Prevalence of tuberculosis in Faridabad district, Haryana State, India.

Background & objectives: Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of bacillary tuberculosis in the district of Faridabad in Haryana State of India among persons aged older than 15 years. Methods: In this cross-sectional study, residents of Faridabad district were assessed for the prevalence of tuberculosis. Twelve rural and 24 urban clusters with estimated populations of 41,106 and 64,827 individuals were selected for the study. Two sputum samples were collected from individuals found eligible for inclusion. The samples were also cultured by modified Petroff’s method and were examined for growth of Mycobacterium tuberculosis once a week for eight weeks. A person found positive by smear and/or culture was identified as sputum-positive pulmonary TB positive. Results: A total of 105,202 subjects were enumerated in various clusters of the Faridabad district. There were 50,057 (47.58%) females and 55,145 (52.42%) males. Of these 98,599 (93.7%) were examined by the study group (47,976 females; 50,623 males). The overall prevalence of sputum smear or culture positive pulmonary tuberculosis in our study was found to be 101.4 per 100,000 population. Interpretation & conclusions: The present results showed that the prevalence of sputum positive pulmonary tuberculosis was higher in Faridabad district than the notification rates recorded by the World Health Organization for the contemporary period, a disparity that could be explained by a difference in case detection strategy employed for the study.

Proportion of Hospitalization at a Respiratory Centre Under RNTCP.

Objective: To determine proportion of patients requiring hospitalization under RNCTP. Methodology:All area-patients registered for treatment under RNTCP at LRS Institute, New Delhi through 16 DOTS centre during the reference period (1st April 2006 to 31st Dec 2006) were listed and those patients requiring hospitalization (upto 31st Dec 2007) at LRS Institute were identified and interviewed by a single investigator using semi-structured proforma with certain inclusion and exclusion criteria’s. The data was entered into master sheet and analysis carried out using software statistical package by computing proportion (%) and chi-square test. Results: It was observed that there were 2,345 patients registered for treatment under RNTCP during the reference period, out of which, 4.22% (99) required hospitalization. The males outnumbered females in absolute numbers, however, gender related hospitalization was similar, 4.08% for males to 4.47% for females (p=0.647). Maximum case load (75.75%) was seen in economically productive age group (15-49 years). The proportion of hospitalization amongst 1- 14, 15-49, 50-60 and 61 years & above age group was 2.36%, 4.10%, 5.11% and 8.60% respectively (p=0.08); category II (7.61%) patient admissions was twice than category I (3.65%) patients (p<0.001). The proportion of hospitalization was 2.37% and 5.4% amongst patients with negative and positive sputum status respectively. Conclusion: The study was undertaken at a respiratory tertiary care centre in a metro city and within the study constraints it highlights disease severity, late presentation and minimum need for TB beds under prevailing socio-economic circumstances in the country.

Comparison of diagnostic yield of AFB with sputum induction to spontaneous sputum examination in suspected pulmonary tuberculosis

To compare the diagnostic yield of AFB positivity with sputum induction to spontaneous sputum examination in suspected cases of pulmonary tuberculosis. Comparative study. Military Hospital, Rawalpindi, from January to December 2006. Sputum specimens were collected by both techniques from 164 patients with clinical and radiological suspicion of pulmonary tuberculosis admitted in medical wards. All specimens were examined for AFB smear and culture positivity. Sputum induction was done for 15-20 minutes with 3% sterile hypertonic saline solution by nebulization in all cases. Proportions were compared using Chi-square test. Among 164 patients, 32 patients [19.5%] were not expectorating spontaneously. Sputum induction was successful in 22 [68.75%] cases and AFB smear was positive in 03 [9.37%] and AFB culture was positive in 7 [21.8%] of these cases. One hundred and thirty two [80.5%] patients were already expectorating and both Day-1 [spontaneous] and Day-2 [induced] sputum samples were available. Day-1 [spontaneous] sputum specimens revealed AFB smear positive results in 20 [15.15%] patients, and AFB culture positive results in 24 [18.18%] patients. Smear positivity on Day-2 [induced] sputum samples was 21.21% [28] with 27.27% [36] culture positivity. In expectorating patients, AFB smear and culture positivity results remain comparable with spontaneous and induced sputum sampling. Sputum induction improves the diagnostic yield for AFB in patients unable to expectorate adequate sputum sample

Prevalence of infectious diseases among food and beverage handlers in an industrial setting

