RESUMO
A review was conducted of 1566 cases of pulmonary tuberculosis admitted to Sahary Chest Hospital in Riyadh between July 1983 and August 1987. The medical records, chest rafiographs, and sputum results were studied. The 21 to 30 year age group represented 40.7% of all patients, which indicates the need for improving measures for the control of tuberculosis in young adults, whose protection may have waned despite BCG vaccination in infancy. Non-Saudi males patients constituted more than half of the admission which raises the question of the efficacy of the current pulmonary tuberculosis screening policy for individuals entering the Kingdom. The four-drug regimen of rifampicin, isoniazid, pyrazinamide, and ethambutol, when properly supervised, was very effective in achieving early sputum conversion. Based on results of this study, decentralizing tuberculosis services and attaching them to other local and general hospitals appears to be recommended.
RESUMO
In a retrospective review of 241 patients with active pulmonary tuberculosis, hypercalcemia was found in 62 (26%). It was detected on presentation in 48 patients and developed in 14 patients 4 to 6 weeks aftr the start of antituberculous therapy. The mean (+/- SD) serum calcium level in those cases was 2.78 (+/- 0.137) mmol/L. The majority of cases (67.6%) had a mild rise in the calcium level that remained below 2.8 mmol/L but 35% had a level that ranged between 2.8 and 3.0 mmol/L. Only 2.4% had serum level higher than 3.0 mmol/L, which could explain the predominant absence of hypercalcemia-related symptoms. Hypercalcemia was more common in patients older than 50 years (P<0.05), but this did not correlate with the extent of the tuberculosis shown on radiological evaluation. Spontaneous return to normocalcemia occurred in all 42 patients who underwent serial assessments of their serum calcium concentration, 6 to 8 weeks after the start of chemotherapy. Saudi Arabia is known to have a high prevalence of vitamin D deficiency, but none of our patients were immobilized or had received vitamin D supplements or multivitamins. This supports the view that vitamin D intake does not play a major role in inducing hypercalcemia in cases of active pulmonary tuberculosis, as has been suspected.
RESUMO
In a retrospective study of 1566 cases of pulmonary tuberculosis, 136 were found to have diabetes mellitus for a prevalence of 8.7%. There were 100 males and 36 females, and the average age patient age was 52 years. Saudis accounted for 94 (69%) of the cases. The prevalence of diabetes was 13% for Saudi patients as compared with 5% for non-Saudis (P < 0.005). Sputum conversion took an average of 46 days. There was a 19% prevalence of lower lung field lesions. Ninety-three (68.4%) patients were on insulin therapy, 25 (18.9%) were on oral hypoglycemics, and 18 (13.2%) were managed on diet alone. Of 104 patients who were sputum positive, 100 showed conversion after treatment with first-line antitubercular drugs. There was no statistically significant difference in the sputum conversion between diabetic and nondiabetic patients.
RESUMO
In a prospective study of 13 patients requiring pneumonectomy for unilateral post-tuberculous lung destruction the left side was found to be affected in 12. Review of a further 172 cases showed the left lung to have been destroyed in 109 (63%). It is suggested that this predominance of the left side is due to the anatomical characteristics of the left main bronchus and that disordered haemodynamics also appear to play a part.
