Résumé
Background: Tuberculosis is the most common cause of secondary spontaneous pneumothorax (SSP) in India. The prevalence of SSP in patients with pulmonary tuberculosis (PTB) is between 1- 3%. There were only few studies in the literature that specifically analyze tuberculous PNTX. In a study from this hospital, author found PTB was the most common cause of SSP. Now, author aimed at studying the clinical profile of tuberculosis associated PNTX cases and compared with pulmonary tuberculosis cases without PNTX.Methods: This was a single centre prospective observational case control study done at a tertiary care hospital. Fifty patients of tuberculous pneumothorax as cases, and 100 patients of pulmonary tuberculosis without pneumothorax were taken as control. The demographic data, clinical presentation, and radiologic presentation, outcomes after treatment were recorded in both the groups. The data was analyzed using statistical software (SPSS) using appropriate statistical tools.Results: The mean age of patients in the PNTX group was 38.18±14.132, where as in the control group it was 45.29±14.89 (p-value of 0.0052). Past history of tuberculosis was present in 27 (54%) cases of PNTX group and in 41 (41%) cases in the control group (p-value of 0.091). The mean duration of length of hospital stay in PNTX group was 16.5±11.865 days and in non-pneumothorax group was 6.2±2.54 days (p-value was 0.0001).Conclusions: Tuberculous pneumothorax was more common between 30-40 yrs age group. Gender and smoking have no association with PNTX. Tuberculous pneumothorax was more common in previously treated cases of TB. Patients with tuberculous PNTX have prolonged hospital stay and complications resulting in increased morbidity, financial burden and mortality.
Résumé
Aims: Procalcitonin, the prohormone precursor of calcitonin rises in serum response to bacterial infections. Circulating PCT levels decrease when the infection is controlled by the host immune system or antibiotic therapy. The present study was conducted to measure the diagnostic and prognostic utility of procalcitonin in tuberculosis. Methodology: The study group consisted of forty patients with pulmonary tuberculosis (PTB) and forty normal controls (NC). Blood was collected from NC and PTB (labeled as PTB-0). Patients underwent the 4-drug chemotherapy for 2 months following which blood was collected again (labeled as PTB-2). They were continued into the next 4 months of the 2-drug regimen. Blood was collected thereafter and labeled as PTB-6. All blood samples were semiquantitatively analyzed for procalcitonin. Results: Serum PCT was < 0.5 ng/ml in thirty seven out of forty normal controls and > 2 ng/ml in three. The prohormone level was > 2ng/ml in fifteen and > 10 ng/ml in the rest of the PTB-0 subjects, thus indicating that PCT levels served as a useful marker of infection in PTB patients at diagnosis. After 2 months of intensive treatment the number of patients with PCT levels > 10 ng/ml increased to thirty two in PTB-2. Only 8 patients recorded plasma PCT levels > 2 ng/ml. At the end of 6 months of treatment, PCT values in all patients had decreased to < 2 ng/ml. Conclusion: Serum PCT seemed to show diagnostic and prognostic utility at the end of treatment however, PCT is not specific for tuberculosis alone and may be raised in other lung infections. Future studies with quantitative analysis of PCT in tuberculosis in comparison to other lung infections are needed for better understanding of the role of PCT in PTB.
Résumé
Neonatal Lupus Erythematosus (NLE) is an uncommon condition manifesting with congenital complete heart block and occasionally other manifestations like hepatitis. Neonatal Lupus with severe cholestasis with positive anti SS-A/Ro and anti SS-B/La antinuclear antibodies in the mother and child is being reported.