BackgroundTuberculosis (TB) infection induces profound local and systemic, immunological and inflammatory changes that could influence the development of other respiratory diseases; however, the association between TB and asthma is only partly understood. Our objective was to study the association of TB with asthma and respiratory symptoms in a Nordic–Baltic population-based study.MethodsWe included data from the Respiratory Health in Northern Europe (RHINE) study, in which information on general characteristics, TB infection, asthma and asthma-like symptoms were collected using standardised postal questionnaires. Asthma was defined based on asthma medication usage and/or asthma attacks 12 months prior to the study, and/or by a report of ≥three out of five respiratory symptoms in the last 12 months. Allergic/nonallergic asthma were defined as asthma with/without nasal allergy. The associations of TB with asthma outcomes were analysed using logistic regressions with adjustments for age, sex, smoking, body mass index and parental education.ResultsWe included 8379 study participants aged 50–75 years, 61 of whom reported having had TB. In adjusted analyses, participants with a history of TB had higher odds of asthma (OR 1.99, 95% CI 1.13–3.47). The associations were consistent for nonallergic asthma (OR 2.17, 95% CI 1.16–4.07), but not for allergic asthma (OR 1.20, 95% CI 0.53–2.71).ConclusionWe found that in a large Northern European population-based cohort, persons with a history of TB infection more frequently had asthma and asthma symptoms. We speculate that this may reflect long-term effects of TB, including direct damage to the airways and lungs, as well as inflammatory responses.
Background Guillain Barre Syndrome(GBS) is an acute, frequently severe, and fulminant polyradiculoneuropathy that is autoimmune in nature. Our aim is to evaluate the grading of disability and outcome among different variants of GBS. Methods All consecutive patients recruited prospectively in the study were of age ≥16 years and were being admitted in department of Neurology of Tribhuvan University Teaching Hospital, Kathmandu, Nepal from 2016 March to 2017 February. All demographic, historical and clinical data were collected. Nerve conduction study, cerebrospinal fluid analysis along with clinical features were evaluated to assess the diagnostic certainty of Brighton Criteria. Overall disability sum score (ODSS) and GBS disability score were assessed in all patients. The study protocol was approved by the Institutional Review Boards. Results A total of 46 patients were included: male patients being predominant (70% vs 30%), mean age= 36.5±16.2, range = 16 - 80 years. Thirty-two patients (70%) were an axonal variant, acute motor axonal neuropathy being more common (18 patients), and 14 patients were acute motor and sensory axonal neuropathy. Fourteen patients (30%) were demyelinating type, out of which 11 patients had both motor and sensory features, and only 3 patients were pure motor demyelinating type. Axonal variants were found to have higher ODSS during nadir (p=0.024) and discharge(p=0.004), and also higher GBS disability score during nadir (p=0.012) and discharge (p=0.021). Acute motor axonal neuropathy (AMAN) had higher GBS disability score than acute inflammatory demyelinating polyneuropathy (AIDP) at nadir (p=0.034) and discharge (p=0.039). Conclusions Axonal neuropathy variants are predominant among the Nepalese population and are clinically severe than demyelinating variants. Further, prospective study of longer duration to include larger number of patients will be needed.
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