Pub Date : 2025-01-01DOI: 10.1016/j.ijtb.2024.06.011
P.C. Kathuria , Manisha Rai
Allergen Immunotherapy (AIT) is the only disease modifying treatment option for patient with IgE mediated allergic disorder. Conventional subcutaneous immunotherapy is associated with adverse events during build-up and maintenance phase but cluster allergen immunotherapy with monoclonal anti-IgE antibody (omalizumab) has complementary and synergistic effect. Omalizumab plus AIT can significantly enhance the efficacy, safety, and steroid-sparing effect of AIT by increasing target maintenance dose (TMD) and sustained unresponsiveness (SU) to allergen while decreasing the adverse events and severe systemic reactions. This review aims to highlight that combination of omalizumab plus AIT is superior than AIT alone.
{"title":"Omalizumab with allergen immunotherapy in respiratory & food allergy","authors":"P.C. Kathuria , Manisha Rai","doi":"10.1016/j.ijtb.2024.06.011","DOIUrl":"10.1016/j.ijtb.2024.06.011","url":null,"abstract":"<div><div><span>Allergen Immunotherapy<span> (AIT) is the only disease modifying treatment option for patient with IgE mediated allergic disorder. Conventional subcutaneous immunotherapy<span> is associated with adverse events during build-up and maintenance phase but cluster allergen immunotherapy with monoclonal anti-IgE antibody (omalizumab) has complementary and synergistic effect. </span></span></span><em>Omalizumab plus AIT</em><span> can significantly enhance the efficacy, safety, and steroid-sparing effect of AIT by increasing target maintenance dose (TMD) and sustained unresponsiveness (SU) to allergen while decreasing the adverse events and severe systemic reactions. This review aims to highlight that combination of </span><span><span>omalizumab</span><em> plus AIT</em></span> is superior than AIT alone.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 1","pages":"Pages 98-102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
India bears a burden of tuberculosis (TB) and undernutrition, both of which are interconnected, as undernutrition increases the susceptibility and affects the outcome of TB infection. To address this, government of India introduced Nikshay Poshan Yojana in 2018 to provide nutritional support to patients with TB. However, the end-usage and barriers of the monetary benefit under this scheme have not been extensively studied.
Objective
To address these gaps, our study aimed to estimate Nikshay Poshan Yojana coverage among patients with tuberculosis in the Ballabgarh tuberculosis unit, explore end-usage patterns, and identify facilitators and barriers for availing the monetary benefit.
Methods
We conducted a mixed-methods study in Ballabgarh tuberculosis unit (TU) in Faridabad district of Haryana state, India. To assess the coverage, we randomly selected patients treated under the Ballabgarh TU between January 2019 and December 2021. We conducted telephonic interviews using a semi-structured questionnaire and collected data on the coverage and end usage of the Nikshay Poshan Yojana scheme. Descriptive analysis was conducted using R software. We conducted in-depth interviews with a senior treatment supervisor and a district tuberculosis officer and two focus group discussions with tuberculosis patients. Thematic analysis was used to identify the factors of end usage, facilitators, and barriers of the use of monetary benefits under the scheme.
Results
Among the 251 patients with TB enrolled in the study, 60.6% received at least one and 22.3% received all instalments. The median amount received was INR 2500 (USD 31.2), with 90.9% of the funds being spent on purchasing food items. Fruits and milk were the main food items purchased. Factors influencing the end usage included personal or family needs, awareness of the nutritional benefits in addressing the disease, advice from parents and Directly Observed Treatment Short-course (DOTS) providers, and the need for diagnostic tests or medications. Facilitators for utilization included assistance in creating bank accounts, centralized monitoring, and the flexibility of receiving the monetary benefit through parents' or family members' accounts. The barriers for utilization of Nikshay Poshan Yojana were non-availability of bank account, dormant bank account, delay due to bank related issues or administrative procedures.
Conclusion
The findings revealed a substantial partial coverage and poor full coverage of Nikshay Poshan Yojana. The monetary benefit received was primarily utilized for purchasing food items, indicating adherence to the intended purpose.