Food handlers play a major role in ensuring food safety throughout the chain of producing, processing, storage and preparation. Mishandling and disregard for hygiene measures on their part may result in food contamination and its attendant consequences. The objective of this study was designed to assess the health status of food handlers in an industrial setting. A descriptive, cross-sectional study was carried out on 32 food handlers operating in one of steel factories. They were interviewed and inspected using a structural questionnaire administered by researchers. Full clinical examination and investigations involved CBC, chest X-ray, sputum culture for TB, stool analysis and culture for shigella, Widal test and hepatitis A, B, C markers. The research team also arranged educational training course to improve the hygienic knowledge of food handlers This study revealed, 3.1% had a +ve HCV and a high prevalence of parasitic infestations was found in 72% with positive parasitic cysts and 12.5% with positive parasitic ova. Salmonella typhi type O carriers in the studied food handlers represented 6.3%. Regarding hepatitis, 3.2% had a positive HCV antibodies. Thirty cases [94%] had long hand nails and lack sanitary knowledge concerning food handling. This study has revealed a poor knowledge and practice of food hygiene among food handlers. It is recommended that a massive health education campaign directed at both the public and food handlers be embarked on, to reduce prevalence of food born illnesses and to enable people take necessary steps to prevent food borne diseases

Telomerase hert catalytic subunit expression in pleural effusions and sputum in lung malignancies

The aim of the present study was to investigate the diagnostic efficacy of telomerase enzyme activity for discrimination of malignant and non malignant pleural effusion and to compare the results with those of cytological examination. Pleural effusions were collected from 40 patients. 31 of them had malignancy, either primary or secondary, confirmed by histopatholological examination and the other 9 patients had non-malignant pleural effusion. Of 31 patients with malignant pleural effusion 10 sputum samples were collected to be subjected to telomerase activity, as a probable early diagnostic marker of lung cancer. 9 sputum samples were collected from control patients. Telomerase activity was determined with telomerase catalytic subunit hTERT-mRNA Gene expression assay using [QRT multiplex real-time PCR]. Telomerase activity was detected in 27/31 [87.1%] and in 2/9 [22.2%] samples from the malignant and non malignant pleural effusion groups, respectively. The X +/- SD of hTERT were significantly different between the malignant and non malignant effusion groups. In sputum samples, telomerase activity was detected in 8/10 [80%] of malignant samples. The X +/- SD of sputum hTERT were also significantly different between the malignant and non malignant groups. The sensitivity and specificity of pleural cytology were 67.8% and 100%, while, the sensitivity and specificity of telomerase activity were [87.1%] and [78%] respectively. Generally, the diagnostic values of cytology were lower than those of hTERT in pleural effusion. However, the sensitivity and specificity rates of pleural cytological examination when combined with telomerase activity were [90.3%] and [100%]. Also, the sensitivity and specificity of sputum cytological examination when combined with telomerase activity were [80%] and [100%], while the sensitivity and specificity of sputum cytology alone were 70% and 100% and those of telomerase activity alone in sputum were [80%] and [78%]. It could be concluded that telomerase activity is a highly sensitive diagnostic biomarker for malignancy and may be used as an adjunct to cytological findings in determining pleural effusion and lung malignancies

Induced sputum versus fiberoptic bronchoscopy in the diagnosis of pulmonary tuberculosis

Tuberculosis still constitutes a major health problem despite advances in diagnosis and treatment. To compare between sputum induction using nebulized hypertonic saline, and fibreoptic bronchoscopy in the diagnosis of pulmonary TB, in clinically and radiologically suspected cases. 30 patients were subjected to: 1-Tuberculin skin test. 2-Microbiological examination of: a. Three successive spontaneous morning samples, b. Sputum induction for 3 successive mornings c. Fibreoptic bronchoscopy with Bronchial washing, brushing and post-bronchoscopic sputum collection. All samples were stained with Ziehl-Neelsen stain. Induced sputum [SI] and bronchial wash were also cultured on L.J medium. The diagnostic yields of sputum induction and post-bronchoscopic sputum were similarly significant. Also, the yields of bronchial washing and bronchial brushing were similarly highly significant. The differences between all these procedures was non significant. The third SI sample was the most sensitive in the detection of AFB. There was no significant difference between SI and Bronchial washing whether by using Z-N stain or L-J culture. Sensitivity, specificity and predictive values of different methods of specimen collection in diagnosing pulmonary TB gave non-significantly different results. Sputum induction is an easy, cheap and non invasive procedure that has a significantly high diagnostic yield for clinically and radiologically suspected cases of pulmonary tuberculosis who have dry cough or whose sputum for three successive days are negative. The third SI sample is the most significant one. There is no significant difference between SI and FOB using any of its procedures

