Background Tuberculosis (TB) is one of the most common infectious diseases and is commonly associated with comorbidities. However, data regarding TB and comorbidities are lacking from northeast India. The aim of the study is to see the clinical spectrum of TB and the frequency of comorbidities. Methods This was a prospective observational study of all hospitalized TB patients between January 2016 and June 2017 who were selected by consecutive sampling. Data were analyzed using SPSS v. 17.0 (IBM Corp., Armonk, NY), and a p-value of <0.05 was considered significant. Results Of the 173 patients selected, the mean age was 41.05±17.04 years with a male:female ratio of 4.27:1. Pulmonary TB (PTB) was found in 43.94%, extra-pulmonary TB (EPTB) in 52.02%, and disseminated TB in 4.04%. Fever (61.27%) was the most common presentation, followed by cough (54.33%) and breathlessness (32.94%). Of the 76 patients with PTB and seven with disseminated TB, making a total of 83 patients, 56 (67.4%) were sputum positive. Out of 90 patients suffering from EPTB, pleural effusion (53.33%) was the commonest type of EPTB, followed by central nervous system (CNS) tuberculosis (26.66%) and abdominal tuberculosis (8.88%). Comorbidities were present in 53.17% of the patients, of which diabetes mellitus (DM) (26.58%) and hypertension (17.34%) were the most common. Comorbid conditions were significantly higher in PTB than EPTB (51 of 83 vs. 41 of 90, p<0.05). Mean glycated hemoglobin (HbA1c) was significantly higher in PTB as compared to EPTB (8.74±2.04 vs. 7.58±0.29, p<0.05). Conclusion Comorbidities, particularly DM, were present in half of the patients, mostly in PTB than EPTB, with glycemic control being significantly poorer in PTB patients.
Background: Prevalence of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) in the haemodialysis (HD) population varies between 3.4-45% and 4.3-45.2% respectively which are substantially higher than the prevalence rates in the general population. We conducted a study to estimate the prevalence of HBV and HCV in HD population in a tertiary care centre in north east India. Methods: Prospective single centre observational study conducted in patients attending a HD unit between November 2012 and June 2015. All patients with Chronic Kidney Disease who underwent haemodialysis were included. Patients with Acute Kidney Injury were excluded. Hepatitis B surface antigen (HBsAg) and anti-HCV were tested using specific enzyme-linked immune-sorbent assay (ELISA) kits. Results: 507 patients with a male to female ratio of 1.26:1 were included. Overall mean age was 45.70±17.54 years. (Male= 43.94±17.32years; Female=47.81±17.51years).69.82% of the patients underwent once weekly dialysis. 2.17% were found to be positive for HBV while and 1.38% patients were found to be positive for HCV. HBV-HCV co-infection was seen in 0.20%. All HBV positive patients were males and had previous blood transfusions. Conclusion: HBV and HCV is seen to affect a significant number of the End Stage Renal Disease (ESRD) patients undergoing HD. Measures including safe transfusion practices, vaccination and equipment disinfection should be undertaken to reduce the burden of such infections in ESRD patients.
Arthritis J o u rn al of Ar th r it is ISSN: 2167-7921Bhattacharya et al., J Arthritis 2015, 4:4 http://dx.doi. org/10.4172/2167-7921.1000171 Keywords: Systemic lupus erythematosus; Lupus pneumonitis; Pulmonary tuberculosis; Differential diagnosis Introduction SLE (Systemic lupus erythematosus) is a multisystem autoimmune disorder which has a waxing and waning course. The clinical manifestations of SLE are variable. They include erythematous photosensitive malar rash, oral ulcers, non-erosive polyarthritis or polyarthralgia, polyserositis, immune-mediated cytopenias, renal, neurologic, pulmonary and cardiac abnormalities. Pulmonary manifestations of SLE were first described by Osler in 1904 who described a patient of SLE with persistent lower lobe infiltrates [1]. A wide spectrum of pulmonary presentations has since been described, which include as pleuritis, pneumonia, pulmonary embolism, pneumothorax and pulmonary haemorrhage [2]. Though infections are a frequent cause of pulmonary infiltrates in patients with SLE, in many cases pulmonary infiltrates are not related to infection [1]. Lupus pneumonitis (LP) is an unusual and life threatening complication of SLE usually occurring during SLE flare-ups, but rarely as a presenting feature. Acute LP may mimic tuberculosis or other acute infectious pneumonia and its incidence varies from 0.9% to 11.7% [3]. Hence a high index of clinical suspicion should be kept, when young females present with unexplained pulmonary infiltrates, especially in tuberculosis endemic countries like India where use of empirical antitubercular therapy is high. We hereby report a case of LP as a presenting feature of SLE, thereby mimicking pulmonary tuberculosis. Case ReportAn 18 years old female was admitted to the hospital with complaints of low grade fever for 2 months, cough with mucoid expectoration for 3 weeks, blood streaked sputum for 1 week and difficulty in breathing for three days prior to admission. She had a history of swelling of hands and feet, off and on, for the past one year although she denied any specific history of joint pain. There was history of irregular menstruation and loss of hair. There was no history of palpitations, breathlessness, weight loss, or exposure to any drugs or toxins. She also gave history of contact with a case of pulmonary tuberculosis in her family. Past medical history was unremarkable and there was no history of travel in the recent past. Her bowel and bladder habits were normal.On examination she was fully conscious and oriented. Her blood pressure was 100/60 mm of Hg. She had tachycardia (pulse rate 106/ min), tachypnoea (respiratory rate -26/min) with dyspnoea, as evidenced by the use of accessory muscles of respiration, fever (oral temperature of 101 0 F). There was presence of pallor and grade-1 diffuse alopecia. On respiratory examination, there were diffuse bilateral coarse crepitations over her chest. Cardiac examination revealed a grade II soft systolic murmur with a prominent pulmonary component AbstractIntroduction: Systemic Lupus...
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