{"title":"Coverage and utilization of Nikshay Poshan Yojana among patients with tuberculosis: Exploring patterns and influencing factors","authors":"Kartik Chadhar, Nagappan Madhappan, Ankit Chandra, Harshal Ramesh Salve, Kapil Yadav, Puneet Misra, Rakesh Kumar","doi":"10.1016/j.ijtb.2023.09.005","DOIUrl":"10.1016/j.ijtb.2023.09.005","url":null,"abstract":"<div><h3>Background</h3><div>India bears a burden of tuberculosis (TB) and undernutrition, both of which are interconnected, as undernutrition increases the susceptibility and affects the outcome of TB infection. To address this, government of India introduced Nikshay Poshan Yojana in 2018 to provide nutritional support to patients with TB. However, the end-usage and barriers of the monetary benefit under this scheme have not been extensively studied.</div></div><div><h3>Objective</h3><div>To address these gaps, our study aimed to estimate Nikshay Poshan Yojana coverage among patients with tuberculosis in the Ballabgarh tuberculosis unit, explore end-usage patterns, and identify facilitators and barriers for availing the monetary benefit.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study in Ballabgarh tuberculosis unit (TU) in Faridabad district of Haryana state, India. To assess the coverage, we randomly selected patients treated under the Ballabgarh TU between January 2019 and December 2021. We conducted telephonic interviews using a semi-structured questionnaire and collected data on the coverage and end usage of the Nikshay Poshan Yojana scheme. Descriptive analysis was conducted using R software. We conducted in-depth interviews with a senior treatment supervisor and a district tuberculosis officer and two focus group discussions with tuberculosis patients. Thematic analysis was used to identify the factors of end usage, facilitators, and barriers of the use of monetary benefits under the scheme.</div></div><div><h3>Results</h3><div>Among the 251 patients with TB enrolled in the study, 60.6% received at least one and 22.3% received all instalments. The median amount received was INR 2500 (USD 31.2), with 90.9% of the funds being spent on purchasing food items. Fruits and milk were the main food items purchased. Factors influencing the end usage included personal or family needs, awareness of the nutritional benefits in addressing the disease, advice from parents and Directly Observed Treatment Short-course (DOTS) providers, and the need for diagnostic tests or medications. Facilitators for utilization included assistance in creating bank accounts, centralized monitoring, and the flexibility of receiving the monetary benefit through parents' or family members' accounts. The barriers for utilization of Nikshay Poshan Yojana were non-availability of bank account, dormant bank account, delay due to bank related issues or administrative procedures.</div></div><div><h3>Conclusion</h3><div>The findings revealed a substantial partial coverage and poor full coverage of Nikshay Poshan Yojana. The monetary benefit received was primarily utilized for purchasing food items, indicating adherence to the intended purpose.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 1","pages":"Pages 38-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135346857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The key for public health programs to succeed is their successful implementation to achieve the desired outcomes. For integrating legislative measures such as the Cigarette and Other Tobacco Products Act (COTPA), which needs a component of enforcement, unless there is optimal engagement and empowerment of the assigned agencies, the outcomes are likely to be weak and incomplete at best.
Current status
Enforcement of COTPA under the National Tobacco Control Programme (NTCP) has succeeded only partly despite the best efforts of State Tobacco Control Cells (STCCs) countrywide. The lack of an execution plan, irregularity in the training schedules of the assigned agencies which lack ownership, suboptimal engagement of the stakeholders, including civil societies (CSOs), missing monitoring and evaluation of their outputs until recently and, above all, an absence of an accountability clause in COTPA for non-performance have led to varied but mostly poor compliance.
Solutions
For successful enforcement of COTPA, the Ministry of Health & Family Welfare (MoHFW), besides integrated solutions proposed by several studies, should consider amending COTPA and strengthening the existing measures to control tobacco, such as setting of a dedicated COTPA-enforcement Police Unit at the State-level, a National Tobacco Control Organization (NTCO) or entrust it entirely to a third-party.
Conclusion
In India, the strictest enforcement of COTPA is critical to reduce the burden of tobacco. The MoHFW, besides amending COTPA at the earliest, should specifically focus on adopting the proposed outcome-oriented strategies. Or else, it should consider working for an endgame of tobacco in India by the year 2030.
