Tuberculosis (TB) remains a global health problem. Treatment and prevention of TB has shifted from inpatient to outpatient settings. A report from the World Health Organization has emphasized educational strategy to ensure students graduate with the appropriate knowledge, skills, and attitudes essential to the effective management of TB. The objective of this study was to determine the level of knowledge, attitudes and practices among medical students. The survey was done from 2012 to 2013. Knowledge, attitudes and practices were assessed regarding tuberculosis with a questionnaire. Knowledge mean score of students was 16.13±2.06 and Attitude score was 36.08±3.76, Knowledge and attitude levels of students were moderate to high in the majority of them. Practice score of the study subjects was 22.77±4.95, 11.9% of students had poor practice level. 43% did not know that a sputum smear is the most important method used for diagnosis of TB. Two-thirds of them did not know the distance that should be kept from contagious patients. Half of them believed that the BCG vaccination has no role in the prevention of TB. This study concluded that more efforts should be made to improve the knowledge of students regarding TB transmission and the role of sputum smear in diagnosis. The importance of the BCG vaccination should be emphasized.

Objective. To evaluate risk factors which influence sputum smear conversion, outcome, and trends of conversion of sputum smear during 5 years and compare outcomes in patients with different regimens. Methods. In a retrospective cohort study, all patients with sputum smear positive tuberculosis were evaluated for comorbidities and demographic, microbiological, and therapeutic data and outcome. Smear examinations were performed at the beginning, at 2 months for CAT I, at 3 months for CAT II, at the end of second month of maintenance phase, and at the end of treatment. Results. This study enrolled 211 sputum smear positive patients, but 189 patients who completed the intensive phase of treatment were evaluated. Sputum smear of 158 patients converted at the end of intensive phase (83.6). Univariate analysis indicated that the risk of a persistent positive smear at the end of intensive phase was greater in diabetic patients ((odds 4.038, 95% CI 1.123–14.516) P = 0.033), and also a 3+bacillary load had risk of 2.933-fold ((95% CI 1.278–6.732) P = 0.011). Overall rate of unfavorable outcome was 20.9%. Factors associated with unfavorable outcome were age (P value 0.000), male gender (P value 0.027), diabetes (P value 0.000), and delayed conversion of sputum at the end of intensive phase (P value 0.000). Outcome for different regimens was not different significantly. Two specimens were isoniazid resistant. Conclusions. We suggest supervised treatment and care for diabetic patients and those with higher bacillary load. Paying attention to early diagnosis of tuberculosis in the elderly to reduce poor outcome and further measures to prevent transfer-out could improve the success rate.

Background:Congenital adrenal hyperplasia (CAH) and vanishing testes are uncommon diseases that can result from hormonal and mechanical factors. Classic CAH is determined by ambiguous genitalia and increase in amount of 17-Hydroxyprogesterone. Simultaneous occurrence of CAH and vanishing testes is a rare condition.Case:A 22-year-old boy, known case of CAH who was diagnosed as female pseudohermaphroditism due to ambiguous genitalia, was referred to Shahid Sadoughi Hospital, Yazd, Iran with colicky abdominal pain and hematuria. Ultrasonography has been performed and prostate tissue was reported. Karyotyping was done because of uncertainty in primary diagnosis, which revealed 46XY. For finding location of testes, ultrasonography and MRI were done and nothing was found in abdomen, inguinal canal or scrotum. Inhibin B serum level was measured to find out whether testis tissue was present in the body, which was <1 pg/ml and vanishing testis was confirmed.Conclusion:Early diagnosis and treatment are essential to prevent further sequels and karyotyping for all patients with CAH is recommended. Lifelong treatment with synthetic glucocorticoid replacement is necessary.

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