Tubercular Osteomyelitis of the Skull in a 14-Year-Old Female: A Rare Case Report and Review of the Literature| Chapter 4 | An Overview of Disease and Health Research Vol. 9

 

Background: Skeletal tuberculosis constitutes about 1٪ of all cases. Usually, spine and limb bones are involved. Tuberculosis is endemic in many developing countries, including Bangladesh, where the disease remains highly prevalent. Tubercular osteomyelitis of the skull is a rare entity; therefore, diagnosis is rarely suspected. Given the rarity of the condition, only a few patients with Tubercular osteomyelitis of the skull have been reported in the medical literature.

 

Case Report: This chapter reports one such rare case of an atypical calvarial skull osteomyelitis in a 14-year-old female who presented with swelling on the right frontoparietal region for 3 months. CT scan of the brain and bony window revealed a lytic bony lesion at the right parietal bone with an associated epidural soft tissue component at the right parietal top, causing compression over adjacent parenchyma- possibly eosinophilic granuloma or chronic osteomyelitis. Haematological test reveals no abnormality except ESR 61mm in 1st hour with a normal chest X-ray. The patient was treated surgically by excision of the lesion with cranioplasty using synthetic bone cement. After surgical treatment, the specimen was sent for histopathology, which showed granulomatous inflammation histologically consistent with tuberculosis. She was treated with antitubercular therapy as per the national tuberculosis guideline.

 

Conclusion: Our Case highlights all these aspects of skull tuberculosis with a review of the available literature relevant to skull tubercular osteomyelitis.

 

 

Author(s) Details

Mohammad Humayun Rashid
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Rashed Mahmud
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Md. Wasiul Alam Taufique
Department of Neurosurgery, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Mafizul Karim
Department of Anaesthesiology, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Md Jahidul Islam
Department of Hospital Management, East West Medical College & Hospital, Dhaka, Bangladesh.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v9/7016

Nutritional Assessment and its Associated Risk Factors of Adult Tuberculosis Patients in Namibia: A Cross Sectional Study | Chapter 7 | An Overview of Disease and Health Research Vol. 7Nutritional Assessment and its Associated Risk Factors of Adult Tuberculosis Patients in Namibia: A Cross Sectional Study | Chapter 7 | An Overview of Disease and Health Research Vol. 7

 

Tuberculosis (TB) is still a big problem for public health around the world, especially in developing countries. In Namibia, the incidence of TB is notably high and is often exacerbated by malnutrition and other socio-economic factors. Namibia is ranked 10th highest in the world, due to the incidence rate of 457 per 1000 population; with a population of about 3 million, it shared a percentage of the global TB burden. The aim of the study was to evaluate the importance of nutritional status and risk factors militating against the health and well-being of newly diagnosed TB patients in Windhoek, Namibia. This study was designed as a cross-sectional study, and non-probability, convenience sampling techniques were used. The study adopted a dynamic uncontrolled process, assessing the nutritional intake of TB patients and not testing an intervention. A total of 111 newly diagnosed TB patients participated in the study. A questionnaire-based survey was used to collect demographic information such as age, gender, education level, marital status, employment status, type of occupation, and household income level, as well as behavioural variables such as smoking habits and alcohol consumption. To get the Body Mass Index (BMI) of participants, height and weight were measured at Direct Observed Treatment (DOT) clinics. The BMI was measured and taken during the last four months of the treatment regime, taking measurements once a month as the participants were coming back for follow-up treatment. BMI evaluated their nutritional status. Males formed a significant majority, representing 67.6%, and females represented 32.4%. The study revealed that 38.7% of patients were malnourished. Malnutrition was more common in males than in females (27%). The result shows a significant association with age group (0.018), marital status (0), educational status (0.0252), and employment status (0.0106) with nutritional status. The data analysis and findings from this study highlight significant insights into the socio-economic and nutritional challenges faced by tuberculosis (TB) patients in Windhoek, Namibia. Moreover, the analysis identifies a strong correlation between Body Mass Index (BMI) and TB status, emphasising that lower BMI is associated with higher TB risk. Factors such as monthly income emerged as significant predictors of nutritional status, suggesting that economic stability was crucial for improving health outcomes among TB patients.

 

 

Author(s) Details

M Musuuo
Preventative Health Science Department, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia.