Microscopic observation of broth cultures: a rapid and efficient method for detection and drug susceptibility testing of mycobacterium in sputum of children

We tried to develop a new, efficient, rapid, reliable and inexpensive method that permits mycobacteria detection and drug susceptibility for children and adolescents with pulmonary tuberculosis. Sputum samples were cultured by using [1]. the microscopic observation broth-drug susceptibility [MODS] method; [2]. radiometric culture technique by using BACTEC system; and [3]. culture on Lowenstein Jensen medium [LJ], in addition to Ziehl-Neelsen staining of sputum. Patients underwent tuberculin skin test. The results proved that the sensitivity of the different diagnostic tests was: MODS 79.3%, BACTEC 96.5%, and culture on LJ medium 55%. Specificity was high for BACTEC, MODS, and LJ medium as none of the 18 control sputum samples were positive by any method. The mean time of detection of mycobacteria was: MODS 10.4 +/- 3.79 days, BACTEC 9.1 +/- 3.1 days, and LJ medium 38.5 +/- 10.3 days. The mean time for doing susceptibility testing was: MODS 10.7 +/- 3.86 days, BACTEC 9.6 +/- 3.1 days, and LJ medium 38.9 +/- 10.6 days. Cost per sample for detection and susceptibility respectively was: MODS 2.7 and 17.5 L.E., BACTEC 25 and 77.5 L.E. and LJ 1.7 and 12.5 L.E. For diagnosis of tuberculosis, MODS method is a rapid, cheap, easy and efficient method for detection and performing susceptibility tests in Egypt

Control de un brote epidémico de histoplasmosis mediante un estudio integral / Control of a histoplasmosis epidemic outbreak by means of a comprehensive study

Se reporta el primer brote epidémico de histoplasmosis pulmonar ocurrido en el municipio de Artemisa, provincia de La Habana. El diagnóstico fue realizado teniendo en cuenta el cuadro clínico-radiológico y los resultados de los exámenes micológicos y serológicos efectuados a los pacientes. Se confirmó la fuente de infección al aislar Histoplasma capsulatum en la cueva visitada por los pacientes. Se hace una valoración de las características del foco y las medidas de control adoptadas

Estudio del valor predictivo de los parametros microbiógicos y citopatológicos de las muestras tomadas por expectoración Vs aspiracion transtraqueal en la infección respiratoria baja de origen bacteriano: informe preliminar / Studies on the predictive values of the microbiologic and cytopathologic parameters of sputum sample vs transtracheal aspiration in the low respiratory tract infections of bacterial etiology: preliminary report

Dieciséis pacientes: 10 mujeres (62,5%) y 6 hombres (37,5%) edad promedio: 51 años (rango 16 a 86) fueron ingresados al azar y prospectivamente en un estudio preliminar para determinar el Valor Predictivo Positivo (VPP) y Negativo (VPN) de muestras obtenidas por expectoración de secreción bronquial y aspiración transtraqueal (ATT) en pacientes con infección respiratoria baja clinicamente bacteriana. Los itms explorados en relación al número y tipo de floras bacterianas coloreadas con la técnica de Gram (FG), número y tipo de colonias bacterianas aerobias (CB), presencia o no de hongos junto con la presencia de colonias crecidas, y la presencia o no de atipias celulares revelaron un VPP significativo (mayor o igual 70%) solamente cuando FG fue menor de 2 y el CB fue igual a 0. El VPN fue globalmente significativo (mayor o igual al 70%) en todos los itms estudiados; indicando que la ausencia del elemento buscando en el esputo estará también ausente en la ATT. Se discute la importancia clínica práctica que de estos hechos se derivan

Prevalence of antibodies to aspergilli in bronchial asthmatics.

Sputum and bleed samples were analysed from 330 cases of bronchial asthmatics and 50 normal persons without features of bronchial asthma. The prevalence of aspergilli and antibodies to different Aspergillus species were detected using cultural methods and serological technique like agar gel double diffusion (DD), counter-immuno-electrophoresis (CIEP) and enzyme-linked immunosorbent assay (ELISA). Out of total 6.06% yielded Aspergillus species in sputum specimens repeatedly. Precipitins against Aspergillus species were detected in 7.88% of cases by DD and CIEP. ELISA test showed 20% of cases to be having antibodies to A. fumigatus. Allergic broncho-pulmonary aspergillosis can be detected in the early course of the disease in bronchial asthmatics using highly sensitive technique like ELISA.