{"title":"Enforcement of COTPA in India- current status, challenges and solutions","authors":"Rakesh Gupta , Garima Bhatt , Ranjit Singh , Puneet Chahar , Sonu Goel , Rana J Singh","doi":"10.1016/j.ijtb.2024.06.007","DOIUrl":"10.1016/j.ijtb.2024.06.007","url":null,"abstract":"<div><h3>Introduction</h3><div>The key for public health programs to succeed is their successful implementation to achieve the desired outcomes. For integrating legislative measures such as the Cigarette and Other Tobacco Products Act (COTPA), which needs a component of enforcement, unless there is optimal engagement and empowerment of the assigned agencies, the outcomes are likely to be weak and incomplete at best.</div></div><div><h3>Current status</h3><div>Enforcement of COTPA under the National Tobacco Control Programme (NTCP) has succeeded only partly despite the best efforts of State Tobacco Control Cells (STCCs) countrywide. The lack of an execution plan, irregularity in the training schedules of the assigned agencies which lack ownership, suboptimal engagement of the stakeholders, including civil societies (CSOs), missing monitoring and evaluation of their outputs until recently and, above all, an absence of an accountability clause in COTPA for non-performance have led to varied but mostly poor compliance.</div></div><div><h3>Solutions</h3><div>For successful enforcement of COTPA, the Ministry of Health & Family Welfare (MoHFW), besides integrated solutions proposed by several studies, should consider amending COTPA and strengthening the existing measures to control tobacco, such as setting of a dedicated COTPA-enforcement Police Unit at the State-level, a National Tobacco Control Organization (NTCO) or entrust it entirely to a third-party.</div></div><div><h3>Conclusion</h3><div>In India, the strictest enforcement of COTPA is critical to reduce the burden of tobacco. The MoHFW, besides amending COTPA at the earliest, should specifically focus on adopting the proposed outcome-oriented strategies. Or else, it should consider working for an endgame of tobacco in India by the year 2030.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 1","pages":"Pages 94-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tuberculosis (TB) is a common disease in underdeveloped countries. Of all tuberculosis cases worldwide, 28% were reported from India. The most prevalent site of infection is the lungs (pulmonary TB), whereas extrapulmonary tuberculosis (EPTB) is less common. The most common form of EPTB in India is Lymph Node TB, which accounts for around 35% of total EPTB cases. Splenic tuberculosis incidence is 8 % whereas tuberculosis of pancreas and gall bladder is extremely rare. Pancreatic and gallbladder tuberculosis (GT) is extremely rare and presents with non-specific features. The clinical manifestations of EPTB are variable, imitate other diseases, and are usually confused with other diseases. Thus, it is crucial to be cautious and highly suspicious of EPTB infection in endemic areas. Probability of developing EPTB in immunocompromised patients is higher than in immunocompetent patients. The burden of EPTB in HIV patients ranges from 15 to 20% of all TB cases in HIV-negative patients, while in HIV-positive people, it accounts for around 40–50% of new TB cases. Histopathological examination (HPE) and positive Acid-Fast Bacilli (AFB) smears are used to make the diagnosis. ATT is given to such patients for 6 months. Due to such a diverse presentation of TB, here, we report a case series of extrapulmonary TB occurring in the abdomen in, pancreas, gallbladder, and spleen.
