Diagnosis of extra pulmonary tuberculosis: An update on novel diagnostic approaches.

Tuberculosis (TB) remains a major global public health problem worldwide. Though Pulmonary TB (PTB) is mostly discussed, one in five cases of TB present are extrapulmonary TB (EPTB) that manifests conspicuous diagnostic and management challenges with respect to the site of infection. The diagnosis of EPTB is often delayed or even missed due to insidious clinical presentation, pauci-bacillary nature of the disease, and lack of laboratory facilities in the resource limited settings. Culture, the classical gold standard for the diagnosis of tuberculosis, suffers from increased technical and logistical constraints in EPTB cases. Other than culture, several other tests are available but their feasibility and effciacy for the detection of EPTB is still the matter of interest. We need more specific and precise test/s for the various forms of EPTB diagnosis which can easily be applied in the routine TB control program is required. A test that can contribute remarkably towards improving EPTB case detection reducing the morbidity and mortality is the utmost requirement. In this review we described the scenario of molecular and other noval methods available for laboratory diagnosis of EPTB, and also discussed the challenges linked with each diagnostic method. This review will make the readers aware of new emerging diagnostic techniques in the field of EPTB diagnosis. They can make an informed decision to choose the appropriate one according to the test availability, their clinical settings and financial considerations.

Changing patterns in the highly contributing aerosol types/species across the globe in the past two decades.

With the rapidly changing aerosol emissions due to the increase in urbanization, energy consumption, population density, and industrialization in the past two decades across the globe, there is an evolution of different chemical properties of aerosols that are yet not quantified properly. Therefore, a rigorous attempt is made in this study to obtain the long-term changing patterns in the contribution of different aerosol types/species, to the total aerosol loading. This study is carried out only over those regions exhibiting either increasing or decreasing trends in the aerosol optical depth (AOD) parameter on a global scale. Applying the multivariate linear regression trend analysis on Modern-Era Retrospective Analysis for Research and Application version 2 (MERRA-2) aerosol species dataset obtained between 2001 and 2020, we found that despite the overall statistically significant decrease in total columnar AOD trend values over North-Eastern America, and Eastern and Central China regions, an increase in the dust and organic carbon aerosols is observed, respectively. As the uneven vertical distribution of aerosols can alter the direct radiative effects, the extinction profiles of different aerosol types obtained using Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) dataset between 2006 and 2020, are further partitioned, for the first time, based on their presence in different altitudes (i.e., within the atmospheric boundary layer and free-troposphere) as well as measurement timing (i.e., daytime and night-time) regimes. The detailed analysis showed that there exists an overall higher contribution of aerosols persisting in the free troposphere region which in turn can have a long-term effect on climate due to their higher residence time, particularly absorbing aerosols. As the trends are mostly associated with the changes in energy use, regional regulatory policies, and/or changing background meteorology conditions, therefore this study also elaborates on the effectiveness of these factors with the changes obtained in different aerosol species/types over the region.