 

O Awofolu
Preventative Health Science Department, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v7/6582

Prevalence and Socio-economic Determinants of Tuberculosis among Patients in a Secondary Hospital in Southern Nigeria |Chapter 3 | Microbiology and Biotechnology Research: An Overview Vol. 5

 

Tuberculosis remains a leading cause of mortality, especially in countries with low socio-economic status. Socio-economic determinants influence individuals’ health behaviours, access to healthcare resources, degree of exposure to certain diseases and environmental factors. The increase in Tuberculosis problem correlates with an increase in countries, particularly in sub-Saharan Africa, where intricate socio-economic factors such as malnutrition, poverty, homelessness, overcrowding, poor and delayed diagnosis, and poor drug susceptibility testing procedures are experienced. This study was carried out to investigate the prevalence of tuberculosis and associated socio-economic determinants among patients attending Immanuel General Hospital in Eket, Akwa Ibom State. A cross-sectional study was conducted among 150 patients with presumptive tuberculosis diagnosis within a period of 12 months at Immanuel General Hospital Eket (IGHE). A structured questionnaire was administered to consenting patients for the collection of relevant data. Deep-cough sputum samples were collected from patients who were able to expectorate and processed according to the standard bacteriological method. Microscopic detection of acid-fast bacilli was carried out by the Ziehl-Neelsen method, while Mycobacterium tuberculosis was cultured in Lowenstein-Jensen (LJ) medium and colonies identity was further confirmed using the SD BIOLINE rapid diagnostic test. Data for the study were collected with the aid of a structured questionnaire and analysed using SPSS software version 27. p-values less than 0.05 were considered to be statistically significant. The confirmed prevalence of tuberculosis in this study was 27.3%. The infection rate was higher in males (29.4%) than in females (21.9%) and was significantly associated with age (P = .02) and employment status (P < .001) of patients. The study found a strong, significant association between TB prevalence and family size, number of people sleeping in a room, income level, number of times meals are taken per day, and previous TB exposure of patients (P ≤ .05). The prevalence of TB is high in IGHE and is significantly associated with some socioeconomic risk factors. The findings of this study support the social and economic determinants of health theory, highlighting the critical role of socio-economic factors in TB infection. This underscores the urgent need for targeted policy interventions by relevant government agencies to improve the socio-economic conditions of residents in Eket.

 

 

Author(s) Details

Etang UE
Department of Microbiology, Faculty of Biological Sciences, University of Uyo, Uyo, Nigeria.

 

Richard RE
Department of Public Health, Faculty of Allied Medical Sciences, University of Calabar, Calabar, Nigeria.

 

Akpan NG
Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Uyo, Uyo, Nigeria.

 

Etor VU
Department of Histopathology and Cytology, Faculty of Medical Laboratory Sciences, University of Calabar, Calabar, Nigeria.

 

Ntekpere EI
Akwa Ibom State Polytechnic, Ikot Osurua, Nigeria.

 

Dodoru TR
Institute for Biomedical Research and Innovations, College of Health Sciences, University of Uyo, Uyo, Nigeria.

 

Michael AA
Department of Histopathology and Cytology, Faculty of Medical Laboratory Sciences, University of Calabar, Calabar, Nigeria.

 

Please see the book here :- https://doi.org/10.9734/bpi/mbrao/v5/6356

Penile Tuberculosis: A Rare Manifestation of Extrapulmonary Tuberculosis | Chapter 4 | An Overview of Disease and Health Research Vol. 6

 

Introduction: The 2024 WHO Global Tuberculosis report labelled Tuberculosis as the leading cause of mortality amongst infectious diseases, surpassing COVID-19. Extrapulmonary manifestations account for almost 20% cases. Penile tuberculosis is a rare variant of genital tuberculosis in males, accounting for less than 1% of all cases.

 

Case: The case of a 65-year-old man, who presented with several painful ulcerative lesions on the glans penis that had developed over the span of 1 year, was presented. Histopathological examination from a wedge biopsy of the lesion revealed granulomatous inflammation, which, being the diagnostic hallmark, confirmed the diagnosis of penile tuberculosis. Thus, the patient was enrolled under the RNTCP program and received Anti-Tuberculous Treatment (ATT).

 

Conclusion: Penile tuberculosis is a rare clinical entity. Therefore, maintaining a high level of clinical suspicion is crucial for achieving a timely and accurate diagnosis, which facilitates the initiation of appropriate therapy.

 

Author(s) Details

Harikrishna R
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

Sanjula Jethwani
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

A T Rajeevan
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

A V Venugopalan
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v6/6236

 

COVID-19 Impact on the National Tuberculosis Elimination Program Guidelines and Its Relevance to the Indian Population | Chapter 3 | Medicine and Medical Research: New Perspectives Vol. 2

 

The COVID-19 pandemic caused a severe dent in the decades of progress achieved in tuberculosis control and elimination measures, indicating that these measures need to be more structured and resilient. This manuscript focuses on the impact of the COVID-19 pandemic on TB control and also on the measures taken by the Government of India in effectively combating this syndemic.

 

The main objective is to emphasise the impact of the COVID-19 pandemic on TB control and also to highlight the various innovative initiatives taken by the Government of India to keep the spread of tuberculosis under check.

