Comparative evaluation of INF-γ as an immunological healing marker based on anti-tubercular treatment among diabetic and non-diabetic pulmonary tuberculosis patients.

OBJECTIVES: Tuberculosis is an infectious airborne disease caused by Mycobacterium tuberculosis. Pulmonary tuberculosis is the ninth most frequent complication of diabetes mellitus. The co-existence of TB and DM in patient causes severe TB symptoms, modify radiological findings, slower response to treatment outcomes and prognosis. IFN-γ is the key cytokine which play role in the protective immune response against mycobacterium infection. The main function of IFN-γ is macrophage activation which is able to exert its microbicidal functions. Estimation and comparison of pre and post treatment serum IFN-γ among pulmonary tuberculosis among diabetic and non-diabetic patients. METHODS: The study was conducted in the Departments of Biochemistry and Pulmonary Medicine, FMHS, SGT University, Budhera, Gurugram and District TB Centre, Gurugram, Haryana, India. In this study, 100 newly diagnosed PTB patients without diabetes mellitus and 100 newly diagnosed PTB patients with diabetes mellitus (PTB-DM) above 15 years of age were included after obtaining written consent. 5 mL venous blood was collected from patients of pre and post anti-tubercular treatment. The level of IFN-γ was measured by ELISA method. RESULTS: The circulating level of IFN-γ in PTB patients was significantly decreased in post-treatment (25.53 ± 6.12 pg/mL) compared to pre-treatment (58.76 ± 16.02 pg/mL) with t-value 32.03 and p-value <0.001. The circulating level of IFN-γ in PTB-DM patients was significantly decreased in post treatment (29.11 ± 7.41 pg/mL) compared to pre-treatment (44.14 ± 10.85 pg/mL) with t-value 31.35 and p-value <0.001. In the present study, level of IFN-γ in pre-treatment PTB patients (58.76 ± 16.02 pg/mL) was significantly raised compared to PTB-DM patients (44.14 ± 10.85 pg/mL) with t-value 7.55 and p-value <0.001. However, level of IFN-γ in post-treatment PTB patients (25.53 ± 6.12 pg/mL) was significantly low compared to PTB-DM patients (29.11 ± 7.41 pg/mL) with t-value 3.71 and p-value <0.001. CONCLUSIONS: The decreased level of IFN-γ in post-treatment compared to pre-treatment in both PTB and PTB-DM patients had shown efficacy of anti-tubercular treatment. However, the post treatment level of IFN-γ was high in PTB-DM patients compared to PTB patients which verified that effect of ATT was low in PTB-DM.

A Comparative Study to Evaluate the Effect of Crook Lying Position versus Sitting Position on Forced Vital Capacity (FVC) in Healthy Individuals.

UNLABELLED: To prove the effect of body position on the Forced Vital Capacity (FVC) and to find out the better position amongst the sitting and crook lying position as both are considered to be the best respiratory positions as far as FVC is concerned, but no research work is done to find out the better amongst the two. MATERIALS AND METHODS: We analyzed the FVC of the randomly selected 100 subjects (both males and females) in sitting and crook lying position respectively. Computerized Pulmonary Function Testing (PFT) apparatus was used for analysis where three readings of FVC were taken in each position from which best ones were taken for analysis. RESULTS: Mean FVC in crook lying position was found out to be 88.83% as compared to 99.07% in sitting position showing a difference of 10.24 %. The values were analyzed by using standard t-test which gave t-value 18.4316 and p-value 0.0001 which is statistically significant. CONCLUSION: The results show that FVC was more in sitting position as compared to crook lying position.

Study to evaluate impact of IEC activities on awareness of Tuberculosis and RNTCP-DOTS among OPD patients around Bathinda area.

INTRODUCTION: Tuberculosis (TB) is still a major public health problem in India. This study was aimed to know the awareness and impact of Information, Education, Communication (IEC) activities about TB and RNTCP & DOTS among general population around Bathinda area of Malwa region of Punjab through patients attending chest OPD of a tertiary care hospital attached to a medical college of this region. MATERIAL & METHODS: A cross-sectional study was conducted in above stated hospital from 1st June, 2012 to 31st May 2013, for a period of one year using a questionnaire and a pictorial poster, which was pilot-tested and results were included in the main study. RESULTS: A total Of 19,259 patients attended chest OPD in the given time period. It included 11412 (59%) male and 7847(41%) female patients. Average age of the patients was 46.8 years. Majority of patients were in the age-group of 26-50 years which is a most active and economically productive age group. CONCLUSION: Although this study shows that knowledge about symptoms, mode of transmission of infection, treatment under RNTCP by DOTS is satisfactory but still IEC activities for RNTCP and DOTS need more and more and repeated sensitization of the general population. It is recommended that such, studies are to be conducted for better implementation of RNTCP and DOTS programme in the country, particularly in the light of HIV and drug resistant Tuberculosis.

Allergic Bronchopulmonary Aspergillosis (ABPA)-The High Resolution Computed Tomography (HRCT) Chest Imaging Scenario.

INTRODUCTION: Allergic bronchopulmonary aspergillosis (ABPA) is a progressive disease which can lead to recurrent exacerbations, bronchiectatic changes and end-stage fibrosis. Early diagnosis and treatment prevents its progression and alleviate its clinical manifestations. High resolution CT of the chest has emerged as a promising investigation for its diagnosis. AIMS AND OBJECTIVES: To review the high resolution computed tomography (HRCT) chest manifestations in ABPA patients. MATERIALS AND METHODS: This study included 110 patients with ABPA who had undergone HRCT of the chest in the routine diagnostic workup for ABPA. The scans were assessed for changes in bronchi, parenchyma and pleura and findings consistent with ABPA were evaluated. RESULTS: HRCT chest was normal in 24 patients. 86 patients demonstrated central bronchiectasis with predilection for upper and middle lobes. Centrilobular nodules with or without linear opacities (tree in bud pattern), mucoceles and high-attenuation mucus were seen in 86%, 59% and 36% patients respectively. CONCLUSION: Central bonchiectasis combined with centrilobular nodules and mucus impaction (especially high attenuation mucus) strongly favour the diagnosis of ABPA.