Pulmonary tuberculosis: missed case in the routine hospital investigations of contacts

To assess hospital performance towards case finding among contacts and to find out the value of polymerase chain reaction [PCR] testing in detection of missed cases, 120 pulmonary tuberculous patients were considered index cases. Their contacts were enlisted. Hospital measures towards contacts were audited through interviews with the hospital personnel and revision of the hospital records. Eighty non tuberculous contacts as revealed by the hospital routine measures were subjected to polymerase chain reaction [PCR]. The study revealed that cases among contacts might be missed due to omitting examination of contacts other than the household ones. Also, some of the enlisted contacts might not attend due to non competence of the calling system, The hospital applied routine investigations failed in detection of some of the cases. The study revealed also that clinically suspected contacts might be managed as tuberculous cases to avoid missing cases. The study recommended enlistment of contacts other than the household ones. It recommended also direct mailing and communications with the primary health care units besides home visits to reach tuberculous contacts

Pulmonary Tuberculosis: determinants and risk factors

This study was conducted to find out the current determinants and risk factors of pulmonary tuberculosis. The study comprised 487 pulmonary tuberculosis patients and 632 non tuberculous ones as a conrrol group, All were interviewed to collect data concerning personal information, socioeconomic chairacteristics, special habits, family history of tuberculosis among close contacts, history of BCG vaccination, and history of intercurrent diseases. The study revealed that pulmonary tuberculosis continues to occur at a peak among those aged 25 -< 45 years. the age group 5-15 years is no more exempted. Contrary to what has been known, rural inhabitants, farmers and house -wives are now more experiencing pulmonary tuberculosis. Illiteracy, large family size and family disruption are sccioeconomic factors behind pulmonary tuberculosis. Smoking and addiction are also operating risk factors. Besides the well known risky occupations, coffee shop workers are new comers. Diabetes mellitus, chronic gastrointestinal diseases are still operating risk factors while bronchial asthma is argumental. BCG vaccination is not the sole preventive measure for pulmonary tuberculosis. The study recommended, routine screening of patients with diabetes mellitus, chronic gastro-intestinal diseases and bronchial asthma and campaigns for screening of house-wives, farmers and seasonal manual workers. It recommends also screening of school age children besides strengthening anti-illiteracy and anti-smoking efforts

effect of antireflux treatment on pulmonary functions and bronchial responsiveness in patients with non - allergic asthma associated with gastro - esophageal reflux

This study was conducted on 100 non allergic asthmatic patients. Upper gastrointestinal endoscopy was performed for all patients and revealed the presence of gastroesophageal reflux [GER] in 38 patients [38%]. According to the results of endoscopy, patients were classified into four groups. Group I: included 13 asthmatic patients associated with GER. They received the classic dose of antireflux medication for 12 weeks. Group II : included 13 asthmatic patients associated with GER they received double the classic dose of antireflux medication for 12 weeks. Group III : included 12 asthmatic patients associated with GER. They did not receive antireflux therapy. Group IV: included 13 asthmatic patients not associated with reflux. They received the classic dose of antireflux therapy for 12 weeks. For all the patients ventilatory function tests, bronchial responsiveness to methacholine and endoscopy were done and repeated after 3 months to evaluate the effect of antireflux therapy on them. In groups I and II, there was marked improvement in the endoscopic findings of GER after treatment. In group II all the parameters of ventilatory function tests were found to be statistically significantly higher after treatment when compared to that before treatment. In groups I and II, PD20 was significantly higher after treatment when compared to that before treatment. It could be concluded that GER is common among asthmatics. Asthma associated with GER can be improved by adequate antireflux therapy taken for at least 12 weeks