 

The positive trends in tuberculosis elimination strategies observed till 2019 showed a dramatic reversal after the onset of the COVID-19 pandemic. Biological interactions between tuberculosis and COVID-19 agents, lung parenchymal damage occurring in both diseases, multiple lockdowns, the reduced workforce at tuberculosis notification centres, and reallocation of funds to control the new-onset pandemic were some of the reasons for the decline in overall notifications across the globe.

 

The National Tuberculosis Elimination Programme initiated a holistic approach to eliminate TB from South Asia by 2030. Innovative strategies like digitalisation of service delivery systems, telemedicine consultations, and a four-tier hierarchy system resulted in a rise in the number of tuberculosis notifications. Making this campaign a public movement, creating Public Support Groups and propagating an online Nikshay portal for tuberculous notification greatly facilitated efforts to create a tuberculosis-free world.

 

Despite the COVID-19 pandemic causing a temporary slowdown, digitalisation processes and various innovative strategies have kept disease elimination hopes still alive. The government alone may not be able to accomplish this goal. By increasing the Government’s responsibility and accountability, facilitating an effective coalition with communities and civil societies, protecting human rights, promoting ethics in treatment, enhancing the equity of distribution of effective treatment across the community, and calling for global collaboration in setting up strategic goals/targets at the national level, the world could be TB-free by 2035. Combined efforts and collective responsibility from the public, medical, and para-medical support staff are imperative in making this dream of a tuberculosis-free society, soon a reality.

 

 

Author(s) Details

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.

 

Kalpana Ramachandran
Department of Anatomy, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1345

 

Tuberculosis in Otorhinolaryngology: A Case Series and Short Review of Related Data from South-Eastern Europe | Chapter 4 | Medicine and Medical Research: New Perspectives Vol. 10

 

This study provides significant contributions to the understanding of tuberculosis in the field of otorhinolaryngology. It highlights the diagnostic challenges posed by the rare ENT manifestations of tuberculosis, which are often mistaken for more common conditions such as neoplasms or chronic infections. The manuscript effectively underscores the importance of including tuberculosis in the differential diagnosis, especially in cases where clinical presentation is typical. Worldwide, tuberculosis can infect any part of the body, however, it most frequently affects the lungs. Even while otorhinolaryngological symptoms of tuberculosis are uncommon and typically develop as a result of lung illness, they nonetheless pose a serious diagnostic difficulty. About 1% of all upper airway localizations are caused by nasopharyngeal tuberculosis, which is uncommon and most frequently manifests as adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. The study presents four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid the occurrence of complications. Tuberculous glossitis remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of oral lesions. It is rarely a primary infection, and an early diagnosis is essential to avoid the occurrence of complications.

 

Author (s) Details

Horia Mocanu
Department of ENT&HNS, Faculty of Medicine, “Titu Maiorescu” University, 031593, Bucharest, Romania and Department of ENT&HNS, Gaesti City Hospital, 135200, Gaesti, Dambovita, Romania.

 

Adela-Ioana Mocanu
Department of ENT&HNS, Gaesti City Hospital, 135200, Gaesti, Dambovita, Romania and Faculty of Medicine, Doctoral School, “Titu Maiorescu” University, 031593 Bucharest, Romania.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v10/2565

A Case of Fibrinous Pericardial Effusion: Tuberculosis Versus Systemic Lupus Erythematosus | Chapter 5 | Achievements and Challenges of Medicine and Medical Science Vol. 12

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with varied presentations, ranging from nonspecific features like fever, malaise, and arthralgia to serious manifestations like serositis (pleural, pericardial effusions), neurological manifestations, and renal involvement (lupus nephritis). SLE is a great mimicker, especially for infections like tuberculosis (TB) which is rampant in low- and middle-income countries (LMIC). We report a case of massive pericardial effusion, which was initially diagnosed and treated as TB on clinico-radiological basis. The patient showed initial clinical improvement. But as the steroids were tapered and stopped, she developed new findings like joint pains, proteinuria, cytopenias, etc leading to reconsideration of diagnosis, which was later revised to SLE based on clinical and laboratory findings. This is one of the uncommon presentations of SLE, leading to misdiagnosis of tuberculosis especially in LMIC.

