Lower respiratory tract infection is one of the common causes of morbidity in India which is occasionally undiagnosed. In this regard tracheobronchomegaly is one of those conditions which masquerade as chronic bronchitis and bronchiectasis and are usually undiagnosed. It is a well-defined clinical and radiologic entity characterized by marked dilatation of the trachea and the central bronchi and is frequently associated with recurrent lower respiratory tract infection. Tracheobronchomegaly has been described by a variety of names, including Mounier-Kuhn syndrome, tracheal diverticulosis, tracheobronchiectasis, tracheocele, tracheomalacia, and tracheobronchopathia malacia.
In India, tuberculosis (TB) notification has been required since 2012. Notwithstanding, notification rates remain low. Non-reporting of tuberculosis cases not only results in an underestimation of cases, but also impedes the country's TB control strategy. Our research aims to assess practitioners' awareness, perception, and practice of tuberculosis case notification, as these factors can help reduce the TB burden. A cross-sectional study of 142 physicians was conducted between August 2018 and December 2019. Doctors were interviewed and given evaluation forms. Seventy-seven percent of the 142 physicians polled worked in medicine-related specialties, while 33% worked in surgery. Public sector physicians (64.7%) knew more about the Nikshay App than private practitioners (40.8%). The vast majority of public-sector doctors were only notified through their hospital's National Tuberculosis Elimination Programme (NTEP) center. However, the majority of private practitioners (47.8%) notified cases directly through the hospital, the local District Tuberculosis Officer (DTO) or NTEP medical officer (24 percent), or the Nikshay portal (28%), whereas the majority of public sector doctors notified only through the hospital NTEP center (85.9%). The primary reasons for non-notification are the high patient load on doctors, a lack of understanding about Nikshay App and its functionality, technological difficulties in using the Nikshay App, and the stigma associated with tuberculosis. The Nikshay App must be popularized as a notification mechanism through the NTEP program. To increase notification rates, practitioners must overcome the challenges they face. In terms of notification, more seminars and training, particularly hands-on training, should be held on a regular basis.
Introduction: Cervical lymph node infection due to nontuberculous mycobacteria in a immunocompetent patients are emerging problem globally. It is presented as chronic enlargement of gland with pain and pus discharge sometimes. Traditionally diagnosis is done through clinical examination, lymph node aspirated samples pathological finding or ZN microscopy, which altogether indicate mycobacterial infection only, unable to differentiate MTB from NTM infection.Increasing incidence of LNTB cases not responding to antituberculous treatment prompted us to pinpoint the etiological agent by doing liquid culture of FNA samples in microbiology laboratory. Materials and Methods: In this study 154 cases were recruited having chronic cervical lymph node swelling of suspicion of mycobacterial infection during January - December, 2014. Therein detailed history and thorough clinical examination of patients were reviewed. All patients were subjected for fine needle aspiration (FNA) using 10 ml syringe fitted with 21 G needle. The aspirated samples were subjected to smear microscopy byZiehlNeelsen (ZN) stain examination, May Grunwald - Giemsa stain and MGIT culture. Positive cultures were primarily identified by cord formation in ZN smear examination, detection of MPT-64 antigen by immuno-chromatographic test (Capilia test). Results: A total 154 lymph node samples were received and processed for culture during the study period. Out of total suspects 7/154 (4.5%) were identified as non-tuberculous mycobacterial lymphadenitis. Clinical examination showed that all the seven cases were presented with lymph node swelling and fever and previous ATT history. Other features seen were pain (2/7 28%), pus discharge (3/7 42%) and montoux positive (3/7 42%). The most common species identified was M. chelonae (3/7, 42%) followed by M. fortuitum (2/7, 28%), M. abscessus (1/7, 14%) and M.terricomplex (1/7, 14%). Four patients were managed surgically, one with surgical resection and medical treatment and 2 patients were lost tofollowup. Conclusion: Definitive and detailed microbiological examination is vital for diagnosing the nontuberculous lymphadenitis. M.chelonae is an important etiological agent.NTMs are important definitive etiological agents in cervical lymph node swelling. Clinical and pathological findings help in suspecting the infection.
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