BACKGROUND MDR-TB caused an estimated 600,000 new TB cases and 240,000 deaths in 2016 and MDR-TB accounts for 4.1% of all new TB cases and 19% of previously treated cases worldwide. Globally, most MDR-TB cases occur in South America, Southern Africa, India, China, and the former Soviet Union. Rapid detection of drug resistance of M. tuberculosis and MDR-TB strains ensures effective treatment of TB patients and limits further development of resistance to additional drugs. The GeneXpert test is a molecular test for TB which diagnoses TB by detecting the presence of TB bacteria, as well as testing for resistance to the drug Rifampicin. In India, where this test is starting to be widely used, it is known as the CBNAAT. The full name of the CBNAAT test is the Cartridge Based Nucleic Acid Amplification Test. The objective of the study is to assess the performance of GeneXpert MTB/RIF as an initial diagnostic tool for the diagnosis of Mycobacterium tuberculosis and Rifampicin Resistance. METHODS The RNTCP programme is being strictly followed and carried out in Shri B.M. Patil Medical college Hospital, BLDE University Vijayapur Karnataka. Samples of patients with symptoms suggestive of tuberculosis including, suspected new TB cases, old TB cases and on treatment TB cases, were received from all the Primary Healthcare Canters, and all other Healthcare Centres including two Medical College Hospitals of Vijayapur district. Samples collected under this programme were analysed by GeneXpert Test at District TB Hospital CBNAAT center Vijayapur, Karnataka. A retrospective study was conducted from 1 January 2016 to 31 December 2018. The samples were subjected to GeneXpert MTB/ RIF manufactured by Cepheid, France for the detection of M. tuberculosis and then rifampicin resistance in them. Data analysis was done using SPSS Version 22.0.0.0. RESULTS In this study a total of 4978 patients' samples was processed for CBNAAT test. Out of these cases, MTB was detected in 1186 (23.82%), Rifampicin Resistance (RR) was detected in 165 (13.91%) cases. Among these 165 MTB-RR cases, the MTB detection level was, 50 (30.30%) High, 65 (39.39%) Medium, 26 (15.79%) Low, 16 (9.69%) Very Low & 8 (4.84%) Intermediate. Out of 4978 cases 427 (8.58%) were HIV positive, among these HIV positive cases MTB was detected in 51 (12%) & RR detected in 13 (25.50%) cases. CONCLUSIONS The implementation of the GeneXpert MTB/RIF assay in programmatic management of TB & MDR-TB in RNTCP has dramatically improved the rapid diagnosis of tuberculosis & drug resistance, especially in People Living with HIV/AIDS (PLWHA).

AIM:The aim of this study is intended to make an effort to determine the incidence of adverse effects and the risk factors for developing side effects against anti-TB drugs. DESIGN:

Systemic corticosteroids are routinely used for the treatment of acute exacerbation of COPD (AECOPD). Preliminary studies have demonstrated that nebulised budesonide to be as efficacious as parental steroids in AECOPD. OBJECTIVES: To evaluate the clinical efficacy of nebulised budesonide with in AECOPD in comparison with parental steroids. MATERIALS AND METHODS: Patient's with AECOPD were included in the study and divided into two groups randomly. Control group who were given parental steroids and Study group received budesonide by nebulisation (2 mg every 12 hrly) for 5 days. These patients were assessed every 12 hrly from H0 to H72, day 5 and at discharge. The outcome variables studied were FVC, FEV1, PEFR, dyspnea score, spO2 and SGRQ score. Both groups received standard treatment i.e. oxygen, salbutamol plus ipratropium by nebulisation and parental antibiotics during study period. RESULTS: A total of 125 patients were included in the study: 65 in study group and 60 in control group. The baseline FEV1, FVC and PEFR were comparable in both groups. The mean improvement in FEV1, FVC and PEFR after 24 hrs, 72 hrs and day 5 were non-significantly increased in both the groups. Similarly, improvements in oxygen saturation and dyspnea grade at day 5 showed no significance between the two groups. Patients in the study group showed better improvement in SGRQ score as compared to control group. Mean duration of hospitalization was less in study group as compared to control group. CONCLUSION: Nebulised budesonide was equally as efficacious as parental steroids in AECOPD. Nebulised budesonide group had reduced duration of hospitalization and showed better improvement in SGRQ score as compared to control group.

BACKGROUND Exacerbations in chronic obstructive pulmonary disease is common and frequent in nature. The present study was done to evaluate the clinical efficacy of nebulised budesonide over parenteral/oral steroids in patients with acute exacerbations of COPD. MATERIALS AND METHODSA randomised controlled study was conducted in a tertiary care teaching hospital. A total of 125 patients with acute exacerbations due to COPD were included in the study. The patients were randomised into study and control groups. The study group patients received inhaled budesonide along with the standard treatment for 5 days, while the control group received standard treatment for acute exacerbation of COPD. The primary outcome variables studied for the treatment efficacy were change in post bronchodilator FEV1, FVC, FEV1/FVC, PEFR. Secondary end points included the changes in dyspnoea score (MMRC grade, SPO2 and SGRQ score). RESULTSA total of 125 patients were finally assessed. Sixty five patients belonged to study group and 60 in the control group. Baseline characteristics were similar and well matched in both the groups. Mean age was 64.20 ± 9.11 years while in control group it was 62.40 ± 11.31 years. There were no improvements in the lung functions (FEV1, FVC, FEV1/FVC, PEFR) at the end of 5 days of nebulised budesonide as compared to the standard therapy. As far as secondary outcome is concerned, it was observed that patients in study group showed better improvement in health related quality of life (HRQL) score as compared to control group at day 5 (p<0.01). Duration of hospitalisation also was lesser in the study group as compared to the control group. No serious adverse effects were observed during the course of the study. CONCLUSIONOverall with the nebulised budesonide for the AECOPD, there was not much improvement in the lung functions, but there was improvement in the quality of life and the duration of hospitalisation in the study group. These findings should be confirmed by conducting a larger population based clinical study.

Background: Diabetes mellitus (DM) is multisystem disease involving many organs of the body. It affects kidneys, eyes, nerves, vessels and heart due to its microvascular and macrovascular complications. It has been reported in previous studies, most of which are from western world that lung capacities are reduced in DM. We tried to evaluate the involvement of lungs in DM in Indian population in present study. Aims and Objective: To record and evaluate the impact of pulmonary function tests in type 2 diabetes mellitus patients and their matched control group. Methods: This study was undertaken in patients admitted to Shri B.M.Patil Medical College Hospital and Research Centre, Vijayapura between November 2015 to July 2017. A total of 73 cases each of type 2 diabetes mellitus cases and normal controls were selected and compared with duration of type 2 diabetes mellitus. Results & Conclusion: Total of 60 females and 86 males were included in study. Comparison of Forced vital capacity (FVC), Forced expiratory volume during first second (FEV1) and Forced expiratory volume during first second / Forced vital capacity (FEV1/FVC) was done and concluded that restrictive pattern with reduced spirometry values was seen in diabetic cases compared to age, gender and BMI matched controls. Mean Also type 2 DM patients with duration more than 10 years were more affected than those with duration less than 10 years. In females, there was more restriction in lung volumes when compared to males of type 2 diabetes of same duration.