Objective: The literature on interstitial lung diseases is limited. The aim of this research was to make this entity of diseases more understandable to clinicians and general population of the region of Pakistan. Methods: We conducted a cross-sectional study on 253 Pakistani subjects who are a part of the hospital-based registry of JPMC. We performed statistical analyses on SPSS version 22.0. We included patients above 15 years of age who exhibited clinical clues and radiological signs of ILD during March 2016 through February 2018 and excluded those who were on tuberculosis treatment, suspected to be suffering from post-infection bronchiectasis, expectant females or had failed to follow-up. Results: There was a 2:3 male to female ratio. Mean age was 49.0±13.2 years. Majority were non-smokers. Idiopathic Pulmonary Fibrosis (IPF) was the commonest ILD (38.8%) followed by Non-Specific Interstitial Pneumonitis (NSIP) (15.1%). Most patients presented with dyspnea and dry cough and about half were clubbed (47.3%). Substantial IPF cases (52.6%) were suffering from GERD symptoms. Conclusion: IPF and NSIP were the major ILDs, GERD was the only predictor of IPF. This entity of lung diseases needs to be explored further to identify patterns of presentation and to make diagnosis at a manageable stage. doi: https://doi.org/10.12669/pjms.36.3.1046 How to cite this:Jafri S, Ahmed N, Saifullah N, Musheer M. Epidemiology and Clinico-radiological features of Interstitial Lung Diseases. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1046 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Tuberculous meningitis (TBM) is associated with significant complications of central nervous system. It is accompanied by nonspecific and heterogeneous clinical symptoms. We focused on the significance of early diagnosis and prompt treatment. We describe a case of TBM in a 19-year-old Asian female. She had a progressive motor weakness with no sensory findings. She was started on antituberculous therapy. Her magnetic resonance imaging (MRI) contrast of dorsolumbar spine showed syringomyelia. Her culture and sensitivity for Mycobacterium tuberculosis (MTB) came negative. She was given a therapeutic trial of quinolones and Steroids. She had an uneventful recovery and was followed up for the past one year.

Aim: To determine the factors associated with persistent sputum positivity at the end of two months of treatment in patients presenting with (drug-susceptible) pulmonary tuberculosis at a tertiary care hospital in Karachi.Setting: A cross-sectional study was conducted at the Department of Chest Medicine (Ward 12), Jinnah Postgraduate Medical Center (JPMC), Karachi over six months.Methods:A sample of 73 consenting, newly diagnosed, smear positive drug-susceptible pulmonary tuberculosis patients was studied. Demographic (age, gender, height, weight and duration of tuberculosis, body mass index (BMI), socioeconomic, occupational, marital, educational and residential statuses) and clinical factors (chest X-ray extent and cavities, initial smear results, diabetic and smoking statuses) which may be associated with sputum non-conversion were entered in a proforma. Patients were followed up at two months of treatment with a sputum smear. Data analysis was done on SPSS-20.0.Results:Rate of sputum positivity after two months of treatment was 17.8%. None of the factors was associated with persistence of sputum positivity except for the presence of chest radiograph (CXR) cavities; which made it 5.5 times more likely that the patient would remain smear-positive at two months (p=0.035).Conclusion:The finding of CXR cavities makes it highly likely that a pulmonary tuberculosis patient may remain infectious or have an unfavourable outcome despite taking treatment for 2 months. Clinicians and national policy-makers should thus bear in mind the implications this can have with regard to disease control and pay particular attention in terms of stringent monitoring and Directly Observed Treatment Short-course (DOTS) provision.

Background Many elements have been studied repeatedly that influence time to sputum culture conversion in multi-drug resistant tuberculosis (MDR-TB). Deranged sugars not only hamper one's infection contesting ability but also increase the chances of drug resistance. Our aim was to establish whether or not glycemic control alters MDR-TB treatment outcome. Methods A prospective cohort study was conducted at the TB Clinic of Jinnah Postgraduate Medical Center, Karachi, Pakistan. Newly diagnosed MDR-TB cases were started on WHOrecommended treatment regime. HbA1c (hemoglobin A1c or glycated hemoglobin) was tested at the start of treatment irrespective of the previous diabetic status. Sputum samples, 30 days apart, were taken during the initial phase of the MDR TB treatment until two consecutive samples showed conversion. Pearson's correlation coefficient was calculated to see the link between time to sputum culture conversion and HbA1c. Results Among 47 patients, 19 (40.4%) new cases, whereas 28 (59.8%) were previously treated for drugsensitive TB. Our 39 patients converted during six months, of which 18 (46%) converted in one month, 14 (35.9%) in two months, 6 (15.4%) in three months, and only 1 in five months. Mean time to sputum culture conversion was 1.77 ± 0.9 months. There was a slightly negative correlation between HbA1c and sputum culture conversion time (r =-0.075, p = 0.649). Conclusions Sugar control does not affect sputum culture conversion in MDR-TB when an optimal treatment regime is applied.

To compare the precision of DECAF (Dyspnea, Eosinopenia, Consolidation, Acidemia, Atrial Fibrillation) and CURB-65 scoring systems in prediction of mortality among patients presenting with an acute exacerbation of chronic obstructive pulmonary disease (COPD).