Background: Tuberculosis is a major global public health problem. It is caused by mycobacterium tuberculosis and it is a leading cause of death in developing countries like India. WHO recommends the detection of acid fast bacilli in sputum as the initial diagnosis of pulmonary TB. Tuberculosis is spread from person to person through air by droplet nuclei. So, early detection and prompt treatment of tuberculosis is main cornerstone to prevent transmission into community. Bronchial washing is very helpful for early detection of mycobacterium tuberculosis.Methods: This is a prospective study of 53 sputum smear negative patients underwent for bronchoscopy. After a detailed medical history and physical examination, Patients with a negative sputum smear AFB examination and a strong clinco-radiological suspicion of pulmonary tuberculosis were then counseled, consented and subjected to fiber-optic bronchoscopy with bronchial washings and bronchial biopsy in case of endobronchial lesions.Results: Our study showed mean age of patient is about 43.49 year and has predominantly male patients. Most cardinal symptoms were fever (83%) and cough (74%). Most radiological findings were consolidation and cavity lesion accordingly. Sputum culture was positive in 14 (26%) patients out of 53 patients and bronchial washing smear positive for AFB in 30 (57%) patients and bronchial washing culture positive for AFB in 40 (75%) patients out of 53 patients.Conclusions: Bronchial washings analysis for detection of AFB is much more reliable in comparison to direct smear microscopy and direct sputum culture examination.

INTRODUCTIONChronic Obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide. 1 The prevalence of COPD is directly related to the prevalence of tobacco smoking, although in many countries outdoor, occupational and indoor air pollution resulting from burning of wood and other biogas fuels are major COPD risk factors. 2The prevalence and mortality due to COPD are projected to increase over the coming decades due to continued exposure to COPD risk factors. In 2011, COPD was the third leading cause of death in the United States. Globally ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. In 2011, COPD was the third leading cause of death. The prevalence and burden of COPD are projected to increase over the coming decades due to continued exposure to COPD risk factors. Thus prevention, early detection and prompt treatment of COPD and it's exacerbations may have an impact on the clinical progression and the risk of hospitalization. This is a prospective study to determine the predictors of mortality in COPD patients hospitalized for an acute exacerbation. Methods: This was a prospective study of 94 patients admitted for acute exacerbation of COPD in a tertiary care hospital over a period of 18 months. After a detailed medical history and physical examination, patient's blood sample was sent for Arterial Blood Gas (ABG) analysis, a complete hemogram, blood sugar levels, serum albumin levels, blood urea nitrogen levels (BUN), serum creatinin levels, SGPT, SGOT and serum sodium and potassium levels. We then compared these parameters in patients who died with those who survived to determine the mortality predictors. Results: A statistically significant relation was obtained between male gender, smoking history (odd ratio of 1.5), number of pack years (p = 0.029), history of prior admission (odds ratio of 2), longer duration of illness (p = 0.045), elevated blood sugar levels (p = 0.035), hypoalbuminaemia (0.001), hypopnatremia (0.001), respiratory acidosis (0.003), elevated partial pressure of CO2 (0.001) and mortality. Conclusions: We found a male preponderance, with increase in mortality with the increase in the number of smoking pack years. Longer duration of illness was also an important predictor of mortality. Respiratory acidosis, hyponatremia, elevated blood sugar levels and hypoalbuminemia at the time of presentation were other important predictors of mortality in patients hospitalized for acute exacerbation of COPD.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality world-wide. In 2016, COPD was the third leading cause of death. Thus prevention, early detection and prompt treatment of exacerbations may have an impact on the clinical progression and the risk of hospitalization. Material and Methods: This is a prospective study of 94 patients admitted for acute exacerbation of COPD in a tertiary care hospital over a period of 18 months. After a detailed medical history and physical examination, patients' blood was sent for Arterial Blood Gas (ABG) analysis, a complete hemogram, blood sugar levels, serum albumin levels, blood urea nitrogen levels (BUN), serum creatinine levels, SGPT, SGOT, serum sodium and potassium levels. We have then compared these parameters in the patients who have died with those who have survived to determine mortality predictors. Result: A statistically significant corelation was observed between male gender, smoking (odd ratio of 1.5), duration of smoking (p=0.0014), history of prior admission (odd ratio of 2), longer duration of illness (p=0.045), elevated blood sugar levels (p=0.035), hypolabuminemia (0.001), hyponatremia (0.001), respiratory acidosis (0.003), elevated partial pressure of CO2 (0.001) and mortality. Conclusion:We found a male preponderance of increased mortality. Increase in mortality was also there with the increase in the duration of smoking. Longer duration of illness was also an important predictor of mortality. Respiratory acidosis, hyponatremia, elevated blood sugar levels and hypoalbuminemia at the time of presentation are other important predictors of mortality in patients hospitalized for acute exacerbation of COPD.