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Background: Due to low sensitivity and inability to detect drug resistance, smear microscopy limits its impact on TB control. Culture methods and drug susceptibility testing is complex, time consuming, and takes around 6-8 weeks. A new diagnostic test, cartridge based nucleic acid amplification test (CBNAAT) was developed based on real-time polymerase chain reaction (RT PCR). Objective of this study to compare the results of CBNAAT for diagnosis of pulmonary tuberculosis with LED fluorescent microscopy and sputum culture.Methods: A cross-sectional study was conducted in the department of Chest and TB, CIMS, Bilaspur. Each Sputum sample of presumptive TB patients were tested with CBNAAT, sputum smear microscopy by light emitting diode (LED) fluorescent microscopy (FM) and solid and liquid culture for diagnosis of Tuberculosis. Results of CBNAAT, Fluorescent Microscopy and Culture for detection of Mycobacterium Tuberculosis were compared.Results: The sensitivity and specificity for CBNAAT were 97% and 100% respectively; while that for Fluorescent microscopy were 70% and 100% respectively. The positive and negative predictive value for CBNAAT was 100% and 96% respectively. The positive and negative predictive value for Fluorescent microscopy was 100% and 73% respectively.Conclusion: CBNAAT is having high sensitivity and specificity for diagnosis of pulmonary tuberculosis. It should be routinely used under national health programme to detect a tuberculosis case efficiently.
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Background: Many of the ILDs are difficult to differentiate on clinical examination and history as they have similar clinical features. Symptom complex is not beyond that of respiratory symptoms. The objective was to study the clinical picture and spirometry pattern of the patients having interstitial lung disease.Methods: Hospital based cross sectional study was carried out among 73 cases of ILDs. Data related to history, clinical examination was recorded. Six minute walk test and spirometry was carried out. The data was analysed using proportions.Results: Incidence of Idiopathic pulmonary fibrosis (IPF) increased with age. Exertional dyspnea (100%) and cough (95.9%) were the commonest presenting symptoms amongst ILD patients. End inspiratory fine crackles (95.1%) and clubbing (67.1%) are the predominant clinical signs. Mean BMI of various ILDs patients were 24.86±8.2 Kg/m² in NSIP followed by 22.9±4.6 in sarcoidosis 21.9±6.4 and 20.8±3.94 in IPF and in Cryptogenic Organizing Pneumonias 19.34±1.8 Kg/M². Serum ACE level was raised in 69.2% patients of sarcoidosis. 81 % of patients could successfully perform 6 Minute Walk Test. Among those who could perform, average desaturation was 8.11% in sarcoidosis, 7.52% in IPF, 6.0% In Hypersensitivity Pneumonitis, 5.75% in NSIP and 4.75% in CTD associated ILDs patients. Raised C Reactive Protein label was consistent (45.2%) in ILDs, maximum in HP (63%) and 2 out of 3 patients with COP and 3 out of 5 patients of CTD associated ILDs. 17.8% cases had positive serum ANA, maximum in IPF.Conclusions: Idiopathic pulmonary fibrosis (IPF) was the commonest Interstitial Lung disease present in 39.7% of 73 cases followed by sarcoidosis in 17.9%, cases.
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Background: Since, Revised National Tuberculosis Control Programme (RNTCP) relies on sputum microscopy for diagnosis, categorization of patients and assessment of treatment, the credibility, success and sustainability of the programme depends on the lab networks. The objectives of this study were to Quality assurance of Sputum Microscopy under RNTCP in Tuberculosis Unit.Methods: A cross-sectional analytic study was conducted at DMC ML Chest hospital, DMC LLRM Hospital and DMC ESI Hospital. On-site evaluation was conducted once a month by Senior Tuberculosis Lab. Supervisor (STLS) of the DMCs (First Controller). This visit included a comprehensive assessment of laboratory safety procedure, conditions of equipment as well as technical components of AFB smear microscopy which includes prepare, staining and reading of smears. This also included examination of five positive and five negative smears in unblinded manner, to observe the quality of smear and staining as well as condition of microscope at each DMCs. A check list prepared for collection and analysis of standard data to point out remedial action.Results: The overall slide positivity rate (SPR) was 20.17% and 23.99% for ZN-stained slides and fluorescence stained slides respectively. On-site evaluation of all DMCs revealed a good result except of DMC- LLR in maintenance of microscope and well organized and clean working areas. The overall concordance for RBRC slides result of ZN-stained slides was 98.64% and overall discordance was 1.35%. The overall agreement in the re-reading of fluorescent stained slides was 100%. The overall sensitivity, specificity, positive predictive value and negative predictive value of blinded re-checked fluorescence stained slides were 100% each respectively.Conclusions: The overall performance of all DMCs is acceptable
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Purpose: To study the attitudes of nursing students towards psychiatry, psychiatrists, mental health, mental illness and mentally ill persons before exposure to training in mental hospital and to find out if there is any difference between pre training and post training attitude Study design: Prospective comparative study. Methodology: 500 GNM. nursing students and 500 Bsc nursing students were taken in the sample who were posted to IMH, Amritsar for training. Their attitude towards psychiatry was assessed by applying two scales i.e. Mental Illness: Clinicians' Attitude Scale (MICA-4) and Opening Minds Scale for Health Care Providers (OMS-HC) before and after the end of the training. Their score was compared within the group and between the groups to detect any improvement in their attitude after the training period. ANOVAand chi square tests were used for statistical analysis. Results:Considering GNM group, their mean score on MICAwas 57.85±6.37 before training but after training it reduced to 55.04±6.90. On OMSHC scale their pre-training score was 59.71±7.04 which reduced to 54.52±5.59. In both of these conditions change was statistically insignificant. Considering Bsc nursing group, their pre-training score on MICA was 55.58±7.00 and their post-training score on the same scale came out to be 46.33±5.06. On OMS-HC scale their pre-training score was 57.17±4.38 which became 55.92±2.56 after the training got over. Change came out to be statistically insignificant in both of the conditions. Conclusion: Our result suggests that the training was able to produce some positive change in some of the students' overall attitudes towards psychiatry, psychiatrists, mental health and people with mental illness. Students with previous experience with people with mental illness or having utilized mental health services themselves, were shown to be less stigmatized compared to students without any such kind of experience.
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The patients of thalassaemia major need repeated blood transfusion which leads to excess iron deposition in various organs like liver, heart, pituitary etc. This iron accumulation causes various complications and ultimately organs' failure. There is no non-invasive, standard and reliable method to know the status of iron overload in various organs of the body. This paper attempts to use magnetic resonance imaging to know the liver iron overload in 8 thalassaemic patients as a pilot study. Eight children suffering with thalassaemia and 3 controls who were the normal siblings of the patient group underwent magnetic resonance imaging of the abdomen using spin-echo T, weighted sequence. Blood serum ferritin levels in the patients' group were also determined on the same day of magnetic resonance imaging examination. It was observed that the ratio of magnetic resonance imaging signal intensity (in spin-echo T1 weighted image) in paraspinous muscle to liver was significantly different in normal control (0.65) compared to that in thalassaemia patients (2.1 to 11.4 depending upon extent of iron deposition). The magnetic resonance signal intensity ratio correlated with the blood serum ferritin level of patients (p = 0.01) which is generally taken as indirect measure of body iron burden. Spin-echo sequence is the simplest imaging sequence and it increases the chance of its routine use. The study concludes that magnetic resonance imaging has good potential to quantify the liver iron deposition non-invasively and may denote the efficacy of iron-chelation therapy which is used to reduce the body iron burden in these patients.