IntroductionTuberculosis is a major health problem in Pakistan. The prevalence of pulmonary as well as extrapulmonary tuberculosis is quite high. Tuberculin skin test, radiological imaging, and sputum smear microscopy have limitations in the diagnosis of tuberculosis. Xpert MTB/RIF was recently approved for the diagnosis of pulmonary tuberculosis and has shown promising results. The aim of this study was to determine the diagnostic accuracy of Xpert MTB/RIF in sputum smear-negative pulmonary tuberculosis using acid-fast bacilli (AFB) culture as the gold standard.Materials and methodsThis cross-sectional study was conducted at Iqbal Yad Chest Clinic and Nazimabad Chest Clinic of Ojha Institute of Chest Diseases, Dow University of Health Sciences. Patients of either gender aged 18-65 years suspected to have pulmonary tuberculosis with at least two sputum samples negative for AFB underwent Xpert MTB/RIF testing. Early morning sputum samples were obtained and sent for AFB smear microscopy, Xpert testing and also for culture analysis.ResultsMean age of the patients was 37.48 ±17.49 years. There were 84 (37.3%) females and 141 (62.7%) males. Positive findings on Xpert MTB/RIF were found in 147 (65.3%) patients whereas AFB culture showed positive findings in 174 (77.3%) patients. Sensitivity, specificity, positive predicted value, negative predicted value and overall diagnostic accuracy of Xpert MTB/RIF was found to be 84.48%, 100%, 100%, 65.38%, and 88%, respectively.ConclusionXpert MTB/RIF has high sensitivity, specificity, and diagnostic accuracy in diagnosis of sputum smear-negative cases of pulmonary tuberculosis.
Asthma is a common disease of airways characterized by chronic inflammation and usually presents with symptoms like shortness of breath, cough, chest tightness and wheezing and these symptoms do vary 1 over time in intensity. Asthma has a great global impact. Estimated prevalence of Asthma in Pakistan as highlighted by report on Global burden of Asthma is 2 4.3%. There are multiple factors that trigger asthma symptoms which include allergen exposure, smoking, allergic rhinitis, sinusitis, gastroesophageal reflux d i s e a s e ( G E R D ) , i n a d e q u a t e u s e o f i n h a l e d corticosteroids (ICS) that include poor adherence to 3,4 medication and inappropriate inhaler technique.Asthma has a great impact on population and when poorly controlled leads to considerable economic impact with loss of work days, school attendance, frequent hospital admissions, poor quality of life and 5 ultimately death. According to a study, approximately 24.2% of the patients with asthma have well controlled 6 asthma. There are multiple studies from different parts of the world that reflect asthma control and also the influence of these factors over symptom control but no 7 -1 0 such study has been conducted in Pakistan. According to a study, 45% patients had uncontrolled
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