Keywords : tuberculosis


The Pattern of Drug Resistance in Iraqi Pulmonary Tuberculosis Patients Referred to the Specialized Center for Chest and Respiratory Disease

Arwa Tahrir Ramadhan; Ahmed Asmer Mankhi

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 2, Pages 181-186

ABSTRACT:
BACKGROUND:
Tuberculosis control in the world today must face the challenge posed by the global spread of Mycobacterium tuberculosis strains that are resistant to standard anti-TB drugs.
OBJECTIVE:
This study was done to identify the drug resistance to the first line antituberculosis drugs in Iraqi Patients.
METHODS:
This prospective study conducted in National Center for Tuberculosis and Chest Diseases in Baghdad from January 2012 to August 2012.For study the demographic characters and drug sensitivity test (DST) in a total number of 155 case of sputum smear positive pulmonary tuberculosis (97 old and58 New) For each patient 3 consecutive sputum samples were taken for direct smear microscopy and cultured to test drug resistance for First Line anti-TB drugs (INH, Rifampicin ,Ethambutol and pyrazinamide).
RESULTS:
In this study we found ethambutol resistant in 20(34.5%)of samples in the new group and in 49(50.5%) of samples in old group. On the other hand,our study showed that resistance to rifampicin in the new group was 58.6% while in the old group was 75.3%. In regard to the INH drug resistance it seen in 72.4% of samples in new group and in 83.5% of samples in old group.This study showed that reistance to streptomycin present in 44.8% of new group samples and in 55.7% of old group samples .The pattern of drug resistance according to patient group show high frequency of polyresistance 82 cases in both patient group(new and old) and low frequency in other group of resistance 14 cases,and MDR type of resistance in total of 17 cases .
CONCLUSION:
The study showed 11%(17/155) of patients with pulmonary tuberculosis in this sample of patients had multidrug resistance MDR tuberculosis .
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Characteristics of Extra Pulmonary TB Cases in the Specialized Center for Chest and Respiratory Disease

Mohammad Yahya Abdulrazaq; Abdulla Janger Al-Farttoosi; Hayder H.Ali Al-Sikafi

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 0, Pages 593-599

ABSTRACT:
BACKGROUND:
Tuberculosis (TB) is a serious global problem. It remains the number one killer infectious disease in developing countries. The clinical manifestations of TB could be either Pulmonary or Extra pulmonary (EPTB).
Extrapulmonary tuberculosis involves relatively inaccessible sites, and often, because of the vulnerability of the areas involved, much greater damage can be caused by fewer bacilli..In 2007 in the United States, 20% of newly reported cases of tuberculosis involved extrapulmonary sites only In order of frequency, the extrapulmonary sites most commonly involved in TB are the lymph nodes, pleura, genitourinary tract, bones and joints, meninges, peritoneum, and pericardium. However, virtually all organ systems may be affected.
OBJECTIVE:
This study was done to identify the Characteristics of extra pulmonary TB cases.
METHODS :
A cross sectional study was done in the specialized center for chest and respiratory disease in Baghdad and respiratory department in the early cancer detection center during the period 9th of January 2011 – 9th of June 2011.
Any patient attending the specialized center for chest and respiratory disease in Baghdad during the study period diagnosed as a new case of extrapulmonary TB was enrolled in this study, also Any patient attending respiratory department in the early cancer detection center during the study period diagnosed as a new case of extrapulmonary TB was enrolled in this study.
A total number of 70 TB patients were enrolled in this study. 35 male TB cases and 35 female TB cases
RESULTS:
In the male group 20 cases (57%) with pleural TB, 2 cases (5.7%) with uveitis-eye TB, 2 cases (5.7%) with pericarditis TB , 2 cases (5.7%) with orchitis TB , 2 cases (5.7%) with meningitis TB , 2 cases (5.7%) with miliray TB , 2 cases (5.7%) with skin TB , 2 cases (5.7%) with LN TB , and 1 case (2.85%) had osteoarticular TB.
In the female group 17 cases (48.5%) had pleural TB , 7 cases (20%) with LN TB , 4 cases (11.4%) with osteoarticular TB , 4 cases (11.4%) had peritonitis TB , 1 case (2.85%) had thyroid TB , 1 case (2.85%) had salpingitis TB , and 1 case (2.85%) with breast TB.
CONCLUSION:
Pleural TB cases consist of more than half the extrapulmonary TB cases , and LN , osteoarticular and peritoneal TB cases consist of about quarter of the extrapulmonary TB cases , while all other cases form the remnant quarter

