ABSTRACT
Latent tuberculous infection [LTBI] lacks a solid gold standard in its diagnosis and many clinicians rely upon tuberculin testing, however there has been an increasing interest in depending on Interferon Gamma Release Assays especially Quantiferon-Gold [QFT-G]. Since chronic renal failure [CRF] poses an important health problem in Egypt and taking into consideration the immuno compromisation caused by this condition, LTBI detection emerged as an important health concern in those patients. In this study, the aim was to find which tool was better in the detection of LTBI in CRF patients. Forty patients with chronic renal failure and on hemodialysis, with exclusion of active tuberculosis and other immuno compromisation conditions were tested for LTBI by tuberculin skin test [TST] and QFT-G. 25% of the tested showed LTBI. It was found that although both tests gave comparable results, yet there was a discrepancy between both. TST + /QFT + group was 10%, TST + /QFT- group was 5%, TST-/QFT+ was 10% and TST-/QFT- group was 75%.In Chronic renal failure and probably any immuno compromisation setting, it would be better to perform both tuberculin and Quantiferon tests to detect latent tuberculous infection
Subject(s)
Humans , Male , Female , Kidney Failure, Chronic , Comparative StudyABSTRACT
The aim of this study is to investigate the efficacy of nebulized magnesium sulphate as a bronchodilator in acute asthma as compared to nebulized salbutamol. This was a randomized controlled study conducted in El-Giza Chest Hospital Emergency Department between January 2010 and June 2011. Randomization was achieved by closed envelope technique. This study involved 48 known bronchial asthma patients presenting with acute or subacute exacerbations. Patients were divided into Control group [A] and Study group [B]. Initial assessment of all patients included history, clinical examination [auscultation, respiratory rate [RR], heart rate [HR] and working of accessory muscles]. In addition to measurement of peak expiratory flow rate [PEFR] and oxygen saturation [SO2]. Patients received standard treatment for their acute attacks in the form of Sodium hydrocortisone hemisuccinate 100 mg every 6 hours, Supplemental oxygen and nebulized bronchodilator which was salbutamol in group [A] in the form of 4 doses of nebulized solution 0.5 gm% [each dose 1 ml containing 5 mg salbutamol] twenty minutes apart and Magnesium sulphate in group [B] in the form of 4 doses of nebulized solution 10 gm% [each dose 1 ml containing 100 mg magnesium sulphate] twenty minutes apart. Reassessment of the patients was performed after 2 hours to detect improvement. The percent change in PEFR in Group A was significantly higher than that in Group B [58.90% and 13.92% respectively, p value 0.00]. There was a statistically significant reduction in the final mean HR in Group B compared to Group A [85 bpm and 96.1 bpm respectively, p value 0.011]. There was a significant reduction in mean final RR in Group A compared to Group B [22.17 bpm. and 25 bpm respectively, p value 0.002].There was a significant increase in oxygen saturation [SO2] in both groups. The use of MgSO4 by nebulization in patients with acute asthma attacks results in improvement of clinical condition, increase in peak expiratory flow rate [PEFR], reduction in heart rate [HR], reduction in respiratory rate [RR] and improvement in oxygen saturation [SO2]. The increase in PEFR [bronchodilatory effect] was significantly less than that achieved in patients receiving the usual treatment with Short acting beta 2 agonists, e.g. salbutamol, when either agents were used alone