Tuberculosis (TB) is the commonest cause of infection-related death globally. Disseminated tuberculosis (TB) is a life-threatening disease which results from the hematogenous spread of Mycobacterium tuberculosis. Genitourinary tuberculosis (GUTB) is usually caused as a result of the hematogenous spread of the mycobacteria during the initial infection. The patient's clinical presentation may vary from asymptomatic to non-specific symptoms related to the organ involved and may also overlap with urinary tract infections caused by other pathogens hence delaying the diagnosis. Here we report one such case where the vague symptoms of the patient and absence of respiratory symptoms delayed the diagnosis of primary disseminated multi-drug resistant (MDR) tuberculosis.
Background: The current global pandemic of the coronavirus severe acute respiratory syndrome coronavirus 2 is the world’s most critical ongoing healthcare problem, with 8.2% of critically ill patients developing acute respiratory distress syndrome and requiring Intensive care unit admission. Our study aimed to correlate CT severity score of the patient at the time of diagnosis with spirometry, 6-minute walk test and breath holding time at 12 weeks after discharge, to determine the nature of residual pulmonary dysfunction and if CT severity was a predictor of poor lung function post recovery. Methods: Ambi-directional single center study conducted in Saveetha medical college Hospital, Chennai. Patients over the age of 18 with a positive COVID-19 RTPCR report and a CTSS>1 were enrolled into the study, and a sample size of 50 patients was taken after systematic random sampling. PFT, 6-minute walk test and Breath Holding Time were done at 12 weeks post discharge. Results: Mean CT severity score was: 11.48. 26% of the patients had more than 50% lung involvement on CT. There was significant negative correlation observed between FVC and Severity score (r=-0.366, p=0.009) and Breath holding and Severity score (r=-0.339, p=0.016) while there was no significant correlation between 6-minute walk test and CT Severity. Conclusions: Patients with significant lung involvement during SARS-COV-2 infection showed impaired pulmonary function test parameters in the form of a reduced FVC and breath holding time, 3 months following diagnosis. Long-term follow up and pulmonary rehabilitation is crucial to achieve respiratory recovery.
Paratracheal air cysts (PTACs) refer to small collections of air, present at the level of the thoracic inlet, adjacent to the trachea. PTACs encompass a variety of pathological entities and are usually encountered incidentally on computed tomography (CT) of the chest. Clinically, most patients remain asymptomatic; while a minority, may be associated with cough, dyspnea and hemoptysis probably as a result of pooled secretions and secondary infections. We report one such case of recurrent hemoptysis in a 30-year-old male, as a result of a right paratracheal air cyst.
Endobronchial tuberculosis (EBTB) is a special form of TB which is associated with significant morbidity and potential mortality. EBTB is the infection of tracheobronchial tree, and continues to remain challenging for clinicians to diagnose. The incidence of EBTB has been reported to be 5.8% to 30% in people with pulmonary TB. 60-year-old male, chronic smoker presented with complaints of dyspnea, cough with expectoration and sore throat for 2 weeks. General examination showed patient to have pallor and respiratory system examination showed decreased breath sounds in left infraaxillary region and bilateral crepitations. Routine blood investigations done showed decreased hemoglobin levels, elevated total leukocyte count, ESR. Sputum AFB was negative. Mantoux-15 mm in duration. Chest X-ray showed homogenous opacities over the left lower zone and elevated right diaphragm. CT thorax done showed a subsegmental peripheral soft tissue density 4.3×2.2 cm in the inferior lingula segment. Bronchoscopy showed whitish plaques over the anterior tracheal wall near carina and over left main bronchus. Endobronchial tissue growth seen occluding the lingula bronchus. Biopsy was taken and histopathology showed a granulomatous lesion, BAL Gene Xpert was positive for MTB. Patient was started on 3 tablets ATT. Clinicians need to be vigilant in patients who are AFB smear negative, with symptoms; bronchoscopy should be considered in those selected cases.
Introduction and Aim: Six Minute Walk Test (6MWT) and spirometry are commonly used tests to assess the functional status of the Chronic Obstructive Pulmonary Diseases (COPD) patients. However, many other simpler tests like Sit to Stand Test (STST) are also available. This study is done to assess the utility of STST in comparison to 6MWT to evaluate the functional status of COPD patients in our hospital. Materials and Methods: This study is a prospective and an observational study conducted on 50 COPD patients. Each patient underwent spirometry and subjected to 6MWT and STST. Quadriceps femoris muscle powers are measured for every patient before start of study. During the test, dyspnoea grade, Pulse rate, respiratory rate, saturation and blood pressure were measured. Results: In this study group mean age was 60.38±11.09 years, mean FEV1 55.24% ±16.18% and then 6MWT and STST were correlating with each other. On comparing parameters hemodynamic parameters before and after performing 6MWT and STST for 30 seconds. There is significant correlation between 6MWT and STST using Pearson’s correlation. However, there is a negative correlation between FEV1 and both 6MWT and STST. Conclusion: Sit to stand test is less time consuming, repeatable and easy to perform. STST can also determine the functional status of COPD patient similar to Spirometry and Six-minute walk test. Hence, STST can be an alternative test for Spirometry and 6MWT in COPD patients in a limited resource facility.
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