 

Author (s) Details

 

Kamal Joshi
Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

 

Aman Elwadhi
Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

 

Binita Poudel
Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

 

Anukriti Agnihotry

Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

 

Prashant K. Verma
Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/acmms/v12/3789

IgG4-Related Disease of Genitalia: When Inflammation Imitates Cancer | Chapter 6 | Newer Frontiers in Urology

The systemic fibro-inflammatory disease known as immunoglobulin G4-related disease (IgG4-RD) usually shows multiorgan involvement. A unique instance of a solitary IgG4-RD of the epididymis in a male adult, age 54, was reported. A painless mass over the lower aspect of the left testicle was his initial presentation. Tuberculosis was diagnosed based on the clinical findings. A comparatively hetero-echoic mass lesion on the left epididymis near the left testis was visible on the scrotum ultrasound. The patient was planned for surgical removal of the epididymal mass. However, intraoperative findings showed the mass was tightly stuck to the left testicle and indivisible from it, which required left total orchiectomy. The histopathology showed that the number of plasma cells and keloid-like collagen was increased along with focal spindle cell proliferation. Vimentin and IgG4 immunohistochemistry were positive, while CD34 was negative. IgG4 was high in the serum (165 mg/dL). There was no evidence of systemic involvement on the abdomen or thorax computed tomography. IgG4-RD of the epididymis was diagnosed and validated by immunohistochemistry and histopathology with high blood IgG4 levels. The medical literature only reports a very small number of solitary cases of IgG4-RD of epididymis with no other systemic manifestations. This study highlights the significance of this rare inflammatory condition mimicking epididymal tuberculosis or testicular malignancy.

 

Author (s) Details

 

Nakul Aher
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Pradhumna Koushik
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Velmurugan Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49238-86-2/CH6

Role of Ayurvedic Medicine with Immunomodulator Properties in the Treatment of Drug Sensitive Tuberculosis | Chapter 7 | Advanced Concepts in Pharmaceutical Research Vol. 8

 Revised National TB Control Programme (RNTCP) has being implemented all over India since 1993. It has been noticed     a high    sputum positivity in follow up smear examination indicating an additional treatment support for early conversion and cure. We are studying there effect of a commercially available  immunomodulator   along with standard and  ATT of DOTS . We studied its effect on 21 smear positive case with 21 as control. TB patients showed a better sputum conversion rate when treated with the Ayurvedic Immunomodulator, along with DOTS. There was a beneficial effect on weight gain and ESR improvement. More studies one this issue with large number of cases are advised.

Author(s) Details:

K. Venugopal,
Government General Hospital, Alappuzha, India.

Sreelatha P. R.,
Medical College, Alappuzha, India.

Gopika Venugopal,
AIMS, Buvanesure, India.

Please see the link here: https://stm.bookpi.org/ACPR-V8/article/view/14044

A Case Series of Extranodal Tuberculosis of Head and Neck, Tunisia | Chapter 9 | Recent Updates in Disease and Health Research Vol. 4

Background: Tuberculosis is a chronic specific infectious disease caused by mycobacteria: Koch bacillus (BK). Despite a re-increase in the incidence of tuberculosis, extra-nodal location on the head and neck remains rare. Clinical symptomatology is non-specific and even data from paraclinical explorations often pose the problem of differential diagnosis with tumor pathology.

 

Methods: We report a series of 29 cases of extranodal tuberculosis collected over a period of 32 years [1986-2018] in the ENT department of the military hospital of Tunis. Epidemiological factors, clinical condition at presentation, biological and radiologic explorations undergone according to each location, methods of biopsy, treatment modalities, follow-up, and outcome were reported.

 

Results: Rhinosinusopharyngeal involvement was predominant (45%) followed by glandular involvement (14%). Laryngeal tuberculosis is relatively rare, representing almost 1% of the extra-pulmonary locations of the disease. The diagnosis was histopathological in most cases. Concomitant pulmonary tuberculosis was detected in two cases and spinal lumbar in one case. Treatment was medical in all cases.

 

Conclusion: The clinical presentation of extranodal tuberculosis is various and non-specific. Neoplastic pathology is the main differential diagnosis. However, diagnosis should be systematically raised in endemic countries.

Author(s) Details:

Sameh Mezri,
ENT Department, Military Hospital of Tunis, Tunis, Tunisia.

Zitoun Chaima,
ENT Department, Military Hospital of Tunis, Tunis, Tunisia.

Thabet Wadii,
ENT Department, Military Hospital of Tunis, Tunis, Tunisia.

Chebbi Ghassen,
ENT Department, Military Hospital of Tunis, Tunis, Tunisia.

Khemaies Akkari,
ENT Department, Military Hospital of Tunis, Tunis, Tunisia.

Please see the link here: https://stm.bookpi.org/RUDHR-V4/article/view/13814

Sudden Cardiac Death as the First Symptom of Cardiac Tuberculoma | Chapter 5 | Advancement and New Understanding in Medical Science Vol. 3

Tuberculosis is one of several preventable and curable communicable diseases that is a major cause of morbidity and one of the top ten causes of death worldwide. Cardiac tuberculosis frequently affects the pericardium. Although rare, most cases of tuberculosis involving the myocardium and endocardium present as sudden cardiac death in asymptomatic patients. Information regarding the myocardial and endocardial involvement of tuberculosis appears in the literature once in a blue moon. As a result, there is a knowledge gap about cardiac tuberculosis among health professionals.