{"title":"Uncommon presentation of gastrointestinal tuberculosis-A case series","authors":"Sapna Dixit , Ajay Kumar Verma , Jyoti Bajpai , Surya Kant , Riddhi Jaiswal , Anjali Singh","doi":"10.1016/j.ijtb.2024.06.010","DOIUrl":"10.1016/j.ijtb.2024.06.010","url":null,"abstract":"<div><div><span><span>Tuberculosis (TB) is a common disease in underdeveloped countries. Of all tuberculosis cases worldwide, 28% were reported from India. The most prevalent site of infection is the lungs (pulmonary TB), whereas extrapulmonary tuberculosis (EPTB) is less common. The most common form of EPTB in India is </span>Lymph Node<span><span> TB, which accounts for around 35% of total EPTB cases. Splenic tuberculosis<span> incidence is 8 % whereas tuberculosis of pancreas and gall bladder is extremely rare. Pancreatic and </span></span>gallbladder tuberculosis (GT) is extremely rare and presents with non-specific features. The clinical manifestations of EPTB are variable, imitate other diseases, and are usually confused with other diseases. Thus, it is crucial to be cautious and highly suspicious of </span></span>EPTB infection<span> in endemic areas. Probability of developing EPTB in immunocompromised patients is higher than in immunocompetent patients. The burden of EPTB in HIV patients ranges from 15 to 20% of all TB cases in HIV-negative patients, while in HIV-positive people, it accounts for around 40–50% of new TB cases. Histopathological examination (HPE) and positive Acid-Fast Bacilli (AFB) smears are used to make the diagnosis. ATT is given to such patients for 6 months. Due to such a diverse presentation of TB, here, we report a case series of extrapulmonary TB occurring in the abdomen in, pancreas, gallbladder, and spleen.</span></div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 1","pages":"Pages 133-138"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ijtb.2024.08.020
Chitra Veluthat , Kavitha Venkatnarayan, Uma Maheswari, Uma Devaraj, Priya Ramachandran
Hemophagocytic lymphohistiocytosis (HLH) is an exaggerated but ineffective immune response secondary to infections, inflammatory conditions, or malignancies. HLH is characterized by macrophage and T-cell activation resulting in phagocytosis of erythrocytes, lymphocytes, and platelets and an exuberant cytokine response respectively leading to catastrophic systemic manifestations. The clinical and biochemical profile of HLH significantly overlaps with that of sepsis, which may lead to misdiagnosis. Tuberculosis (TB) is an important infectious cause of HLH with a reported mortality of more than 50%. HLH may be misdiagnosed in patients with tuberculosis as the reticuloendothelial system is extensively involved in both disseminated TB and HLH. We present a series of four cases of TB-HLH admitted to the respiratory intensive care unit in a tertiary care hospital.
{"title":"Hemophagocytic lymphohistiocytosis (HLH) secondary to tuberculosis: A case series","authors":"Chitra Veluthat , Kavitha Venkatnarayan, Uma Maheswari, Uma Devaraj, Priya Ramachandran","doi":"10.1016/j.ijtb.2024.08.020","DOIUrl":"10.1016/j.ijtb.2024.08.020","url":null,"abstract":"<div><div>Hemophagocytic lymphohistiocytosis (HLH) is an exaggerated but ineffective immune response secondary to infections, inflammatory conditions, or malignancies. HLH is characterized by macrophage and T-cell activation resulting in phagocytosis of erythrocytes, lymphocytes, and platelets and an exuberant cytokine response respectively leading to catastrophic systemic manifestations. The clinical and biochemical profile of HLH significantly overlaps with that of sepsis, which may lead to misdiagnosis. Tuberculosis (TB) is an important infectious cause of HLH with a reported mortality of more than 50%. HLH may be misdiagnosed in patients with tuberculosis as the reticuloendothelial system is extensively involved in both disseminated TB and HLH. We present a series of four cases of TB-HLH admitted to the respiratory intensive care unit in a tertiary care hospital.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 ","pages":"Pages S94-S97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ijtb.2025.02.001
Shubham Chandra , Thomas Vadakkan Devassy
Background
Patients with chronic kidney disease (CKD) are more vulnerable to tuberculosis (TB) because of weakened immune systems, which is a serious health risk, especially in low-to-middle-income nations.Epidemiology: CKD patients have a 6.9 to 52.5 times higher risk of developing TB, with dialysis patients at even greater risk.
Pathogenesis
Impaired cell-mediated immunity, malnutrition, Vitamin-D deficiency, and Zinc deficiency contribute to TB susceptibility in CKD patients.
Diagnostic challenges
Atypical symptoms, nonspecific presentation, and limited diagnostic tools hinder TB diagnosis in CKD patients.
Management
Collaborative care and tailored treatment are essential. Anti-TB therapy requires dosing adjustments, careful monitoring, and consideration of comorbid conditions.
Conclusion
TB in CKD patients presents a complex clinical picture, requiring heightened awareness and multidisciplinary collaboration. Further research is needed to develop CKD-specific TB screening tools, optimal treatment regimens, and improved understanding of TB-CKD pathophysiology.
