Title: Retrospective Study of Non-Responding Patients to ATT Presenting To the RNTCP Center of a Tertiary Care Hospital
Authors: Dr Naveen kumar Verma, Dr Raghvendra Singh Gaur, Dr Rajni Prajapati, Dr Swati Chandel4, Dr Karan Singh Chandrakar
DOI: http://dx.doi.org/10.18535/jmscr/v4i2.19
Tuberculosis (TB) is a pandemic and half of the cases are in six Asian countries. WHO estimates that at least one third of the world population is infected with Mycobacterium tuberculosis. It is a major health issue; its treatment is more expensive of a longer duration and gives less than ideal cure rates with higher relapse rates. In this study all patients who were not responding to medical treatment of ATT were assessed. A total of 74 case sheets from the outdoor patient clinic selected, of which 73% (54 cases) of cases were male and 27% (20 cases) cases were female. Data collected in heading of Smear, culture and sensitivity and PCR reaction. 86 % (64 cases) cases were sputum positive, out of which 76.6 % (49 cases) were male and 23.4 % (15 cases) female. 72.9 % (54 cases) sample was positive on culture, out of which male were 76 % (41 cases) and female 24 % (13 cases). All sample were positive for PCR, out of which 75.7 % (56 cases) were male and 24.3 % (18 cases) were female. Segregation of data done according to category. Immunocompromised status was taken in account and only 1 patient found HIV positive and was a case of pulmonary tuberculosis. At present, it can be concluded that the smear is cheap and rapid method of detecting mycobacterium tuberculosis but it has a very low sensitivity. Culture is more sensitive but it takes a longer time to give results while PCR is specific, rapid, more sensitive but expensive technique, and it should only be used in difficult cases where diagnosis become a challenge. 1. WHO: Global tuberculosis control - surveillance, planning, financing. WHO Report 2006 2006:362 2. Morre DF, Curry JI. Detection and identification of mycobacterium tuberculosis directly from sputum specimen by Amplicore PCR. J Clin Microbiol 1995; 33:2686-91. 3. Truffot-Pernot C, Véziris N, Sougakoff W. Modern diagnosis of tuberculosis. Presse Med 2006; 35 (Pt 2):1739-46. 4. Daniel, T. M. 1990. The rapid diagnosis of tuberculosis: a selective review. J. Lab. Clin. Med. 116:277-282. 5. Pervez MAK, Hasan QN, Rumi MAK, Ahmed S, Salimullah M, Tahera Y et al. PCR can help early diagnosis of pulmonary tuberculosis. Southeast Asian JTrop Med Public Health 2003; 34: 147-53. 6. Tiwari V, Jain A, Verma RK. Application of enzyme amplified mycobacterial DNA detection in the diagnosis of pulmonary and extra-pulmonary tuberculosis. Indian J Med Res 2003; 118: 224-8. 7. Cegielski JP, Devlin BH, Morris AJ. Comparison of PCR, culture, and histopathology for diagnosis of tuberculous Pericarditis. J Clin Microbiol 1997;35: 3254-7. 8. Kesarwani RC, Pandey A, Misra A.. Polymerase chain reaction (PCR): its comparison with conventional techniques for diagnosis of extra-pulmonary tubercular disease. Indian J Surgery 2004; 66: 84-8. 9. World Health Organization. Treatment of tuberculosis: guidelines for national programmes. [Geneva]: WHO;1993. 10. Kamboj SS, Goel MM, Tandon P.l. Correlation study of histopathology and bacteriology in patients of tubercular lymphadenitis. Indian J Chest Dis Allied Sci 1994; 36:187-91. 11. Saleem S, Shabbir I, Iqbal I. Value of three sputum smear microscopy in diagnosis of pulmonary tuberculosis. Pak J Med Res 2007; 46: 94-7. 12. World Health Organization. Proposed reduction of number of smears for the diagnosis of pulmonary TB: ackground document. Available from: URL:http://www.who.int/tb/dots/laboratory/Reduction%20 of % 20 smears. 13. Dunlap NE, Bass J, Fujiwara P. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161: 1376-95. 14. Yeager IIJ Jr, Lacy J, Smith L. Quantitative studies of mycobacterial populations in sputum and saliva. Am Rev Respire Dis 1967; 95: 998-1004. 15. Negi SS, Anand R, Basir SF. Protein antigen b (Pab) based PCR test in diagnosis of pulmonary and extra pulmonary tuberculosis. Indian J Med Res 2006; 124: 81-8.Abstract
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