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INTRODUCTION-India is the second-most populous country in the world but unfortunately, one fourth of the global incident TB cases occur in India annually. Tuberculosis treatment need multi drug combination to eradicate tuberculosis bacteria. Inability to complete the prescribed regimen, is an important cause of treatment failure, relapse, acquired drug resistance and continuous transmission of infection. OBJECTIVES-1. To study the sociodemographic characteristics of pulmonary tuberculosis patients under RNTCP. 2. To study the factors associated with non adherence to ATT among them. MATERIALS AND METHODS-This study was a cross-sectional study, in which 93 patients of pulmonary tuberculosis who were non adherent to ATT were interviewed. Information regarding their personal and socio demographic data, treatment history and reasons for non adherence to ATT was obtained. Data was entered in Microsoft Excel and percentages were calculated. RESULTS-In our study, majority of the non adherent patients were in the age group of 30-60 years, residents of rural area (72%), illiterate (76.3%) and from lower or upper lower socioeconomic status (76.3%). Maximum patients (36.5%) stopped their ATT during 3 rd month. adverse effects of ATT (54.8 %) was the most important reason followed by feeling of early improvement (32.8 %) and then family problem (31 %), loss of work (20.4 %), and stigma related (19.3%). CONCLUSION-Various reasons given by patients as causes of non adherence, mostly reflected the influence of poor background coupled with illiteracy and ignorance.

INTRODUCTION -Lymphadenitis is the most common extrapulmonary manifestation of tuberculosis. It is important for otolaryngologists to be aware of TB in head and neck region and its various manifestations. Lymphadenopathy can progress to abscess and fistula formation, which can be disabling and socially unacceptable. ATT under dots is the main treatment while surgery is required for enlarged lymph nodes or tuberculous lymph node which does not regress with medication. OBJECTIVE -This study aims to find the role of surgical excision of lymph nodes in treatment of tuberculosis of neck lymph node. MATERIALS AND METHODS -Total 91 patients were diagnosed first time with tuberculosis of neck lymph node. All patients were started on anti tubercular treatment. Those patients who had been cured after completion of ATT cat-I, were followed up for 1 year. Surgical intervention (adjuvant to ATT cat-II ) was done in patients who were not cured after ATT cat-1, or had relapse in 1 year follow up. RESULTS -Surgical interventions were done in total 37 patients (25 treatment failure patients and 12 relapse patients). and all patients who got surgical interventions had no relapse or treatment failure during follow up. CONCLUSION-In patients who are not cured with ATT alone, early surgical intervention reduce complications such as abscess, sinus, fistula formation, or spread of disease to other parts of body. Timely surgical intervention also reduce the morbidity and increase the quality of life of patients.

BACKGROUND The clinical spectrum of SARS–CoV-2 infection encompasses asymptomatic infection, mild upper respiratory tract infection, and severe viral pneumonia with respiratory failure and even death. This study attempts to estimate the time interval between symptoms onset to severity, time taken for hospitalization, length of stay in hospital along with demographic and clinical characteristics of deceased patients infected with Covid-19. METHODS This retrospective study was conducted in SSMC associated Dedicated Covid Hospital, Rewa district, India. Covid-19 positive deaths (112) that occurred from May 2020 to January 2021 in this institute were considered for this study. Information regarding socio-demographic profile, systemic diseases / underlying medical conditions, signs and symptoms of the disease, clinical course, and investigations were collected and analysed. Time duration variables included were time from the initial symptom to breathlessness, time taken to seek treatment, delay in hospitalization, and length of stay in the hospital. RESULTS Elderly males with 2 or more comorbid conditions were found to be at higher risk of mortality. Median duration from onset of initial symptom to treatment seeking / hospitalization in DCH was 5 days. While mean duration from onset of initial symptoms to onset of breathlessness was 2 days 6 hrs. There was a delay of 3 days in hospitalization after experiencing breathlessness. 90 % patients had bilateral lung involvement at the time of admission. More than half of the patients had multiple organ involvement. Positive correlation was observed in delay in hospitalization, with syndrome severity at the time of admission and negative correlation with length of stay in hospital. CONCLUSIONS Delay in hospitalization is observed as an important factor which affects clinical course. Disease severity increases and length of stay decreases with delayed presentation at the time of admission. It should be addressed with awareness generation activities in community and self-assessment tool appropriate and suitable for implementing in general population. KEYWORDS Covid 19, Covid Infection, Mortality, Time Delay, Length of Stay (LoS)

