BACKGROUND The Acute Rheumatic Fever (ARF) and its sequelae Rheumatic Heart Disease (RHD) continue to be a major cause of cardiac morbidity and mortality in developing countries and diagnosing ARF solely on Jones criteria could lead to under-diagnosis in developing countries. The recent AHA 2015 guidelines highlighted a subgroup of "exceptions to Jones Criteria" for patients with chorea, indolent carditis and previous history of rheumatic fever or "rheumatic heart disease." Such patients may also remain undiagnosed if not properly investigated. Although, the guidelines failed to highlight the role of echocardiography in these subgroups. It is important that suspected population be subjected to echocardiographic screening, as clinical detection of soft murmurs can sometimes be very difficult. Doppler and colour flow mapping is even more sensitive in picking up minor valvular regurgitation. Since in India ARF and RHD continue to be on rampant, we decided to investigate the role of echocardiography in diagnosis of subclinical cases of acute rheumatic fever and rheumatic heart disease in young population of India.
BACKGROUND India is the highest TB burden country in the world and patients with treated TB may remain lifelong sufferers of disabling sequelae. In cured pulmonary tuberculosis patients, many survivors develop into pulmonary sequelae that are characterized by bronchial and parenchymal structural changes, including bronchovascular distortion, bronchiectasis, emphysematous changes, and fibrotic bands. Structural changes lead to obstructive, restrictive, or mixed patterns of impaired pulmonary function. Objective-This study was designed to analyse the pattern of pulmonary function abnormalities using spirometry with cured pulmonary tuberculosis (PTB) patients.
MATERIALS AND METHODSThis was a cross sectional study conducted in a department of internal medicine & department of respiratory diseases, GSVM Medical College, Kanpur (India), from January 2017 to July 2017. The patients of old treated pulmonary tuberculosis, presented with complaint of dyspnoea, were picked up from out-patient and in-patients section of the hospital at random. These patients were further divided into group A and group B.
RESULTSSeventy-eight patients with cured pulmonary tuberculosis were enrolled during the study period. There were 53 males (67.9 %) and 25 (32 %) females. The mean age among males and females study population were 46.5 and 41.5 years respectively. The mean duration of anti-tuberculosis treatment was 12.5 months (range: 6-38 Months). Dyspnoea was associated in all the cases. Majority of the patients in both groups, belongs to MMRC grade 2 & 3. The airflow obstruction was found in 50%, followed by mixed defect (37.1 %) and restriction in 12.8 % cases.
CONCLUSIONThe present study highlighted that most common pulmonary impairments were obstruction, followed by mixed and restrictive pattern.
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