This chapter aims to review the challenges related to the diagnosis and management of cardiac tuberculoma and provide the latest information from the literature on the diagnosis and management that allows appropriate management and monitoring of potential associated complications. In addition, the mechanisms for complications and sudden cardiac deaths are reviewed to break new ground in early diagnosis and therapy. Furthermore, to illustrate this, an exemplary case of sudden cardiac death from tuberculoma of the right atrium with a secondary thrombus causing bicaval obstruction observed in an asymptomatic immunocompetent young man is presented. This case report provides valuable insights into the rare but critical issue of cardiac tuberculoma, shedding light on its early diagnosis and management for healthcare professionals.

Author(s) Details:

Alemayehu Shiferaw Lema,
Department of Forensic Medicine and Toxicology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Please see the link here: https://stm.bookpi.org/ANUMS-V3/article/view/13160

WGS: An Innovative Approach for Management of Tuberculosis | Chapter 8 | Advancement and New Understanding in Medical Science Vol. 2

Whole genome sequencing (WGS) of Mycobacterium tuberculosis is becoming a promising tool for clinical applications for the diagnosis and management of tuberculosis in public health care. Since absence of a consensus and international standards in the analysis and validation of quality controlling of WGS technology, result may lack harmonization and comparability for diagnosis. In this review, the significance of WGS in diagnosis and surveillance is outlined.

Author(s) Details:

Chamila Priyangani Adikaram,
National Tuberculosis Reference Laboratory, Central Public Health Laboratories, Ministry of Health, Muscat, Oman.

Please see the link here: https://stm.bookpi.org/ANUMS-V2/article/view/13094

Decortications through Video-Assisted Thoracoscopic Surgery and Open Thoracotomy in Empyema Thoracis: A Retrospective Study | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 1

Background: Empyema Thoracis, a condition in which purulent fluid accumulates within the pleural cavity, is commonly caused by bacterial infection (both Gram-positive and Gram-negative), such as Mycobacterium tuberculosis, and rarely by fungal infection. Timely intervention significantly reduces morbidity and mortality. Surgical intervention is needed in advanced disease. An early intervention can reduce the morbidity and mortality of the patient as well as the financial burden the disease entails. This study aimed to evaluate decortications performed through video-assisted thoracoscopic surgery (VATS) and open thoracotomy.

Methods: This retrospective study included 47 patients who underwent decortications by either VATS or open thoracotomy for empyema Thoracis at the Department of Surgery of, BLDE DU Shri B M Patil Medical College from May 2015 to August 2020.

Results: Tuberculosis was the most common etiological factor for empyema Thoracis. In 19 patients who underwent VATS decortications, VATS was converted to open thoracotomy in 11 patients. Only 8 patients achieved successful decortication with VATS. Thirty- nine patients (including 11 whose VATS was converted to open thoracotomy) underwent successful open thoracotomy decortications. Thirty-two patients had postoperative bronchopleural fistula, and all cases were successfully managed conservatively. The timing of the surgical intervention is critical in reducing morbidity and mortality. The more advanced the disease, the higher the failure rate of VATS in attaining complete decortications.

Conclusion: Empyema Thoracis can affect patients of all age groups, with the peak incidence in the fourth decade. Tuberculosis is a common etiological factor in our region. Open thoracotomy decortication remains the gold standard in attaining complete decortications in advanced Empyema Thoracis.

Author(s) Details:

Vikram Sindgikar,
Department of General Surgery, BLDEDU’s Shri B M Patil Medical College Hospital, Vijayapur, Karnataka, India.

Tejaswini Vallabha,
Department of General Surgery, BLDEDU’s Shri B M Patil Medical College Hospital, Vijayapur, Karnataka, India.

Mallikarjun Patil,
Department of General Surgery, BLDEDU’s Shri B M Patil Medical College Hospital, Vijayapur, Karnataka, India.

Girish Kullolli,
Department of General Surgery, BLDEDU’s Shri B M Patil Medical College Hospital, Vijayapur, Karnataka, India.

Samhitha Reddy,
Department of General Surgery, BLDEDU’s Shri B M Patil Medical College Hospital, Vijayapur, Karnataka, India.

Please see the link here: https://stm.bookpi.org/ANUMS-V1/article/view/13018 

A Rare Case Report on Relapse of Takayasu’s Arteritis with Tuberculosis Relapse | Chapter 1 | Advanced Concepts in Medicine and Medical Research Vol. 10

Takayasu's Arteritis (TA) is a ailment of uncertain cause accompanying an annual incidence of 1.2 to 2.3 cases per million society. Takayasu arteritis is a rare and never-ending granulomatous vasculitis that affects main elastic arteries, generally the aorta and its main arms, as well as the pulmonary and heart failure arteries, and is defined histologically by an instigative cell pervade affecting all coatings of the arterial wall. Takayasu arteritis targets the aorta and allure branches and is still of mysterious aetiology. It often influences female patients under 50 age of age. A relationship 'tween Takayasu arteritis and tuberculosis has existed suggested for a very long time. The cause of TA is unknown, but a link between TA and infection (TB) has been projected. Mikito Takayasu, a Japanese medical doctor specializing in eyes, described the first instance of Takayasu's arteritis in 1908. Despite the link to infection and the resemblance of granulomatous lesions in two together diseases, the exact involvement of Mycobacterium tuberculosis in the aetiology of TA remnants uncertain.