{"title":"Epidemiological, and management challenges in tuberculosis with chronic kidney disease","authors":"Shubham Chandra , Thomas Vadakkan Devassy","doi":"10.1016/j.ijtb.2025.02.001","DOIUrl":"10.1016/j.ijtb.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients with chronic kidney disease (CKD) are more vulnerable to tuberculosis (TB) because of weakened immune systems, which is a serious health risk, especially in low-to-middle-income nations.Epidemiology: CKD patients have a 6.9 to 52.5 times higher risk of developing TB, with dialysis patients at even greater risk.</div></div><div><h3>Pathogenesis</h3><div>Impaired cell-mediated immunity, malnutrition, Vitamin-D deficiency, and Zinc deficiency contribute to TB susceptibility in CKD patients.</div></div><div><h3>Diagnostic challenges</h3><div>Atypical symptoms, nonspecific presentation, and limited diagnostic tools hinder TB diagnosis in CKD patients.</div></div><div><h3>Management</h3><div>Collaborative care and tailored treatment are essential. Anti-TB therapy requires dosing adjustments, careful monitoring, and consideration of comorbid conditions.</div></div><div><h3>Conclusion</h3><div>TB in CKD patients presents a complex clinical picture, requiring heightened awareness and multidisciplinary collaboration. Further research is needed to develop CKD-specific TB screening tools, optimal treatment regimens, and improved understanding of TB-CKD pathophysiology.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 ","pages":"Pages S64-S67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stigma associated with tuberculosis (TB) and other diseases can have severe consequences on patient care and treatment outcomes. It is closely linked to social behaviour and deep rooted taboos.Stigma reduces trust in caregivers, leading to less attention to doctor's advice, lack of follow-up and poor adherence to treatment. To avoid facing stigma, patients may ignore treatment recommendations, ultimately creating problems in managing their disease. Stigma is a significant factor in delaying or avoiding treatment, not only in TB but also in mental illness, anxiety, depression, as it affects approximately 40% of cases.
{"title":"Tuberculosis and stigma: Break the silence…","authors":"V.K. Arora (Chairman), K.K. Chopra (Consultant and Ex- Director), Sanjay Rajpal (Director)","doi":"10.1016/j.ijtb.2025.02.015","DOIUrl":"10.1016/j.ijtb.2025.02.015","url":null,"abstract":"<div><div>Stigma associated with tuberculosis (TB) and other diseases can have severe consequences on patient care and treatment outcomes. It is closely linked to social behaviour and deep rooted taboos.Stigma reduces trust in caregivers, leading to less attention to doctor's advice, lack of follow-up and poor adherence to treatment. To avoid facing stigma, patients may ignore treatment recommendations, ultimately creating problems in managing their disease. Stigma is a significant factor in delaying or avoiding treatment, not only in TB but also in mental illness, anxiety, depression, as it affects approximately 40% of cases.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 ","pages":"Pages S1-S2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ijtb.2025.02.010
V.K. Arora , Sanjay Rajpal
{"title":"Tuberculosis and COPD: A multimorbidity syndrome","authors":"V.K. Arora , Sanjay Rajpal","doi":"10.1016/j.ijtb.2025.02.010","DOIUrl":"10.1016/j.ijtb.2025.02.010","url":null,"abstract":"","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 ","pages":"Pages S3-S4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.ijtb.2025.02.008
Arun Sampath , Saravanan Mani
Abdominal Tuberculosis represents 11–16% of extrapulmonary tuberculosis and usually presents with vague abdominal symptoms that can mimic other diseases such as inflammatory bowel disorders, malignancy and sarcoidosis. Often the diagnosis is delayed and complications such as adhesions, obstruction, fistula or bleeding can occur. The common types are peritoneal and intestinal TB. Clinical findings should be complemented with appropriate imaging techniques such as ultrasound, CT/MRI scan, barium roentgenograms and endoscopy. Due to the paucibacillary nature, the sensitivity of AFB smear, culture, PCR assays are usually lower and interventional procedures such as endoscopy/laparoscopic biopsy should be promptly utilized wherever needed so as to initiate early treatment and avoid late complications. Standard anti-TB regimen (2RHZE/4RHE) usually achieve higher cure rates in drug sensitive TB. Close follow-up monitoring is needed to evaluate the effectiveness of proper and regular treatment. Endoscopic interventions or surgery may be required in managing complications.
