Abstract
Objective: The aim of present study was to evaluate the incidence and pattern of tuberculosis in Bronchial asthma patients receiving inhalational corticosteroid therapy by MDI.
Materials and Method: A total of 76 patients taking MDI steroid for bronchial asthma, and 76 patients suffering from the similar disease but not receiving MDI steroids serves as a control, were included in the study and evaluate for the incidence and pattern of tuberculosis. All the patients were followed up for 18 months.
Results: Out of 76 patients, 4 patients (5.26%) receiving MDI steroid developed tuberculosis as against patients not receiving MDI steroid, out of 4 patients, who developed tuberculosis, one developed sputum smear positive pulmonary disease, one had sputum smear negative disease and two had extra pulmonary tuberculosis in the form of pleural effusion and tubercular lymphadenitis one each. All patients were treated with standard anti tuberculous therapy using RNTCP guidelines and all patients recovered from the disease.
Conclusion: Inhalational corticosteroid in the form of MDI causes a significant increase in incidence of tuberculosis.
Keywords: Tuberculosis, Bronchial asthma, MDI, pleural effusion, Incidence.
References
- Global Initiative for Asthma Global Strategy for Asthma Management and Prevention. National Institute of Health -National Heart, Lung and Blood Institute Publication No 02-3659 Updated 2004 document.
- Factsheet: Asthma-a worldwide problem. Document accessed on February 8, 2005 at website of International Union Against Tuberculosis and Lung Diseases (IUATLD)
- Jindal SK, Gupta D, Aggarwal AN, Jindal RC, Singh V. Study of the prevalence of Asthma in adults in north India using a standardized field questionnaire. J Asthma 2000; 37: 345-351 4.
- Gupta D, Aggarwal AN, Kumar R, Jindal SK. Prevalence of bronchial Asthma and association with environmental tobacco smoke exposure in adolescent school children in Chandigarh, North India. J Asthma 2001; 38: 501-507 5.
- Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Prevalence of bronchial asthma in school children in Delhi. J Asthma 1998; 35:291-296. 6.
- Singh D, Sobti PC, Arora V, Soni RK. E pidemiological study of asthma in rural children. Indian J Community Med 2002; 27:167-170 7.
- Awasthl S, KaIra E, Roy S, Awasthi S. Prevalence and risk factors of asthma and wheeze in school-going children in Lucknow, North India. Indian Pediatrics 2004; 41: 1205-1210. 8.
- Aggatwal AN, Chaudhry K, Chhabra SK, D'Souza GA, Gupta D, Jindal SK, et al. Prevalence and risk factors for bronchial asthma in Indian adults: a multicentre study. Indian J Chest Dis Allied Sci. 2005. In press 9.
- Gaur SN, Kumar R, Sinha R. Prevalence of bronchial asthma in petrol pump workers of Delhi. Indian J Occup Environ Med 2003; 7:13-16. 10.
- Mishra V. Effect of indoor air pollution from biomass combustion on prevalence of asthma in the elderly. Environ Health Perspect 2003; 111:71-78. 11.
- Khan S, Roy A, Christopher DJ, Cherian AM. Prevalence of bronchial asthma among bank employees of Vellore using questionnaire based data. J Indian Med Assoc 2002;100:643-644, 655. Paramesh H. Epidemiology of asthma in India. Indian J Pediatr 2002; 69:309-312.
- Marple BF, Fornadley JA, Patel AA, Fineman SM, Fromer L, Krouse JH, Lanier BQ, Penna P; Keys to successful management of patients with allergic rhinitis: focus on patient confidence, compliance, and satisfaction. Otolaryngol Head Neck Surg. 2007 Jun;136(6 Suppl):S107-24.
- Lamer B; Allergic rhinitis: selective comparisons of the pharmaceutical options for management. Allergy Asthma Proc. 2007 Jan-Feb;28(1):16-9. Review. 15.
- Liping, W, Yin,j Lanier,Bil Baboon Syndrome Contact Dermatitis 56:356-357, 2007 16.
- Lanier, Bob 0.-1- Unanswered questions and speculations about the role of anti-immunologlobulin E in atopic and nonatopic disease , Allergy Asthma Proceedings Vol. 27, No. 2 March-April 2006, Supplement No.1.
- MICROMEDEX(R) Healthcare Series Vol. 143 expires 3/2010 18:2. Alvesco Product Insert. 3M Healthcare Ltd. (supplied with Proforma).
- Deeks and C.M. Perry. Ciclesonide: A Review of its Use in the Management of Asthma. Adis Drug Evaluation. Drugs 2008: 68 (12): 1741-1770.
- Gelfand EW, Georgitis JW, Noonan M, Ruff ME. Once-daily ciclesonide in children: efficacy and safety in asthma.J Pediatr. 2006 Mar;148(3):377-83.
- Pedersen S. Efficacy and safety of ciclesonide once daily and fluticasone propionate twice daily in children with asthma. Pulmonary Pharmacology & Therapeutics 22(2009) 214-220.
Corresponding Author
Dr Gaurav Tiwari
Tutor, Department of Pharmacology, Sri Krishna Medical College, Muzaffarpur, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.23
