جستجوی مقالات مرتبط با کلیدواژه « pulmonary tuberculosis » در نشریات گروه « پزشکی »

Rifampicin (RIF) and isoniazid (INH), two most potent antibiotics, are prescribed to cure tuberculosis. Mycobacterium tuberculosis, the causative agent of multidrug-resistant tuberculosis (MDR-TB), is resistant to these first-line drugs. Here, two molecular techniques were demonstrated such as PCR sequencing-based and GeneXpert assay for rapidly identifying MDR-TB.

Pulmonary samples (sputum) were collected from 55 MDR-TB suspected patients from the Na- tional Tuberculosis Reference Laboratory (NTRL), Dhaka where the research work was partially accomplished and con- tinued in the department of Microbiology, University of Dhaka, Bangladesh. We strived for sequencing technique as well as GeneXpert assay to identify mutations in rpoB and katG genes in MTB strains and sputum directly. Culture-based drug susceptibility testing (DST) was performed to measure the efficacy of the molecular methods employed.

When analyzed, rpoB gene mutations at codons 531 (54.54%), 526 (14.54%), and 516 (10.91%) were found by sequencing in 80% of the samples. Nucleotide substitution at katG315 (AGC→ACC) was spotted in 16 (76.19%) out of 21 samples. When comparing the sequencing results with DST, sensitivity and specificity were investigated to determine drug-resistance (rifampicin-resistance were 98 and 100% whereas isoniazid-resistance were 94 and 100% respectively). Additionally, as a point of comparison with DST, only 85.45% of RIF mono-resistant TB cases were accurately evaluated by the GeneXpert assay.

This research supports the adoption of PCR sequencing approach as an efficient tool in detecting MDR-TB, counting the higher sensitivity and specificity as well as the short period to produce the results.

Polymorphisms in the vitamin D receptor (VDR) play an effective role in the susceptibility of pulmonary tuberculosis (TB). Given the importance of this polymorphism and its association with pulmonary TB, this study aimed to investigate the prevalence of VDR polymorphisms in people with pulmonary TB.  

The search process was performed from 2009 to 2023 according to PRISMA (Preferred reporting items for systematic reviews and meta-analyses). The strengthening of the reporting of observational studies in epidemiology (STROBE) checklist was used to qualify the articles. The data was entered into STATA version 14 software, then the fixed effects model and the random effects model, effect size (ES), and Q test (P < 0.10) were used for data analysis at a confidence interval level (CI) of 95%. Two-sided statistical tests were considered with α=0.05.  

In this research, 28 articles were analyzed. Polymorphisms showed a significant relationship with susceptibility to pulmonary TB (P = 0.000), and significant heterogeneity (P = 0.000) was seen between polymorphisms. FokI (95% CI: 0.39-0.46, P = 0.000, ES = 43%), ApaI (95% CI: 0.31-0.48, P = 0.000, ES = 39%) and BsmI  (95% CI: 0.24-0.50, P = 0.000, ES = 37%) showed the most frequent gene polymorphisms after TaqI (95% CI: 0.34-0.77, P = 0.000, ES = 56%).  

ApaI, BsmI, FokI, and TaqI polymorphisms were found in patients suffering from pulmonary TB. Polymorphisms related to the TaqI gene were the most frequent. Controlling and prescribing vitamin D may be needed in these patients.

Genetic polymorphisms are predictors of the immune response and susceptibility to certain infectious diseases, including pulmonary tuberculosis (TB). We evaluated the association of monocyte chemoattractant protein-1 (MCP1) (-2581 A/G) and interferon-gamma (IFNγ) (+874 T/A) polymorphisms with susceptibility to pulmonary TB in an Iranian population.

A total of 124 patients with pulmonary tuberculosis and 244 healthy subjects (121 related normal controls and 123 unrelated subjects) were included. The MCP1 polymorphic region (-2518 A/G) was genotyped by PCR-RFLP, while ARMS-PCR was used to amplify and detect IFNγ (+874 T/A). SNPStats and SPSS v. 20 were used for the statistical analysis of the data.

The comparison of MCP1 (-2518 A/G) alleles and genotypes in TB patients and healthy subjects showed no significant association in all the constructed heredity models. No association was observed between TB patients and normal subjects in all the constructed inheritance models for IFNγ (+874 T/A) alleles and genotypes.

Due to the lack of association between MCP1 (-2518 A/G) and IFNγ (874 T/A) polymorphisms and susceptibility to PT in our study and the conflicting results of some previous studies, further clinical and molecular research is needed to clarify the role of the studied polymorphisms in the pathogenesis of tuberculosis.

