ABSTRACT
Background: Multi-drug resistant tuberculosis has become major public health problem and obstacle to effective control of tuberculosis. Objectives was to study the socio-demographic profile of multi- drug resistant tuberculosis patients and its association with severity of ADR (adverse drug reactions) in DOTS plus centre at tertiary hospital in Himachal Pradesh.Methods: It was a prospective observational study carried out from November 2012 to October 2013 on multi-drug resistant tuberculosis (MDR-TB) patients after approved from Institutional Ethics Committee.Results: Out of 104 patients the mean age of patients was 39.9 ±14.26 years. Majority of the patients were in the economically productive age groups. Multi-drug resistant tuberculosis was more in male (76%) than female (24%) and 96% of patients were belonged to rural area. The educational status of the MDR-TB shows 24% patients were illiterate. 63.46% MDR-TB patients were underweight (BMI<18.5%) according to WHO guidelines for obesity. Severity of ADR assessed by Hart wig and Siegel’s scale showed 21% patients experienced mild ADRs, 49% patients had moderate and 17% patients had severe ADRs. Severity of ADR is seen more in male, economically productive age group, subjects on vegetarian diet, patients who were underweight (BMI<18.5%) and with lower educational status.Conclusions: MDR-TB is a rapidly increasing health problem with major socio-economic and individual consequences. Multi-drug resistant tuberculosis mainly affects middle age that is in the economically productive age group which hampers the social and economic development of individual, society and nation.
ABSTRACT
BACKGROUND: Lung cancer is one of the most common malignancies with high morbidity and mortality. Nonsmall cell lung cancer (NSCLC) accounts for majority of cases. AIMS: This study aims to study the clinical and pathological features of lung cancer patients treated at our institute between January 2011 and December 2016. SUBJECTS AND METHODS: It is a retrospective study. 446 patients of lung cancer were retrospectively analyzed for demographic data, history of smoking, histological type, and presence of epidermal growth factor receptor (EGFR) mutation/anaplastic lymphoma kinase (ALK) mutations. RESULTS: Of the 446 patients analyzed, 304 (68%) were males and 142 (32%) were females, with the ratio being 2:1. Most of our patients had a lesion localizing to the right side (45.7%) than left (37.8%). NSCLC was reported in 81.1% of our patients. EGFR mutation was found in 60 (24%) patients, the most common mutation being the deletion of exon 19 (73%) followed by L858R mutation (21.6%). CONCLUSIONS: EGFR and ALK mutation testing of all the lung cancer patients is to be encouraged as these mutations form druggable targets.
ABSTRACT
Background: As other microvascular complications, respiratory involvement is far less studied among patients with type-2 Diabetes Mellitus (DM). Objective: to study the extent of pulmonary function limitation among patients with type-2 DM. Methods: Hospital based matched case-control study. Results: Total of 90 cases and 90 controls matched for age, sex, height and weight were recruited. Patients with DM had neuropathy [63.3% (57; male=27: Female: 30)], retinopathy [44.4% (40; male=22: Female: 18)], nephropathy [41.1% (37; male=17: Female: 20)] and microalbuminuria [14.4% (13; male=5: Female: 8)]. All cases and 88 controls observed with FEV1:FVC ratio of >70.0%, further assessment for delineation of normal and restrictive pattern patients with high level of predicted values of FEV1 as compare to FVC showed that significantly (P = 0.00) more (Cases: 76.6%; Controls: 42.2%) cases had FEV1 >FVC predicted levels as compare to controls, means among diabetics odds of restrictive pattern of lung abnormality is four times (OR: 4.4; CI: 2.3-8.5) more as compare to non-diabetics. In addition a long duration of DM was significantly (r: 0.39; P = 0.00) positively correlated with lung dysfunction. Conclusion: Patients with type 2 DM patients as compare to its controls observed with restrictive pattern of lung dysfunction.
ABSTRACT
Summary: A 42-year-old female presented with a history of receiving PPD on right forearm intradermally before two days. Patient started having itching and irritation within a few hours and pain, oedema and vesicles formation by next day at the injection site. On examination, the whole right forearm was oedematous with induration of size 50mm x 50mm around the site of injection. Tubercular infection was suspected and the patient was subjected to further investigation but nothing, including physical examination, hemogram, fundus examination, chest X-ray, USG abdomen and CT thorax, was found suggestive of tuberculosis, leading to a diagnosis of LTBI.