Original Research Article Objective: In this study our main goal is to evaluate the demographic pattern of patients suffering from extra pulmonary tuberculosis. Method: This cross-sectional descriptive type study was carried out at Medicine departments of Sir Salimullah Medical College & Mitford Hospital, Dhaka from 19 th December 2016 to 18 th June 2017. A total 100 patients were included in the study where detailed history was taken then thorough clinical examinations. Results: More than fifty percent (56.0%) of the patients were in the age group 20-40 years and 30.0% of the patients were in age group 20 and below while only 14.0% of the patients were in the age group above 40 years. Also, male and female ratio of the patients was almost equal. Majority of the patient's had the history of contact with TB patients. Majority of the patient's had normal chest x-ray findings (60.0%) while 26.0% of the patient's had homogenous opacity in chest xray findings and 2.0% and 4.0% of the patient's had cavity lesion and fibrosis respectively, in chest x-ray findings. Conclusion: Our study concludes that majority of the tuberculosis patients are within the economically productive age group ranged between 20-40 years. Females are the majority of the patients with extra pulmonary tuberculosis. Based on this results TB control programme might usefully target young and female populations for early diagnosis to decrease tuberculosis morbidity and mortality.
patients who were being considered for immuno-suppresant therapy. Methods All IGRAs requested from Glasgow Royal Infirmary (GRI) over a 21 month period were retrospectively assessed for the following: patient history, test indication and result, CXR report and patient outcome. GRI serves the most deprived population in the UK. A single laboratory provides TB bacteriology for the whole of Glasgow, and is the sole provider of IGRA testing for LTBI utilising the 'T-Spot.TB'. Results Between August 2010-May 2012, 354 T-Spot.TB tests were performed. Planned immuno-suppressant therapy was the indication in 70% (n = 248); etanercept was the most commonly proposed drug (32%, n = 78), followed by adaluminab (29%, n = 72), anti-TNF not otherwise specified (11%, n = 28) and infliximab (6%, n = 15). Of those for whom immunosupression was the indication, 80% (n = 199) of T-Spot.TB tests were negative, 17% (n = 41) indeterminate and 3% (n = 8) positive. A CXR was performed in all but 6% (n = 11). CXR findings and patient outcomes for patients with negative T-Spot. TB tests are summarised in table 1. All 16 abnormal CXRs were referred to a TB specialist for review and none had chemoprophylaxis commenced or any alterations in their management recommended. Conclusions With increasing use of IGRAs, new guidance on screening for LTBI prior to anti-TNF therapy is required. In our cohort of 248 patients, the majority had a negative T-spot test reflecting that despite high levels of deprivation TB prevalence in Glasgow is low. CXR did not alter patient management, TB chemoprophylaxis was not given in any case and there were no cases of LTBI reactivation or de novo TB within the follow-up period (11-32 months). We propose that if IGRA is negative, CXR is not required as part of screening for LTBI prior to anti-TNF therapy.
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