Delay in the diagnosis of tuberculosis (TB) leads to poor response to treatment and the disease transmission to susceptible individuals. The Xpert MTB/RIF assay efficiently detects Mycobacterium tuberculosis (MTB). The present study aimed to compare acid-fast bacilli (AFB) microscopy, culture, and Xpert MTB/RIF assay in the diagnosis of pulmonary and extrapulmonary tuberculosis cases.
Materials &

This retrospective study was conducted in the Department of Microbiology, Government Medical College, Srinagar, India over 18 months from February 2019 to July 2020. Samples were processed and evaluated using AFB microscopy, culture, and Xpert MTB/RIF assay.

Among the 1862 samples evaluated, 224 samples were found to be positive using AFB microscopy, culture, and Xpert MTB/RIF assay. The overall sensitivity and specificity of the Xpert MTB/RIF assay in diagnosing pulmonary TB cases was 98.23 and 97.69%, respectively. Among the smear-negative extrapulmonary samples, 52 (5.75%) and 86 (9.6%) samples were positive in culture and the Xpert MTB/RIF assay, respectively. The maximum recovery of MTB by Xpert MTB/RIF assay was from tissue biopsy specimens. Rifampicin resistance was observed in six samples.

Both culture and Xpert MTB/RIF methods were sensitive in detecting smear-positive samples. Although both techniques missed some smear-negative pulmonary and extrapulmonary TB cases, the Xpert MTB/RIF assay enhanced the detection rate of MTB compared to culture. The Xpert MTB/RIF assay enabled the accurate diagnosis of tuberculosis cases with a rapid turnaround time; therefore, it could assist clinicians to start timely therapeutic interventions for these patients.

Tuberculosis (TB) is still a significant medical and social problem in developing nations like Indonesia, with high morbidity and mortality rates. Tuberculosis infection are mostly found in the lungs, but they can affect other organs as well. Secondary spontaneous pneumothorax (SSP) is one of the most serious complications of tuberculosis, requiring the insertion of a chest tube in the majority of cases. The Heimlich valve can be used in complicated and persistent pneumothorax. The Heimlich valve may be outdated, but it is a very efficient one-way valve that provides safe air evacuation from the thoracic cavity. A 53-year-old man was hospitalized after complaining of left-sided chest discomfort and shortness of breath. The patient confirmed receiving tuberculosis treatment four years ago. During a physical examination, hyperresonance to percussion and decreased vesicular breath sounds was found on left side, wheezing on the right, and SaO2 of 92% in room air. An x-ray of the chest revealed a left side pneumothorax and fibrosis at the right lung's apex. Emergency drainage was done and an X-ray evaluation of  the collapsed lung aeration was observed. However, even though drainage has been done for 19 days, an examination revealed persistent pneumothorax, requiring extended drainage. Due to a lack of resources and to prevent prolonged hospitalization, we began using a Heimlich valve to treat pneumothorax. The chest tube and Heimlich valve were detached successfully after two months. In conclusion, the Heimlich valve provides a practical and affordable treatment for ambulatory care of persistent pneumothorax.

Diabetes and immunosuppressive diseases have been reported as increased risk factors for developing invasive pulmonary tuberculosis and mucormycosis.

Case report: 

We presented here a case of a 55-year-old uncontrolled diabetic male with rhinosinus mucormycosis and pulmonary TB coinfection. Maxillary and ethmoid sinus involvement was observed in paranasal computed tomography. His chest computed tomography showed tree in the bud sign and cavitary lesions in the lungs. Mycobacterium tuberculosis was confirmed through molecular diagnosis using a realtime polymerase chain reaction assay. The nasal cavity biopsy revealed the fungal elements (aseptate hyphae) and confirmed mucormycosis infection. Amphotericin B liposomal, teicoplanin, and tazobactam were administered to treat the mucormycosis. The patient was successfully treated with a recommended four-drug regimen for TB without any adverse reaction.

The clinicians must consider tuberculosis and mucormycosis tests when confronted with an uncontrolled diabetic patient with clinical symptoms of hemoptysis, fever, and cavitary lesions.

Tuberculosis (TB) is a major health problem worldwide. To date, the standard diagnostic method for TB is still the direct observation of Mycobacterium TB in a sputum smear or culture.

There is an urgent need for a method to detect the disease in a shorter time with acceptable sensitivity and specificity and help monitor the treatment.

A panel of 34 adults newly diagnosed with smear-positive pulmonary TB was followed during their treatment period of five months. Neopterin (NPT) serum levels were measured three times (before treatment and two and five months after treatment) using the Brahms ELItest Neopterin kit, and the results were analyzed using descriptive and graphical methods.

The mean NPT for the first time before treatment was 27.47 ± 20.7 nmol/L. NPT was measured two months after the anti-TB treatment, and the associated mean was 16.97 ± 14.14 nmol/L. At the end of the fifth month, the mean NPT concentration reached 11.3 ± 10.5 nmol/L. The mean serum NPT before treatment had a statistically significant difference with the mean NPT at the end of the second and fifth months of the treatment (P = 0.001).

