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Category: Volume 06 Issue 02 February 2018
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Title: A Cross Sectional Study on X-Ray Pattern of Patients of Pulmonary Tuberculosis with Diabetes Mellitus in a Tertiary Care Hospital in Tripura

Authors: Somnath Das, Sukanta Sen, Ankita Debnath, Pritha Das, Sumitra Basuthakur, Prabir Kumar Saha, Chinmoy Biswas

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.88

Abstract

Background: Diabetes prevalence has increased worldwide as a result of population ageing, urbanisation, changes in diet and reduced physical activity patterns resulting in increasing obesity.  The prevalence of TB-DM is higher in low- and middle-income countries where TB and DM are most prevalent.

Methodology: In this cross sectional hospital based observational study, 60 X-rays has been studied who had pulmonary tuberculosis and diabetes mellitus both.

Results: The X-ray pattern of TB patients who are suffering from diabetes mellitus are cavitary lesion 25(41.66%), infiltration in 15(25%), consolidation 11 (18.3%), non-homogenous opacity found in 8(13.3%) and miliary shadow found in 1(1.6%) patients. 20(33%) patients had the X-Ray abnormality involving only single zone. About 15(25%) patients had abnormality in 2 zone. Nine (15%) patients had x-ray abnormality in 3 zones. Four (6.6%) patients had abnormal x-ray in 4 zones. Eight patients had bilateral extensive involvement of lung affecting all six zones. The involvement of lung by cavity was more significantly associated with the young group (<50 years) compare to the elderly age group (p value <0.001). The non-homogenous opacity was significantly found in younger age group (p= 0.05). However, infiltration (p=0.08), consolidation (p=0.18) and miliary TB (p=0.43) was not significantly associated with any age group.

Conclusion: In this study it is found that there is a significant association between the elderly age group patients and the development of lower lung field tuberculosis (p<0.001).

Keywords: Pulmonary Tuberculosis, Diabetes Mellitus, X-ray pattern.

References

  1. World health organisation global TB report 2017 who.int/tb/publications/global_report/en/. [Accessed on 30 Jan 2018]
  2. Revised National Tuberculosis Control Programme. Central TB division. Director General of health services. New Delhi. India. 2010. Module 1-4. https://tbcindia.gov.in/index1.php?lang=1&level=1&sublinkid=4160&lid=2807
  3. Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis.2009 Dec;9(12):737-46. 
  4. Barach J. Historical facts in diabetes mellitus. Ann Med Hist 1928;10:387.
  5. Root H. The association of diabetes and tuberculosis. N Engl J Med 1934;210:1, 78,127.
  6. Koziel H, Koziel MJ. Pulmonary complications of diabetes mellitus. Infect Dis Clin North Am 1995;9(1):65e90.
  7. Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med 2008;5(7):1091e101
  8. Banerjee S, Banerjee M. Diabetes and tuberculosis interface. J Indian Med Assoc.2005 Jun; 103(6):318, 320, 322 passim.
  9. World Health Organization (2006) Diabetes fact sheet 312. Available: http://www.who.int/mediacentre/factsheets/ fs312/en/index.html. Accessed 12 Jan 2018.
  10. Morris JT, Seaworth BJ, Mc Allister CK. Pulmonary tuberculosis in diabetics. Chest 1992; 102(2):539e41.
  11. Umut S, Tosun GA, Yildirim N. Radiographic location of pulmonary tuberculosis in diabetic patients. Chest 1994;106(1):326.
  12. Hatim K, Sanaa H, Eddine Pr B J. Pulmonary Tuberculosis and diabetes mellitus: radiological characteristics. International Journal of Technical Research and Application 2016;4(2):9-11.
  13. Chaya BE, Vishwakumar SN. A study of pulmonary tuberculosis in diabetes mellitus and its clinicoradiological correlation. Indian Journal of Basic and Applied Medical Research; March 2015: 4(2):30-38.
  14. Pablo-Villamor MP, Benedicto JP, Benedicto MTJU, Perez VM. Screening for diabetes mellitus in patients diagnosed with pulmonary tuberculosis. Philippine Journal of Internal Medicine. 2014; 52(4):1–9.
  15. Patel AK, Rami KC, Ghanchi FD. Radiological presentation of patients of pulmonary tuberculosis with diabetes mellitus. Lung India.2011 Jan;28(1):70.
  16. Khalil IK. The relationship between tuberculosis and Diabetes Mellitus in patients. Al-Kufa Journal for ِBiology 2011; 3(1). Available at: http://www.uokufa.edu.iq/journals/index.php/ajb/article/view/711/620 [Accessed on 12 Jan 2018].
  17. Kishan J, Garg K. Tuberculosis and Diabetes Mellitus: A Case Series of 100 Patients. SAARC J. Tuber. Lung Dis. HIV/AIDS2010;7(2):34-38.
  18. Ezung T, Devi NT, Singh NT, Singh TB. Pulmonary tuberculosis and diabetes mellitus--a study. J Indian Med Assoc.2002 Jun;100(6):376, 378-9.
  19. Perez-Guzman C, Torres-Cruz A, Villarreal-Velarde H, Vargas MH. Progressive age-related changes in pulmonary tuberculosis images and the effect of diabetes. Am J Respir Crit Care Med 2000; 162:1738-40.
  20. Touré NO, Dia Kane Y, Diatta A, Ba Diop S, Niang A, Ndiaye EM et al. Tuberculose et diabète. Rev Mal Repir 2007;24:869-75.
  21. Maâlej S, Belhaoui N, Bourguiba M, Mahouachi R, Chtourou A, Taktak S, et al. Pulmonary tuberculosis and diabetes: Retrospective study of 60 patients in Tunisia. La Presse Médicale January 2009; 38 (1):20-24.
  22. Nissapatorn V, Kuppusamy I, Jamaiah I, et al. Tuberculosis in diabetic patients: a clinical perspective. Southeast Asian J Trop Med Public Health 2005;36(Suppl 4):213–220.
  23. Pe´rez-Guzma´n C, Torres-Cruz A, Villarreal-Velarde H, et al. Atypical radiological images of pulmonary tuberculosis in 192 diabetic patients: a comparative study. Int J Tuberc Lung Dis 2001;5(5): 455–461.
  24. Ikezoe J, Takeuchi N, Johkoh T, et al. CT appearance of pulmonary tuberculosis in diabetic and immunocompromised patients: comparison with patients who had no underlying disease. AJR Am J Roentgenol 1992;159(6): 1175–1179.

Corresponding Author

Dr Sukanta Sen

Associate Professor, Department of Pharmacology,

ICARE Institute of Medical Sciences & Research, Haldia, West Bengal 721645

Ph: +91- 8420532336 (M), Email: This email address is being protected from spambots. You need JavaScript enabled to view it.