Author(s) Details:

Sunil Chandrasen Chand,
Narendra Modi Medical College (AMCMET), LG Hospital, Gujarat, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V10/article/view/12815

Determining the Effectiveness of CBNAAT in the Diagnosis of Extrapulmonary Tuberculosis | Chapter 12 | Advanced Concepts in Medicine and Medical Research Vol. 4

 This affiliate aims to determine the influence and reliability of CBNAAT in the diagnosis of extra pulmonary infection (EPTB) cases in comparison to AFB taint. Tuberculosis is still a major community health issue around the globe. Mycobacterium tuberculosis is thought to pollute one-after second of the world's state. The two types of clinical proof of tuberculosis (TB) are pulmonary TB (PTB) and extrapulmonary TB (EPTB). While pulmonary tuberculosis is most accepted presentation, extrapulmonary infection is also an main clinical question. Diagnosing extrapulmonary tuberculosis continues expected a challenge due to the paucibacillary type of the samples collected from unreachable sites and variable dispassionate presentation of the disease. Various direct and unintended methods of experiment are available for diagnosing extrapulmonary infection accurately. Two of these tests which are usually performed and are surely accessible are AFB taint and CBNAAT. AFB smear test is a system of visualization of acid-fast bacilli under microscope inasmuch as CBNAAT is a cartridge-located nucleic acid elaboration test that has long been used to pinpoint pulmonary tuberculosis (PTB).The study is a retrospective explanatory study conducted at MGM Hospital Aurangabad, Maharashtra, India. The study secondhand data from January 2017 to July 2018. Data from 166 subjects with possible extrapulmonary TB were obtained. The efficacy of CBNAAT in the disease of EPTB was compared to that of AFB besmirch.AFB smear and CBNAAT were acted on samples taken from 166 suspected EPTB inmates. Lymph node, liquid matter, pleural fluid, tissue, CSF, stomachic lavage, cystic fluid, peritoneal fluid, ascitic fluid, colonic fluid, synovial fluid, and excretion samples were collected. In AFB smear results, 17 cases were certain for TB bacilli while 149 proven negative. In the CBNAAT results, 25 cases were positive for TB bacterium whereas 141 proven negative. Eight cases were AFB smear negative but CBNAAT positive in a corresponding examination.The candor and quick reaction time of CBNAAT manage a valuable tool for diagnosing EPTB cases. For the diagnosis of cases accompanying EPTB, CBNAAT is more useful than AFB sully. However, other demonstrative tools concede possibility be taken into consideration in addition to CBNAAT for better diagnostic yield overall.

Author(s) Details:

Shivprasad Kasat,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Mahendra Biradar,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Ashish Deshmukh,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Sunil Jadhav,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Hafiz Deshmukh,
Department of Respiratory Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V4/article/view/12481

Hydropneumothorax: Evaluation of Advance Clinical Knowledge and Effectiveness of Diagnostic Techniques for Treatment | Chapter 13 | Advanced Concepts in Medicine and Medical Research Vol. 2

 The objective search out add to and advance dispassionate knowledge as well as the influence of diagnostic methods for treating hydropneumothorax subjects. Hydropneumothorax is an abnormal ghost of air and fluid in the pleural space. Even though the knowledge of hydro-pneumothorax dates back to the days of old Greece, not many internal or international literatures are recorded. Hydro-pneumothorax became enlightened in old, cave-home Greece. It is a word that depicts the simultaneous attendance of fluid (hydrothorax) and free air (pneumothorax) in the pleural space. Diagnosed cases of hydropneumothorax from casualty and routine OPD are thought-out. Detail of clinical environment entered. Patients were subject for analysis of sputum, ancestry and pleural fluid.  Radiological investigation was accomplished. Patients underwent hose thoracotomy procedure and observed till determination. Total 97 subjects had performed. Among them 76(78.35%) were fathers and 21 (21.64%) women. 91(93.85%) matters had shortness of breath. 34 matters (35.05%) had tuberculosis earlier. Sputum smear AFB was definite in 19 subjects (19.58%). Plural fluid GeneXpert MTB was detected in 11 issues (11.34 %) and MGIT Culture positive in 23(23.71%) issues. Plural fluid gram stain idea was conclusive in 24 (24.74%) matters. Pleural fluid ADA was raised in 74 (76.28%) subjects. Hypoxemia was noticed in 46 (47.42%). In 38 (39.19%) cases chest hose was removed betwixt 31 to 60 days. The most frequent aetiology of hydropneumothorax is found to be infection, and the length momentary needed for determination is unknown. To label the condition's cause, pleural fluid analysis (cytology, microbiological education, biochemical measurement), and computerized axial tomography scanner were crucial.   In order to treat hydropneumothorax, breast tube thoracotomies are still the most average procedure. Advanced processes, however, offer a chance for supplementary research and have promising results.

