The current review presents up-to-date knowledge on tuberculosis (TB) in diabetic patients. On the basis of available literature, there is little doubt about the close relationship between these two conditions. Diabetes mellitus in this association may still contribute substantially to the burden of TB and negatively affect control of the latter. Chronic hyperglycemia at least to some extent may alter the clinical manifestation, radiological appearance, treatment outcome and prognosis of TB. Although the pathogenesis is not clear, diabetes may impair both innate and adaptive immune responses to Mycobacterium tuberculosis. Eventually, effective screening and dual management of the diseases have to be addressed both in low- and high-income countries in order to limit the negative effects of the forthcoming global diabetes epidemic.
peared to attenuate the negative effect of testosterone on the prostate in that subjects who received the dual regimen had no increase in prostate-specific antigen levels and had a significantly lower increase in prostate volume than those treated with testosterone alone (5). While these data are encouraging, they are based on small patient numbers, and the favorable effects on prostatespecific antigen levels may not necessarily translate to a reduction in prostate cancer risk. In addition, while finasteride was shown to reduce the development of prostate cancer in middle-aged men, the incidence of high-grade prostate tumors and sexual side effects was increased (6).Therefore, I believe that further research is still needed to identify the androgen regimen that confers optimal benefit to older men without compromising prostate health and overall patient safety.
Lung cancer and pulmonary tuberculosis (TB) are highly prevalent and representing major public health issues. They share common risk factors and clinical manifestations. It is also suggested that TB predicts raised lung cancer risk likely related to chronic inflammation in the lungs. However, it does not seem to influence the clinical course of lung cancer provided that it is properly treated. We present a case report of a 57-year old male with concurrent TB and lung cancer. He was diagnosed with positive sputum smear for acid fast bacilli (AFB) and subsequent culture of Mycobacterium tuberculosis. Besides, his comorbid conditions were chronic hepatitis C virus (HCV) infection and peripheral artery disease (PAD). Later while on anti-tuberculous treatment (ATT) squamous cell lung cancer (SCC) was confirmed with computed tomography (CT) guided biopsy. Due to poor general condition the patient was not fit for either surgery or radical chemo-and radiotherapy. He was transferred to hospice for palliative therapy. We want to emphasize that both TB and lung cancer should be actively sought for in patients with either disorder. In addition, there is no doubt that these patients with lung cancer and with good response to TB treatment should be promptly considered for appropriate anticancer therapy. Case reportThe interaction between lung cancer and tuberculosis (TB) has been long established [1]. There is good evidence that preexisting TB is independently associated with an increased risk of lung cancer [2]. Besides, solid-organ malignancy raises the likelihood of TB reactivation particularly in patients with old healed TB lesions [3].A 57-year old severe underweight (bodymass-index (BMI) 15 kg/m 2 ) male was admitted to a respiratory ward with a history of 3-week long anorexia, fatigue, purulent cough and 1-month long fever. His cough started 6 months before. He reported significant weight loss of 15 kilos for 6 months. He had no chest pain and haemoptysis. As an out-patient he received the course of amoxicillin with clavulanic acid with short-lived improvement. Also, the patient complained of intermittent claudication after a short walking distance. He was a resident of the shelter for homeless for a few years. His primary profession was a garage worker whereas his most recent occupation was garbage sorting. There was a history of heavy smoking (30-pack years) and alcohol addiction. He had not been drinking for last 2 years. He had no evident contact with a confirmed TB source. In the distant past he underwent an ear-nose-throat operation for the nose deformity. On examination, he was undernourished, nor-
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