RESUMO
Introduction: An estimated 9.9 million people fell ill with tuberculosis globally in 2020 with India and China contribu?ng a major percentage to the burden of TB. India is grouped under high TB, high HIV associated TB and MDR TB burden countries and 1.24 lakh fell ill with drug resistant TB out of which 56000 were started on second line treatment in 2020. Annually India accounts for 27% of missing TB cases. Diagnosis: The major forms of drug resistant TB that are of clinical importance are INH monoresistant TB, mul?drug resistant TB, pre- XDR TB and XDR TB.WHO approved newer molecular tests for MTB detec?on and drug suscep?bility tests. Treatment: Few newer drugs and few previously used drugs are showing promise when used in combina?on which have come up in recent years. Bedaquiline based regimens are showing improved cure rates. Conclusion: Guidelines based regimens should be strictly adhered to by both public and private TB case trea?ng physicians.
RESUMO
Background: Diagnosis of intrathoracic masses is a difficult challenge for clinicians. The compact anatomical arrangement of the medias?num with diverse pathologies is usually encountered. The present study was done to determine the efficiency of computed tomography (CT) guided Fine-Needle Aspira?on Cytology (FNAC) in the evalua?on of various thoracic mass lesions Methods : A total of n=46 pa?ents presen?ng as intrathoracic mass lesions, confirmed on contrast-enhanced CT, were included in the study. A commercially available CT (Ingenuity 128 slices, Philips) was used for biopsy. All pa?ents were subjected to detailed clinical history and physical examina?on. Inves?ga?ons: Complete blood count, Erythrocyte sedimenta?on rate, bleeding ?me, clo?ng ?me, Prothrombin ?me, Ac?vated par?al thromboplas?n ?me, HIV and HbsAg, Chest X-ray postero Anterior view, and Lateral view done in all cases. Chest X-ray AP view and Ultrasound was done wherever needed. Plain and contrast CT was done in all cases before FNAC. Results: The posi?ve diagnos?c yield in our study is noted in 45 of the 46 pa?ents(97.82%); the posi?ve yield for malignancy was 89.13% (41 of 46 pa?ents), benign in8.69 % (4/46), and undiagnosed in 1/46 (2.17%). Out of 46, 40(86.96%) were parenchymal lesions and 6(13.04%) were medias?nal lesions. Out of 40 parenchymal lesions, 38/40(95%) were malignant, which consisted of 55.3% Squamous cell carcinoma, 28.9% Adenocarcinoma. Conclusion: FNAC is useful for obtaining samples for the diagnosis of focal pulmonary infec?ons, even in immunocompromised pa?ents, and planning appropriate chemotherapy op?ons in lung cancer and metasta?c lesions.CT-guided FNAC is an ini?al approach for the diagnosis of small pulmonary nodules of less than 20mm, aiding in early diagnosis and treatment interven?ons improving prognosis.