeiro, Brazil. Of the 113 patients studied, a final diagnosis of pleural TB was made in 84 patients (71 HIV seronegative) and a final diagnosis of METHODS another disease in 29 patients. Histopathologic examination of the pleural biopsy tissue had the highest diagnostic yield (78%; 66/ Patient Selection 84). The bacteriologic yield was 62% (52/84) for the pleural tissue, This study prospectively evaluated patients aged 18 years and older 12% (10/84) for pleural fluid, and 52% (44/84) for sputum cultures with clinical and radiographic findings consistent with pleural effusion obtained by SI. The yield of SI culture for M. tuberculosis was 55% due to TB. All patients were evaluated between January 1, 1998 and (35/64) in patients with a normal radiograph (except for the pleural April 31, 1999 and were referred from Rio de Janeiro outpatient clinics effusion) and 45% (9/20) in those with evidence of parenchymal in the 3-1 Planning Area or from the Ambulatory Service of the Hospidisease suggestive of pulmonary TB (p ϭ 0.6). The yield of sputum tal Universitá rio Clementino Fraga Filho (HUCFF). Patients were not cultures obtained by SI is high in patients suspected of having eligible if they had clinical and/or radiographic evidence of renal, carpleural TB even in those cases with no pulmonary parenchymal diac, or liver failure; lung cancer; pregnancy; or had a Karnofsky Performance Status score less than 50%. In addition, patients were excluded abnormalities on the chest radiograph. if, during the three months before enrollment, they had hemoptysis or Keywords: tuberculosis; induced sputum; diagnosis; pleural effusion had received antituberculosis therapy or anticoagulant therapy for more than 1 week. Informed written consent was obtained from all partici
Does pleural tuberculosis disease pattern differ among developed and developing countries
Respiratory Medicine, 2005
Background: A number of reports from developed countries have documented a rising age at which pleural tuberculosis occurs and increase in the frequency of reactivation disease being as the main cause of pleural involvement. Objective: To determine the age at which pleural tuberculosis occurs, study its clinical pattern, and to determine whether pleural tuberculosis is a result of reactivation of pulmonary tuberculosis or it is a primary one comparing our findings with results from developed countries. Method: Retrospective study of 100 cases discharged from Hamad General Hospital with the diagnosis of pleural tuberculosis from January 1996 to December 2002. Results: Pleural tuberculosis tends to affect younger age groups (84% are below the age of 45 years, with mean age of 31.5). The disease tends to be mostly a primary infection. Fever is the most common symptom (90%) and the disease is usually an acute or sub acute one. Weight loss precedes other symptoms. Exudative pleural effusion with predominant lymphocytosis is characteristic. Majority of patients have no predisposing conditions for the disease. Conclusion: In contrast to what has been reported in some developed countries, Pleural tuberculosis tends to be a primary disease in the present study. Younger age groups are particularly affected.
JPMER, 2013
Background: Chemotherapy is a risk factor for occurrence of infections. Tuberculosis is a common infection in high prevalence countries. Data on incidence of tuberculosis following lung cancer chemotherapy is limited. The current study was conducted to assess the spectrum and clinical profile of pleuro-pulmonary tuberculosis following lung cancer chemotherapy at a tertiary care institute in North India.