Background: Second wave of coronavirus disease 2019 (Covid-19) pandemic has been particularly devastating in India. COVID-19 and mucormycosis (also known as black fungus) are causing comorbid conditions to worsen the extent of infection and mortality rates especially in India. Mucormycosis can involve nose, sinuses, orbit, central nervous system, lung (pulmonary), gastrointestinal tract any many other organs, but rhino orbital cerebral mucormycosis is the most common variety seen. Rapidity of dissemination of mucormycosis is an extraordinary phenomenon and a delay in the diagnosis could be fatal. Aims and Objectives: The objective of this study is to document the clinical features, radiological extent, risk factors, management,and outcome of mucormycosis. Materials and Methods: The study was retrospective observational study. Eighty-two mucormycosis patients admitted in SGMH Rewa were selected as study subjects. Data regarding clinical features, radiological extent, associated risk factors, comorbidities, management during hospital stay, and outcome of mucormycosis patients were collected on excel sheet and analyzed using appropriate statistical tests. Results: In our study, majority of the patients were unvaccinated (88%). Most common presenting complaint was nasal congestion with or without discharge in 78% patients followed by Facial swelling, visual disturbances, facial weakness, dental pain, etc. On CT or magnetic resonance imaging examination, all cases of mucormycosis had maxillary sinus (100%) involvement, followed by ethmoid (82%) and sphenoid (78%) sinuses. Diabetes mellitus was most common comorbidity seen in 52% cases. About 83% cases had history of receiving high dose steroid intravenously during management of COVID illness. Among study cases 72% patients have taken oxygen supplementation for more than 72 h, for COVID-19 pneumonia before hospitalization for mucormycosis. Therapy of Liposomal Amphotericin B and Oral Triazole (predominantly oral Posaconazole) was the most common medical treatment offered to all patients with COVID associated mucorpatient. Functional endoscopic sinus surgery was done on 93% cases followed by Modified Denker’s procedure was done in 12% cases. Conclusion: In our study, mucormycosis appears to be associated with COVID-19, diabetes, and use of corticosteroids. Full vaccination with COVID-19 vaccines, judicious use of corticosteroids in patients with COVID-19 and strict control of blood glucose level along with timely and proper management is highly recommended to reduce the incidence of fatal mucormycosis.

Background and aims: The emergence and spread of drug-resistant strains of Mycobacterium tuberculosis are greatly complicating tuberculosis (TB) control efforts in many countries. In India, in 2018, out of 2.4 million notified cases of TB, there were an estimated 66359 and 3,882 laboratory-confirmed cases of multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant TB (XDR-TB) respectively. The main objective of this study was to assess pattern of drug-resistant tuberculosis (DR-TB) and factors associated with it in Rewa district of Madhya Pradesh, India. Methods: This descriptive-analytical cross-sectional study was carried out at a tertiary care center in Rewa district from March 1, 2019, to February 29, 2020 (12 months). Taking the census method into account, all of 186 DR-TB cases registered at District Tuberculosis Centre (DTC), Rewa district, with the age of 18 years and above were included in the study. All the patients were interviewed thoroughly using a pre-tested, pre-validated, and reliable pro forma which included information regarding socio-demographic profile and history of TB. For statistical analysis, chi-square test (with/without Yate’s correction) was applied and a P value less than 0.05 was considered statistically significant. Results: In the present study, 71.6% and 28.4% of the cases were reported to be male and female, respectively. Additionally, 78.4% of the study subjects belonged to the age group of less than 45 years. Besides, rifampicin-resistant TB (RR-TB) was found to be the most prevalent type (56.4%), followed by isoniazid-resistant TB (HR-TB) (13.4%), and mixed pattern (12.4%) of DR-TB. Conclusion: DR-TB was more commonly observed in males of the economically productive age group (45 years and below), which can affect the social and economic development of individual, society, and nation.