BACKGROUND Tuberculosis (TB) is a major health problem in India. The World Health Organization has recently in 2010 endorsed the GeneXpert MTB/RIF assay for rapid detection of smear negative and multidrug-resistant tuberculosis. The aim of the study is to evaluate the role of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) in sputum AFB negative Pulmonary Tuberculosis (PTB). MATERIALS AND METHODS This is an observational study conducted in the Department of Pulmonary Medicine, RRMCH, Bengaluru, between August 2016 to June 2017. Patients who presented with symptoms and signs suggestive of pulmonary tuberculosis, chest x-ray showing features of pulmonary tuberculosis were included in the study whose sputum for AFB was negative. Sputum/BAL samples from these patients were sent for CBNAAT. RESULTS CBNAAT was done for 80 samples of the patients who were having history and CXR suggestive of pulmonary tuberculosis with sputum AFB negative. Out of these 80 sputum-AFB negative samples, 29 (36%) were CBNAAT positive. Most of the cases were men aged >50 yrs. Most diabetics (78%) were CBNAAT positive. Most diabetics had HbA1C >10. Most diabetics had lower zone infiltrates on CXR. CONCLUSION Because of its simplicity, rapidity and sensitivity, this seems to be a very novel tool for diagnosis of extrapulmonary tuberculosis from clinical samples and that it should be researched more thoroughly.
BACKGROUND Bronchiectasis is defined as "abnormal and permanent dilatation of one or more bronchi due to weakening or destruction of the muscular and elastic components of the bronchial walls." HRCT has become the gold standard to diagnose bronchiectasis. Antibiotics and chest physiotherapy are main forms of management. The aim of the study is to study the outcome of treatment in acute exacerbation of bronchiectasis in adults. MATERIALS AND METHODS This study was done prospectively in the Department of Respiratory Medicine in Rajarajeswari Medical College and Hospital from November 1, 2015, to April 30, 2017. Out of 55 cases admitted during the study period, 44 cases (10 females) were eligible for participation in the study. 2 cases of Kartagener's syndrome under follow up in our department for past 3 years were included. Flexible bronchoscopy was done in 31 patients. RESULTS Cough with sputum was the commonest symptom. Breathlessness was documented in 32 patients. Arterial blood gas analysis was abnormal in 29 patients. Haemoptysis in 13 cases. History of antituberculous therapy was present in 34 patients. Digital clubbing was present in 30 patients. Pedal oedema was documented in 14 cases. Associated cultures were positive in 28 cases. CONCLUSION The most frequent form of bronchiectasis is post-tuberculous. Pseudomonas aeruginosa is the most frequently isolated bacteria. The most frequent concomitant disease in bronchiectasis is COPD. Piperacillin/tazobactum is the most effective antibiotic for initial empirical treatment of acute exacerbations of bronchiectasis.
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