Author(s) Details:

Mayur Vikram Devraj,
Department of Respiratory Medicine, Dr. VPMCH&RC, Nashik, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V2/article/view/12314

A Case Report on Extrapulmonary Tuberculosis in the Uterine Cervix | Chapter 7 | Current Progress in Medicine and Medical Research Vol. 4

 The aim concerning this chapter is to edify health peasants and medical students that for some woman giving with abnormal vaginal discharge, bizarre vaginal bleeding or a injury on the cervix, tuberculosis of the uterine narrow connector should be individual the differential diagnoses. Being airborne, Tuberculosis (TB) usually affects the alveoli. However, TB can affect any means of the body and when it is outside the alveoli, it is called extrapulmonary TB. Tuberculosis is an ancient ailment that has been a big cause of suffering and death for many age. Until the 1980s, before HIV, TB was the leading cause of afterlife among infectious afflictions. A 23-year-traditional nulliparous woman presented to our gynaecology hospital with post-coital grieving and irregular menstrual periods. Review of her medical and surgical record revealed that she act highly active antiretroviral cure (HAART) since her teens and she was adherent to treatment. She was investigated with TB of the uterine narrow connector. TB of the uterine cervix presents with vague symptoms and signs that are also common to additional female genital environments like cancer of the cervix. Therefore, misdiagnosis and wrong situation are not uncommon. Health providers, so, should have a high index of hint of cancer of the uterine narrow connector when managing women the one present with bizarre vaginal discharge, abnormal vaginal bleeding and post-coital extorting especially in nations where HIV and TB are endemic.

Author(s) Details:

Charles Lukanga Kimera,

Department of Maternal and Child Health, Obstetrics & Gynaecology, School of Medicine, University of Namibia, Namibia.

Fredrick Sinyinza,

Department of Maternal and Child Health, Paediatrics, School of Medicine, University of Namibia, Namibia.

Linda Ndesipandula Lukolo ,

Department of Community and Family Medicine, School of Medicine, University of Namibia, Namibia.

Please see the link here: https://stm.bookpi.org/CPMMR-V4/article/view/11322

A Diagnostic Challenge of Ulcerative Lesion over the Tongue | Chapter 8 | New Advances in Medicine and Medical Science Vol. 4

 This case climaxes the importance of considering TB in the characteristic diagnosis of non-restorative ulcers of the tongue in India, particularly in invulnerable-compromised things and HIV patients. Tuberculosis is caused by Mycobacterium infection, It remains the most ordinary infectious affliction affecting the lungs in India to date, and can present accompanying various extrapulmonary proofs. One rare manifestation of TB is infection of the tongue, that is often misdiagnosed as malignant spoken neoplasms. In this case, we present a 69-year-old patient accompanying TB of the tongue, the one presented with a never-ending painful non-curative ulcer, so far very few cases stated.

Author(s) Details:

Ashfaque Ansari,
Department of ENT, Mahatma Gandhi Mission Medical College, Aurangabad, Maharashtra, India.

L. V. Manjusha Bavisetty,
Department of ENT, Mahatma Gandhi Mission Medical College, Aurangabad, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/NAMMS-V4/article/view/10711

Tuberculosis and Cervical Lymphadenopathy: Treatment and Diagnosis | Chapter 11 | Research Highlights in Disease and Health Research Vol. 7