Newly discovered cases of pulmonary tuberculosis in Cairo during the year 1987

Then were 3633 Newly discovered Tuberculous cases attending Abbassia Chest Hospital and different chest dispensaries in Cairo during the year 1987. Incidence rate among population in Cairo was [0.06%]. Incidence in males 65.4% was higher than females [34.6%]. Highest occurance of disease was among those ranging between 12 - 35 years of age. Cough was the most frequent symptom. Positive sputum for acid fast bacilli occured in 80.2% of cases. Bronchogenic Tuberculosis had highest percentage being 74. 7%. Cases with Diabetic history were 3.8%. Tuberculin test was positive in 94.0% of cases and 13.1% had history of contact

Aspergillus species infection in respiratory diseases

This study had been carried on 100 patients with various broncho-pulmonary diseases, in addition to 40 apparently healthy controls. Direct microscopic examination of sputum and sputum culture for Aspergillus on sabouraud's dextrose agar and brain heart infusion agar were performed repeatedly. The mycological examination of sputum by direct microscopy showed that 10% of the studied cases were suggestive for pulmonary Aspergillosis. By culture, Aspergillus was isolated in 28% of cases The isolated Aspergillus species were in order of Frequency : A. niger [15%], A. fumigatus [7%], A. fumigatusus [2%] and a combination of A. niger and A. fumigatus in [4%] of the cases. It was found that males were more susceptible to Aspergillus infection than females. Thus, repeated demonstration of the same fungus in culture from successive sputum samples are in favour for the diagnosis of pulmonary A. spergillosis

Investigación de cuerpos ferruginosos en espectoración, de exposición a la inhalación de fibras de asbestos: estudio comparativo de 3 técnicas de laboratorio para su identificación / Screening for ferrouginous antibodies in seputom of individuals exposed to asbestos fibre: comparison of 3 technics

Los asbestos son silicatos con una estructura fibrosa-cristalina; al ser inhalados crónicamente causan fibrosis pulmonar (asbestosis y se les ha relacionado con la producción de cáncer, particularmente el pulmonar y el mesotelioma pleural. En el organismo forman los llamados "cuerpos ferruginosos", cuya identificación se considera un signo de gran utilidad para caracterizar la exposición a estas fibras. Se llevó a cabo un estudio para comparar la eficacia de tres técnicas de laboratorio para identificar los cuerpos ferruginosos en la espectoración de una población expuesta laboralmente (N=37) y una población testigo (n=34). Mediante la técnica de Smith y Naylor, se identificaron en 28/37 de la población expuesta (75.7%) y en 1/34 de la testigo (3%); por la técnica de Gomori en únicamente 5/37 de los expuestos (13.5%) y por la técnica de Papanicolaou en ninguno (0.0%). Esta última mostró ser útil para evidenciar cambios citológicos sugestivos de la acción mecánica o química de los asbestos y posiblemente otors contaminantes ambientales. Tales hallazgos ocurrieron en toda la población expuesta y en solo cinco individuos de la testigo lo que sugiere la acción primaria de los asbestos en su produccíon. Se conclcuye en la superioridad del método de Smith y Naylor para el estudio de la exposición a los asbestos y en la necesidad de un seguimiento estrecho de la población de alto riesgo

Estudos da estabilidade da secreçäo mucóide / Stability studies of mucus secretion

O objetivo do trabalho, é a determinaçäo de parâmetros definitórios do modelo de comportamento reológico da secreçäo mucóide das expectoraçöes, analisando as variaçöes produzidas em doentes tratadas ou näo como fármacos mucolíticos. Finalmente, é estudada a estabilidade da secreçäo mucóide frente a uma açäo de fricçäo repetitiva, definido o parâmetro de caracterizaçäo (coeficiente de perda logarítmica de viscosidade por ciclo), verificando, desta forma, sua estabilidade

Diagnostico laboratorial de legionella em amostras clinicas / The diagnosis of legionella infections

Os autores revisam as alternativas laboratoriais para o diagnostico de infecçoes por Legionella. E enfatizado o emprego de amostras clinicas acessiveis, como escarro e analisados metodos bacteriologicos e sorologicos