The Effect of Age on Clinical and Radiological Presentation in Patients with Pulmonary Tuberculosis in Baghdad

Hashim M.Al-Kadhimi; Haider Noori Dawood

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 1, Pages 125-129

ABSTRACT:
BACKGROUND:
Mycobacterium tuberculosis causes the most common type of human tuberculosis worldwide .The most common mode of transmission is by inhalation of droplet nuclei from expectorated respiratory secretions.Active infection is diagnosed by documenting the presence of M tuberculosis in respiratory secretions or other body fluids or tissues.Age is an important determinant of the risk for the disease .The risk may increase in the elderly
OBJECTIVE:
To compare the effect of age between elderly and younger on clinical and radiological presentation in patients with pulmonary tuberculosis in Iraq.
PATIENTS AND METHODS:
A prospective study was done for 251 patients with smear positive pulmonary tuberculosis in outpatient's clinic in the Chest and Respiratory Disease Specialized Center in Baghdad.Collected from January to May 2009.The following parameters were assessed:
Age, gender, symptoms, risk factors, radiological findings, and incidence of recurrent .The relation of these parameters between elderly and younger was evaluated
RESULTS:
There were 174 young adult patients and 77 elderly patients .The elderly group age was between 60-
80years ,and younger adult age was between 17-59 years. There was no significant difference in the symptoms between the two groups .Family history of pulmonary tuberculosis (p=0.009) was more common in young adult, while DM (p=0.001) was more common in elderly .Comparison of radiological findings in young adults vs. elderly patients shown a typical findings (p=0.036) which is more in elderly .There was no significant difference in the incidence of recurrence between the two groups.
CONCLUSION:
There was no significant difference in the symptoms between elderly and younger age groups .
Family history of PTB was more common in young adults, while DM was more common in elderly.
A typical radiological findings were more in elderly.There was no significant difference in the incidence of recurrence between the two groups

Does Normal Chest X ray in Patients with Chronic Cough Exclude Pulmonary tuberculosis?

Mohammad Yahya Abdulrazaq; Abdulla Janger Minshed

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 1, Pages 130-133

ABSTRACT:
BACKGROUND:
Tuberculosis is the second infection in causing deaths from infectious agent in the world, currently in Iraq approximately 67% of new cases of Tuberculosis involve the lung only ,cough is the most common symptom of pulmonary Tuberculosis , pulmonary Tuberculosis nearly always causes detectable abnormalities on chest film, but still atypical or absent radiologic findings can occur.
OBJECTIVE:
This study was designed to determine whether in patients with chronic cough normal chest X ray exclude pulmonary tuberculosis.
PATIENTS AND METHODS:
One hundred seventy two patients attending the respiratory clinic, complaining from chronic cough and they are suspected cases of tuberculosis, were enrolled in this study. A full medical history and physical examination was done then a chest X ray was ordered, for those with normal chest X ray finding (seventy seven patients), sputum smear for acid fast bacilli (AFB) ordered .
RESULTS:
47 females (61%), 30 males (39%) with chronic cough with females to male ratio = 1.56/1.The age ranged between 17-67, with mean age of 37.16 years. The age of males ranged between 18-67 and the mean was 39.32 years, the age of females ranged between 17-66 and the mean was 34.93 years. X ray finding were negative in all the patients. Positive AFB in sputum smear examination by microscopy was found in only one patient but with ENT examination it was proved to be a case of laryngeal tuberculosis not pulmonary tuberculosis.
CONCLUSION:
Normal chest x ray in patients with chronic cough excludes pulmonary tuberculosis