Background: Pulmonary tuberculosis being the predominant manifestation of the disease extra-pulmonary sites can also involve as a result of dissemination from a chief focus. Extra- pulmonary tuberculosis is more common in HIV cases. The present study aims to determine the presentation and outcome of patients with extra-pulmonary tuberculosis treated with DOTS and to assess any difference in outcome of treatment in HIV positive extra-pulmonary tuberculosis.Methods: Data was collected from cases of tuberculosis patients diagnosed and treated under DOTS at Sri Siddhartha Medical College for the period of one year (during 2015). We evaluated extra-pulmonary cases and recorded sites of involvement in order of frequency. We also studied treatment outcome by recording as per definitions given by the WHO and also evaluated any difference in outcome of extra-pulmonary tuberculosis disease with HIV co-infection.Results: Extra-pulmonary cases accounted for 30.5% of total TB cases. Among 224 cases of extra-pulmonary TB studied, 136 (60.7%) were males and 88 (39.3%) were females. Most common site of extra-pulmonary tuberculosis was pleura (29.9%) followed by meninges (22.5%), abdomen (19.6%) and lymph node (10.7%) tuberculosis. Among these patients 82.2% completed treatment, 7.5% were defaulted, 9.9% died and 0.4% treatment failure. The most common reason for default was irregular treatment (29.5%) followed by alcohol abuse (23.5%). Among 8 HIV reactive patients, 5 patients completed treatment and the remaining 3 patients died during the course of treatment.Conclusions: Extra-pulmonary Tuberculosis accounts for 30.5% of the total cases studied. Pleura is most common site of extra-pulmonary TB in our study. Treatment irregularities and alcohol abuse are the two most common reasons for default.   Co-infection with HIV seems to have a poor outcome on patients with extra-pulmonary TB and needs to be studied in large number of samples.

Background: DOTS under RNTCP is the current treatment available for Pulmonary Tuberculosis. This treatment exhibit a greater level of efficacy with a small degree of toxicity. The present study aims to determine demography of patients with pulmonary tuberculosis and to study the ADRs caused by anti tubercular drugs and to assess the causality and severity of the reported ADRs.Methods: We studied cases of Pulmonary Tuberculosis diagnosed and treated under category I DOTS at Department of Pulmonary Medicine for the period of one year (during 2015). Adverse effects observed during treatment course were recorded in standard ‘Adverse Drug Event Reporting Form’. ADRs were also assessed for their causality and severity by using WHO-UMC criteria and Hartwig’s scale.Results: Pulmonary cases accounted for 67.6% of total TB cases. Among 434 cases of pulmonary tuberculosis 33 (7.6%) patients were defaulters; among them 3(9.5%) cases were defaulters due to ADRs. In our study 96 patients developed 123 ADRs of various types and most of the ADRs noted within first 2 weeks of initiation of treatment. Gastritis was the most common ADRs (28/22.7%) followed by anorexia (26/21.1%).Conclusions: In our study 22.1% of patients developed ADRs. ADRs recorded in our study were categorised under ‘probable’ and ‘possible’ causes and severity assessment showed 48% are moderate and 52% are ‘mild’ in nature. Still ADRs accounted for 9% default rate. Hence implementations of good patient care oriented programs are needed for early diagnosis and to reduce default rate and drug resistance.

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Background: The objective of the study was to assess the awareness of P- drug selection among rural general practitioners’s (GP) for common medical conditions.Methods: Fifty general practitioners in Tumakuru district were provided with proformas for selection of P- drugs for mild to moderate hypertension, diabetes, upper respiratory tract infections and acid peptic disease based on safety, affordability, need, and efficacy (SANE criteria).Results: Forty one GP’s responded by completing the proformas. Seventeen of them were aware of the concept of P- drug selection. In hypertension, beta blockers followed by Angiotensin Converting Enzyme (ACE) inhibitors were most commonly preferred. In diabetes, biguanides followed by sulfonylureas were preferred as oral hypoglycemic agents. Ampicillin, Ciprofloxacin and Cotrimoxazole were the commonly used antibiotics for upper respiratory tract infections. Ranitidine and antacids were preferred for acid peptic disease. Affordability followed by efficacy was the deciding criteria for P- drug selection.Conclusions: There is lack of awareness of P- drug selection among many rural GP’s. Therefore, there is necessity to create awareness about P- drug selection through continued medical education for rational use of drugs.