 This study aims to decide the prevalence of infection in cases of cervical lymphadenopathy as well as the universal presentations and aetiologies of cervical lymphadenopathy.  Lymphadenopathy is a common dispassionate finding in a patient pursuing oral health management. It may be in a localized, restricted, or generalized form. Malignancies, contaminations, autoimmune disorders, iatrogenic, and other miscellaneous environments are considered as the causes for cervical lymphadenopathy. Unexplained cervical lymphadenopathy is a cause of concern for surgeon and patient because consistently it could be the exhibition of an underlying virulence. Tuberculous cervical lymphadenopathy usually presents with diversified lymph node increase without constitutional sign. Fine annoy aspiration and excisional biopsies are frequently done to form a definitive diagnosis. Commonest performance may be narrow connector swelling (92%), trailed by fever, cold swelling, non-healing abscess, discharging sinus, anorexia and pressure loss.The study was attended from July 2010 to august 2013 at the resection department of Ziauddin Medical University hospital Karachi, Pakistan. Inclusion tests included all sufferers with cervical lymphadenopathy. The data was resolved by Statistical Package for Social Sciences (SPSS) version 17.In total 220 subjects were recruited to compete at the beginning of the study while only 175 sufferers remained in the study till the reviews were done. Hence study comprised of total 175 parties with reaction rate of 79.5%. Age range of the participants was 13-69 age that included146 (83.4%) females and 29 (16.6%) men. The maximum patients were in 21-30 age of age group followed by 11-20 age.Cervical lymphadenopathy is prevalent in Pakistan, accompanying most likely disease as Tuberculosis, as seen in adulthood of the cases. Neck mass, migraine and fever are the most frequent performance of cervical lymphadenopathy. A good follow-up idea is also necessary to monitor the need for additional demonstrative tests in the setting that a patient forsakes to respond to appropriate initial cure.

Author(s) Details:

Farzeen Tanwir,
Department of Periodontology, Bahria University Health Sciences, Karachi, Pakistan and Department of Odontology, Karolinska Institute, Stockholm, Sweden.

Saima Mazhar,
Department of Periodontology, Bahria University Health Sciences, Karachi, Pakistan.

Tauqeer Bibi,
Department of Periodontology, Bahria University Health Sciences, Karachi, Pakistan.

Anum Baqar,
Department of Prosthodontics, Bahria University Health Sciences, Karachi, Pakistan.

Ahmed Bin Khalid Khan,
Department of Periodontology, Bahria University Health Sciences, Karachi, Pakistan.

Yasmeen Mahar,
Department of Anatomy, Bahria University Health Sciences, Karachi, Pakistan.

Arsalan Khalid,
Department of Oral and Maxillo Facial Surgery, Bahria University Health Sciences, Karachi, Pakistan.

Hira Ijaz,
Abbassi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan.

Maryam Faiz Quereshi,
Department of Anatomy, Western University of Health Sciences, Pomona, California, USA.

Areeba Younus,
Department of Anatomy, Bahria University Health Sciences, Karachi, Pakistan.

Mahail Khan,
Department of Anatomy, Bahria University Health Sciences, Karachi, Pakistan.

Mariya Azam Khattak,
Department of Anatomy, Bahria University Health Sciences, Karachi, Pakistan.

Kashmala Zakir,
Department of Anatomy, Peshawar Medical College, Peshawar, Pakistan.

Imran Ahmed,
Ziauddin University, Pakistan.

Shahkamal Hashmi,
Ziauddin University, Pakistan.

Sadia Ahmed,
Ziauddin University, Pakistan

Please see the link here: https://stm.bookpi.org/RHDHR-V7/article/view/10576

Stature of Chest Rontgenography in Extra Pulmonary Tuberculosis; A Prospective Observation at Tertiary Care Center | Chapter 9 | Research Highlights in Disease and Health Research Vol. 5

 Introduction: One from every five cases of TB come as extra pulmonary tuberculosis(EPTB).In 2019 about 16% cases of EPTB contributed to the 7.5 heap incident cases of infection in worldwide.Material & Methods: This was anticipated observational study. The habitual cases of EPTB of all group of same status were included in study. Clinical record, examination and examinations were done. We assembled the findings of breast roentgenogram in these confirmed cases of EPTB. We categorize the findings in accordance with the pattern of involvement as I) Normal II) Parenchymal (Infiltrates / cavitation) iii) Hilar outstandingness (Unilateral or Bilateral) IV) Pleural.Results: Total 96 cases of EPTB were included in the study.27 (28.12%) were diabetic, 21 (21.87%) were Hypertensive and 08 (8.33%) had hypothyroidism. Out of 96 cases adulthood of cases were of cervical lymphadenopathy 41 (41.70%), 22 (22.90%) were Spine TB and 13 (13.54%) were Genitourinary TB. Gastrointestinal cases were 11 (11.45%) while 09 (9.37%) were Meningeal TB. Total 27 (28.12%) cases had Chest radiograph irregularities. Among those 27 subjects 18 (18.75%) had parenchymal lesions, 6 (6.25%) had Hilar Lymphadenopathy, 3 (3.12%) had pleural and 69(71%) had sane chest picture of inside a body.Conclusion: Our objective search out emphasize the breast Rontgenography in EPTB which remind pulmonary involvement. We establish significant cases of EPTB had irregular changes in chest image suggest alveolus involvement that can be spreading in community. We authorize the statement of nationwide guideline for need of rib cage imaging in EPTB.

Author(s) Details:

Mayur Vikram Devraj,
Department of Respiratory Medicine, Dr. VPMCH&RC Nashik, Maharashtra, India.

Please see the link here: https://stm.bookpi.org/RHDHR-V5/article/view/10121