Title: Demography, Clinico-Pathological Features and Outcome of Extrapulmonay Tuberculosis: 2 Years Prospective Study
Authors: Dr Hilal Ahmad Wagay, Dr Aadil Bashir Rather, Dr Gh Nabi Dhobi, Dr Ajaz N Koul
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.23
Abstract
Introduction
Tuberculosis (TB) is an infectious disease that primarily affects lungs followed by other organs. Extra-pulmonary TB can present with non-specific symptoms such as unintentional weight loss (more than 1.5 kg in a month), night sweats and fever for more than 2 weeks. Other symptoms depend on the site or organ affected.
Aims and Objectives; To study the demographic, clinico-pathological features and outcome of extra- pulmonary tuberculosis patients at a tertiary care hospital of Kashmir valley.
Materials and Methods: A prospective study with regard to demography and clinic-pathological features and outcome, of extra-pulmonary tuberculosis patients above 18 years was conducted over two years which was recorded interpreted and analyzed.
Results and Observation: In our study of 148 patients of extra- pulmonary tuberculosis we found 106 of them below age of 45 years with mean age of 45 yrs±11.22. Males predominated being 91 (61.4%), labourers and students comprised 40 each (27%). 116(78.3%) were from rural areas. 2 patients were found to be HIV Positive. 36 (24.3%) were smokers and a total of 93 (62.8%) were married. Mean Hb was 10.8±2.30 g/dl, TLC count was 7.73±2.80 mm3, platelet count was 232.23±100 mm3. Erythrocyte sedimentation rate was 46.2±11.3mmhr. Fever, Weight loss and anorexia were most common symptoms. 144 (97.2%) gotcured, 4 patients died not because of tuberculosis , but of underlying diseases. 24 (16.2%) patients had ATT induced Hepatitis, 11 (7.4%) had Hyperurecemia, 9(6.08%) had Gastritis, 6(4.05%) had Nausea/Vomiting, 2 (1.35%) had Neuropsychiatric manifestation.
Conclusion: Tuberculosis most commonly occurs in younger patients, especially from rural area. The disease is most often seen in those who work in overcrowded and unhygienic places. Due to low prevelance of HIV in Kashmir association with HIV was low. Most patients had good response to daily regimen and most common drug related side effect was hepatitis. Genetic aspect could be the possible factor for drug response and toxicity.
Keywords: Demography ;Extra-pulmonary tuberculosis; outcome.
References
1. "Tuberculosis Fact sheet N°104". WHO. October 2015. Retrieved 11 Feb 2016.
2. Tuberculosis". World Health Organization. 2002.
3. Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs, worldwide, 2000–2004. [Online] 2006 [cited 2010 July 12]; Available from: URL:http://www.ncbi.nlm.nih.gov/pubmed/16557213
4. Ogboi SJ, Idris SH, Olayinka AT and Ilyas Junaid. Socio-demographic characteristics of patients presenting pulmonary tuberc-ulosis in a primary health centre, Zaria, Nigeria. Journal of Medical Laboratory and Diagnosis Dec. 2010 Vol. 1(2): 11-14.
5. Gebretsadikberhe ,Fikreenquselassie and Abraham aseffa treatment outcome of smear positive pulmonary tuberculosis patients in tigray region northern Ethiopia BMC public health 2012,12:537.
6. MengistuEndris et al treatment outcome of tuberculosis patients at enfraz health center,northwest Ethiopia: a five year retrospective study hindawi publishing corporation, tuberculosis research and treatment, vol 2014,article ID 726193,7 pages).
7. Jianming Wang* and HongbingShen Review of cigarette smoking and tuberculosis in China: intervention is needed for smoking cessation among tuberculosis patientsBMC Public Health 2009, 9:292 doi:10.1186/1471-2458-9-292)
8. Burnet et al(2011) High prevalence of smoking among patients with suspected tuberculosis inSouth Africa( EurRespir J 2011; 38: 139–146
9. Onyebuchi Stephanie Ofoegbua et al Treatment outcome of tuberculosis patients at National Hospital Abuja Nigeria: a five year retrospective study South African Family Practice 2015; 57(1):50–56
10. Bahl, R, Singh, B, Singh R et al . Prevalence of HIV Infection Among Patients of Pulmonary Tuberculosis Atten-ding Chest Diseases Hospital, “Jammu (Jammu and Kashmir). Indian Journal of Community Medicine Oct. 2007, Vol. 32 Issue 4: p288
11. Mubarik Ahmad Mir, Peer Maroof Ahmad et al Clinical and demographic profile of HIV/AIDS patient diagnosed at a tertiary care centre in Kashmir Vol. 60, No. 6, June 2010
12. D Acharya,J P Majra a clinical epidemiological study of tuberculosis among hospitalized cases in dakshinak-annada district of Karnataka NTI Bulltin 2007,43/3&4,43-46).
13. M. FatihGarcaa,*, Mehmet Aslanb, et al Evaluation of the patients with lymph node tuberculosis,Eastern Journal of Medicine 18 (2013) 118-122
14. ArunGopi, MBBS; Sethu M. Madhavan, et al, Diagnosis and Treatment of Tuberc-ulous Pleural Effusion Chest Volume 131, Issue 3, March 2007, Pages 880–889
15. Mbata Godwin C1, AjuonumaBenneth C1, et al Pleural Effusion: Aetiology, Clinical Presentation and Mortality Outcome in a Tertiary Health Institution in Eastern Nigeria – A Five Year Retrospective Study , · January 2015
16. Akintunde EO, Shokunbi WA, Adekunle CO African Journal of Medicine and Medical Sciences [1995, 24(2):131-134])
17. Hu ML, Lee CH, Kuo CM, et al Abdominal tuberculosis: analysis of clinical features and outcome of adult patients in southern Taiwan.Chang Gung Med J. 2009 Sep-Oct;32(5):509-1
18. N.E. Anderson a,*, J. Somaratne a, et al review of tuberculous meningitis at Auckland City Hospital, New Zealand Journal of Clinical Neuroscience 17 (2010) 1018–1022
19. J. Ayatollahi Clinical manifestations and outcome of miliary tuberculosis ActaMedicaIranica, Vol. 42, No. 6 (2004)
20. Singh, K. J. et al(30) conducted a study on Significance of haematological manifesta-tions in patients with tuberculosis..( Journal of the Association of Physicians of India, 49 (788). pp. 790-794.
Olaniyi JA, Aken'Ova YAHaematological profile of patients with pulmonary tuberculosis in Ibadan, NigeriaAfrican Journal of Medicine and Medical Sciences
22. Jagdeep sing et al Anti tubercular treatment induced hepatotoxicity ;does acetylator status matterIndian J Physiol Pharmacal 1995; 39(1) : 43-46
23. Mengistu Endris, Feleke Moges,et al treatment outcome of tuberculosis patients at enfraz health center, northwest Ethiopia: a five year retrospective study hindawi publishing corporation, tuberculosis resea-rch and treatment, volume 2014, article ID 726193,7 pages).