{"title":"Diagnostic evaluation and management of abdominal tuberculosis","authors":"Arun Sampath , Saravanan Mani","doi":"10.1016/j.ijtb.2025.02.008","DOIUrl":"10.1016/j.ijtb.2025.02.008","url":null,"abstract":"<div><div>Abdominal Tuberculosis represents 11–16% of extrapulmonary tuberculosis and usually presents with vague abdominal symptoms that can mimic other diseases such as inflammatory bowel disorders, malignancy and sarcoidosis. Often the diagnosis is delayed and complications such as adhesions, obstruction, fistula or bleeding can occur. The common types are peritoneal and intestinal TB. Clinical findings should be complemented with appropriate imaging techniques such as ultrasound, CT/MRI scan, barium roentgenograms and endoscopy. Due to the paucibacillary nature, the sensitivity of AFB smear, culture, PCR assays are usually lower and interventional procedures such as endoscopy/laparoscopic biopsy should be promptly utilized wherever needed so as to initiate early treatment and avoid late complications. Standard anti-TB regimen (2RHZE/4RHE) usually achieve higher cure rates in drug sensitive TB. Close follow-up monitoring is needed to evaluate the effectiveness of proper and regular treatment. Endoscopic interventions or surgery may be required in managing complications.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 ","pages":"Pages S7-S11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tubercular affection of talus in children is considered extremely rare with literature limited to few case reports. This study reports five cases of tubercular infection of talus in children and traces the various presentations and the treatment outcome.
MethodsThe series describes five children with biopsy proven affection of tuberculosis of talus. Data reviewed included the demographic data, clinical presentation, diagnosis, treatment and outcome at final follow up.
Results
Among the five cases described in this series, the majority were osseous (4/5). The location of the osseous lesions was noted in the head as well as the head-neck junction of the talus. The duration of symptoms varied from three to 12 months. Three of the five cases healed uneventfully after the initiation of standard anti-tubercular therapy with normal appearing radiographs at the latest follow up. Two cases still had small, geographic lytic lesions in the talus. These might represent healed cystic cavities filled with fibrous.
Conclusion
The diagnosis of tuberculosis of talus in children is challenging. A high index of suspicion is required for patients presenting pain around the ankle and hindfoot for more than four weeks. The involvement of the talar bone in tuberculosis can be osseous or synovial. Lesions in the head and neck should particularly be investigated for tubercular etiology. Once diagnosed, antitubercular drugs are effective in healing the lesions clinically as well as radiologically. The presence of lesions in the non-weight bearing area of the talus prevents bony collapse and eventual shape is maintained.
{"title":"Insight into tuberculosis of talus in children: A review of five cases","authors":"Anil Agarwal , Sitanshu Barik , Lokesh Sharma , Yogesh Patel , Mohit Gera , Varun Garg","doi":"10.1016/j.ijtb.2023.11.004","DOIUrl":"10.1016/j.ijtb.2023.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Tubercular affection of talus in children is considered extremely rare with literature limited to few case reports. This study reports five cases of tubercular infection of talus in children and traces the various presentations and the treatment outcome.</div><div>MethodsThe series describes five children with biopsy proven affection of tuberculosis of talus. Data reviewed included the demographic data, clinical presentation, diagnosis, treatment and outcome at final follow up.</div></div><div><h3>Results</h3><div>Among the five cases described in this series, the majority were osseous (4/5). The location of the osseous lesions was noted in the head as well as the head-neck junction of the talus. The duration of symptoms varied from three to 12 months. Three of the five cases healed uneventfully after the initiation of standard anti-tubercular therapy with normal appearing radiographs at the latest follow up. Two cases still had small, geographic lytic lesions in the talus. These might represent healed cystic cavities filled with fibrous.</div></div><div><h3>Conclusion</h3><div>The diagnosis of tuberculosis of talus in children is challenging. A high index of suspicion is required for patients presenting pain around the ankle and hindfoot for more than four weeks. The involvement of the talar bone in tuberculosis can be osseous or synovial. Lesions in the head and neck should particularly be investigated for tubercular etiology. Once diagnosed, antitubercular drugs are effective in healing the lesions clinically as well as radiologically. The presence of lesions in the non-weight bearing area of the talus prevents bony collapse and eventual shape is maintained.</div></div>","PeriodicalId":39346,"journal":{"name":"Indian Journal of Tuberculosis","volume":"72 1","pages":"Pages 74-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135664409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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