Abstract
Introduction: India being Diabetic Capital with largest number of tuberculosis patients. Several studies have highlighted that Diabetes as a risk factor for TB. TB in Diabetic patients tends to have more cavitatary, bilateral, multiple lobe involvement. Hence We would like to highlight the varied pulmonary manifestations through our study.
Methodology: Cross sectional study conducted at department of Respiratory Medicine, U.P.U.M.S., SAIFAI, ETAWAH with 220 patients. Pulmonary TB was diagnosed through history, examination, Sputum Microscopy and Chest X ray.
Results and Discussion: Out of 220,154(70%) males & 66(30%). Maximum incidence of TB was seen in >50 years with peak incidence in 51-60 & 61-70 years. Symptoms noted were cough(94.55%),Fever(90%), Anorexia (52.73%), Loss of weight (50.91%), Dyspnea (43.64%), Haemoptysis (21.81%),night sweats (17.27%), Chest pain(7.27%).
Sputum positive cases male (138/154) and female (54/66) with P=0.011.Cavity with nodule was present in 36.36% of patients and patients have normal chest x-ray is seen in 2.72% of patients.
Conclusions: There was a linear relationship between duration of DM & TB incidence. Majority of our patients had poorly controlled sugars, suggesting that severe hyperglycaemia is associated with development of pulmonary tuberculosis.
Lower lung field involvement was noted in 20.90% of patients. Early diagnosis and properly monitored treatment regimen is the only time proven answer.
References
- Chang JT, Dou HY, Yen CL, Wu YH, Huang RM, Lin HJ, Su, et al. Effect of type 2 diabetes mellitus on the clinical severity and treatment outcome in patients with pulmonary tuberculosis: a potential role in the emergence of multidrug-resistance. J Formos Med Assoc. 2011;12(6):372–381.
- Barach JH. Historical facts in Diabetes. Ann Med Hist.1928;10:387-401.
- World Tuberculosis Day: WHO enjoins all to end TB by 2030, report 2016.
- TB India 2016 Revised National TB Control Programme Annual Status Report, New Delhi, 2016 www.tbcindia.nic.in/
- International Diabetes Federation(2015) IDF diabetes atlas. 7th edition. Brussels, Belgium: International Diabetes Federation.
- Surya Kant, Hem Lata, SM. Nathu, Arvind Kumar Mishra and N.S. Verma. Diabetes Mellitus with Pulmonary Tuberculosis: A double trouble. Journal of Indian Medical association review article. 2013;111 (3):187-91.
- Patel Anand K, Rami Kiran C, Ghanchi Feroz. Clinical profile of sputum positive pulmonary tuberculosis patients with diabetes mellitus in a teaching hospital at Jamnagar, Gujarat. National journal of medical research.2012;2(3):309-312.
- Carreira, J. Costeira, C. Gomes, J.M. André, N. Diogo. Impact of diabetes on the presenting features of tuberculosis in hospitalized patients. Rev port.pneumol. 2012; 18(5):239-243.
- Hariprasad S, Ramakrishnam R, Trupti R, Sreekantha, Avinash S, and Vinodchandran. The study of pulmonary tuberculosis in diabetes Mellitus patients. International Journal of Pharma and Bio Sciences. 2013 Apr; 4(2): (B) 559 – 571.
- Hem Lata, Surya Kant. Increased Glycaemic Level Favours The growth of Mycobacterium Tuberculosis Microbacilli. Int J Pharma Bio sci.2013 Jan;4(1):(B) 747-754.
- Dr Chaya BE., Dr S N Vishwakumar. A study of pulmonary tuberculosis in diabetes mellitus and its clinicoradiological correlation. Indian Journal of Basic and Applied Medical Research.2015;4(2):30 -38.
- Nilofe Shaik, Surendra Kumar, C., Satyasri, S., Harita Krishna Veerapaneni, Sajit Kishan Gollapalli and Raghu Ram Uppalapati. Clinical and radiological study of pulmonary tuberculosis in diabetes mellitus. International Journal of Current Research.2016;8(12):43862-43867.
- Babu Anand, A. Vinoth. Study on clinical and radiological presentation of pulmonary tuberculosis in diabetic patients in a tertiary care hospital. Journal of evidence based medicine and health care. 2017;4(78):4622-4626.
- American Diabetes Association: Position Statement: "Standards of Medical Care in Diabetes—2010".Diabetes Care.2010;33(1):11-61.
- F. Segarra, D. S. Sherman, and J. Rodriguez-Aguero. Lower lung field tuberculosis. The American Review of Respiratory Disease.1963; 87 :37–40
Corresponding Author
Dr Harender Singh Chaudhary
Senior Resident, Department of Respiratory Medicine, U.P.U.M.S., Saifai, Etawah, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.158
