BG Saroja

Abstract

Introduction: Bronchiectasis (BE) is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low income and middle income countries “Bronchiectasis” is a chronic debilitating respiratory condition, natural history of Bronchiectasis is variable, some patients have only a few chest infections per year with no disease progression overtime, while others have more frequent prolonged infective episodes and progress more quickly to respiratory failure with an associated increase in risk of death.1;2A vicious cycle of infection and inflammation exists in damaged airways with patient suffering from persistent cough, purulent sputum production, recurrent chest infections and general malaise, associated with increased morbidity and reduced quality of life and socioeconomic, cost of long term management is significant. Materials and Methods: 162 CT confirmed adult patients 18 years were included in the study, data of patients were retrieved demography, clinical features, causative factors, spirometry and imaging reports were studied and analysed. Results: 162 adult patients were included in the study. Males (54%) and more than 50 years age group population [64%] was predominantly affected. 58% were non-smokers. Chronic cough (100%) with sputum production (86%) and fatigue (78%) were the most common symptoms, digital clubbing and crackles were the most common examination findings. Dominant cause of BE was post infection (46%) followed by COPD (20%), ABPA (10%) and miscellaneous causes. Obstructive abnormality (42%) was the most common spirometric pattern observed. Higher incidence of cystic BE (57%) was found in our study. Conclusions: Patients > 50 years and males were predominantly affected. Most of the study population had never smoked. Most common symptom found was chronic productive cough and fatigue. Etiology of BE is heterogeneous. Post Tuberculosis BE variety was common. BE in COPD patients was not less common. Central Bronchiectasis was not uncommon. Keywords: Bronchiectasis, HRCT, Post infection, COPD.

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Abstract

Introduction: In a developing country like India tuberculosis (TB) is a common infectious disease diagnosed both in rural and in urban population. According to WHO (world health organisation) an open case of tuberculosis has at least three close contacts in their household resulting in prevalence rate of 2.5% among the close contacts. In the developing country it adds on to the economic burden. Many factors have been attributed to persistence of sputum positivity even at the end of intensive phase of TB treatment. Objective: We conducted a retrospective study at our institution to identify the clinical, radiological and bacteriological factors of the patients influencing sputum conversion for AFB (acid fast bacilli) at the end of intensive phase (2 months) of anti- tubercular treatment in category 1. Material and Methods: A retrospective Study was conducted at our institution from January 2016 to December 2017. Newly diagnosed open cases of TB were included in the study with retro viral cases being excluded from the study. Results: Out of 179 cases in the study 103 cases were male and 86 cases were females. The predictive analysis and chi square test showed statistically significant association of smoking, cavity formation and degree of bacillary load and persistent sputum positivity. Conclusion: Smoking, cavity formation and higher ABF load in the initial smears have higher possibility of persistent sputum positivity requiring more vigilant monitoring of such patients. Keywords: Tuberculosis; Sputum positivity; Smoking; Cavity formation; Bacillary load.

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