Isolated Unilateral Testicular Tuberculosis in a Young, Immunocompetent Patient: A Case Report.

Testicular or epididymal tuberculosis is a rare form of extrapulmonary tuberculosis. Extrapulmonary tuberculosis of any form is very difficult to diagnose by microscopy because it is usually paucibacillary. Therefore, molecular methods play a major role in the diagnosis of extrapulmonary tuberculosis. We present a rare case of unilateral testicular tuberculosis in a 23-year-old immunocompetent patient with no history of contact with a known tuberculosis case. He presented to us with swelling on his testis for one month and a discharging sinus in the left testis for 15 days, along with an intermittent fever for a week. A pus swab from the discharging sinus of the testis was sent to microbiology, where a cartridge-based nucleic acid amplification test (CBNAAT) was done, which detected Mycobacterium tuberculosis complex (MTBC), but resistance to rifampicin was not detected. A line probe assay was also done on the sample for first-line drugs, and no resistance was detected for rifampicin or isoniazid. The patient was started on first-line drugs in the intensive phase, and after the completion of two months of treatment, the patient's discharge stopped and he showed clinical improvement. Being a young patient, if he had not been diagnosed and treated as early as possible, it could have led to infertility. This again emphasizes the importance of molecular methods for the diagnosis of extrapulmonary tuberculosis.

Pilot Trial of a Social Cognitive Theory-Based Physical Activity Intervention Delivered by Nonsupervised Technology in Persons With Multiple Sclerosis.

BACKGROUND: Physical inactivity is prevalent in people with multiple sclerosis (MS) and this highlights the importance of developing behavioral interventions for increasing physical activity (PA) in MS. This pilot trial examined the efficacy of a 6-week, behavioral intervention based on social cognitive theory (SCT) delivered by newsletters and phone calls for increasing PA in persons with MS who were physically inactive and had middle levels of self-efficacy. METHODS: The sample included 68 persons with relapsing-remitting MS who were randomly assigned into intervention and control groups. The intervention group received SCT-based information by newsletters and phone calls, whereas the controls received information regarding topics such as stress management over 6 weeks. Participants completed self-report of PA and social cognitive variables. RESULTS: The intervention group had a significant increase in self-reported PA (d = 0.56, P = .02) over the 6 weeks, but the controls had a nonsignificant change (d = -0.13, P = .45). Goal setting was changed in the intervention group (d = 0.68, P ≤ .01) and identified as a significant mediator of change in self-reported PA. CONCLUSIONS: This study provides initial evidence for the benefit of a theory-based behavioral intervention for increasing PA in MS.

Social cognitive predictors of physical activity in relapsing-remitting multiple sclerosis.

BACKGROUND: Persons with relapsing-remitting multiple sclerosis (RRMS) are often sedentary, despite the benefits of the regular physical activity. This has motivated the search for variables that act as determinants of physical activity. Such variables are derived from theory and presumably represent targets of behavioral interventions for increasing physical activity. PURPOSE: This prospective, observational study examined variables from social cognitive theory as determinants of physical activity 6 weeks later in persons with RRMS. METHODS: Persons (N = 68) with RRMS initially completed a questionnaire battery that included measures of self-efficacy, physical, social, and self-evaluative outcome expectations, functional limitations as an impediment, social support as a facilitator, and goal setting for physical activity. The participants wore an accelerometer and completed a self-reported physical activity measure 6 weeks later. Data were analyzed using path analysis in Mplus 3.0. RESULTS: Self-efficacy (path coefficient = 0.19, p < 0.05), functional limitations (path coefficient = -0.33, p < 0.0001), and goal setting (path coefficient = 0.26, p < 0.01) had statistically significant direct effects on physical activity. Self-efficacy further had a statistically significant indirect effect on physical activity by way of functional limitations (path coefficient = 0.12, p < 0.05), but not by goal setting (path coefficient = 0.02, p = 0.66). This model explained 28 % of the variance in physical activity. CONCLUSIONS: This prospective study suggests that self-efficacy, functional limitations, and goal setting might represent modifiable targets of behavioral interventions for increasing physical activity among persons with RRMS.