According to the national protocol for treating TB, a sputum smear is still necessary for patients’ follow-up. It seems that the serum NPT level should be measured to monitor response to treatment in patients that, for any reason are not able to give sputum in TB treatment follow-up.

Pulmonary pneumatoceles (PCs) are thin-walled, air-filled cysts that develop within pulmonary parenchyma. PCs are usually seen in the lung after infection, trauma. In case of infection, as a complication of acute pneumonia, caused by Staphylococcus aureus, and are more frequently in infants and children. Adult tuberculous pulmonary pneumatoceles are seldom reported.   PCs are usually asymptomatic. Large PCs may compress adjacent lung with mediastinal shift causing respiratory or cardiovascular symptoms.  Surgical intervention is only indicated when PCs cause cardiopulmonary compromise or rupture into the pleural space or unresolved infection.

Zinc (Zn) is nutritionally essential trace element, and thus deficiency may severely affect human health. The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. Our goal is to investigate whether Zn supplementation can increase the effects of anti-TB treatment or not.

Patients with newly diagnosed tuberculosis were divided in to 2 groups. One group (n= 37) received capsule contains 50 mg of elemental zinc (as zinc sulfate) for 6 months every other day (micronutrient group) and Group II (n= 37) received placebo. Both groups received the same anti-tuberculosis treatment recommended by the WHO. Clinical examination, BMI, chest X-ray, direct sputum examination, assessment of serum zinc levels (by atomic absorption spectrophotometry), and biochemical markers serum concentration (by using an RA1000 AutoAnalyzer) were carried out before and after 2- and 6-months anti-tuberculosis treatment.

Plasma zinc concentrations in the micronutrient group was higher than placebo group After treatment. In the placebo group increasing in SGOT and SGPT concentrations were significantly higher than micronutrient group after 2 months of treatment (p< 0.05). The significant changes (p< 0.05) were observed on the serum levels of total protein, albumin. Alkaline phosphatase (ALP) levels, serum creatinine, uric acid and urea in groups were not significantly different.

Zinc supplementation results in earlier sputum smear conversion in the micronutrient group during the first 6 weeks. Increased body weight and serum zinc and serum albumin and decrease in total protein was observed in the micronutrient group.

It is important to determine the type of tuberculosis and its related factors in order for effectively treating a disease and reducing its side effects in the society.

This study aimed to determine vitamin D level in patients with pulmonary and extrapulmonary tuberculosis in Karaj, Iran in 2017-2018.

In this observational study, 102 patients suffering from pulmonary and extra-pulmonary tuberculosis disease were availably selected in Karaj, Iran in 2017-2018. They were examined and, then, their vitamin D level were assessed and compared according to the type of tuberculosis.

The study results showed that vitamin D level was normal in 39.2% of the case study population, but it was abnormal in 60.8% of it (18.6% deficiency and 42.2% insufficiency). Vitamin D deficiency was 15.8% in pulmonary tuberculosis patients and it was 22.2% in extrapulmonary tuberculosis ones, showing no significant difference (P>0.05) statistically.

According to the obtained results, hypovitaminosis-D was detected in more than half of the patients with pulmonary and extra pulmonary tuberculosis, which was not associated with the type of tuberculosis. Seemingly, the patients needed the same amount of – or even more – food, medical supplements, sports, and sunlight compared to healthy people.

Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis (Mtb). This infection causes the release of proinflammatory cytokines that affect hemostasis. Pulmonary TB infection causes an increased activation of procoagulant factors, decreased anticoagulant factors and suppresses fibrinolysis which causes hypercoagulable. Our study is conducted to assess the association between pulmonary TB infection (PTB) with hemostatic parameters before and after intensive phase treatment.

This was an analytic observational prospective cohort design. The study was conducted at the Community Center for Lung Health in South Sulawesi. Studied subjects were recruited by consecutive sampling, in which the patients who met the inclusion criteria received intensive phase of ATD treatment. PT, aPTT, fibrinogen, and D-dimer were measured before treatment and after the intensive phase of ATD. These data were analyzed using the SPSS Version 22.

In this study, 30 subjects are new cases of PTB. Prothrombin time, aPTT and Ddimer levels were higher in far advanced lesions and smear-positive sputum group (p<0.001). There was a significant level decrease in PT, aPTT, fibrinogen, D-dimer after intensive phase treatment (p<0.001).

Pulmonary tuberculosis infection is associated with hypercoagulability which is characterized by an increase in hemostatic parameters and has significant improvement after intensive phase of ATD treatment.

Tuberculosis (TB) is an old problem that is currently considered as a great challenge, mostly in developing countries. It may be a lethal disease. Thus, rapid diagnosis of Mycobacterium tuberculosis (MTB) infection plays a critical role in controlling the spread of TB, whereas conventional methods may take up to several weeks or longer to diagnose the infection. Hence, nested polymerase chain reaction (NCR) assay was applied for direct identification of the MTBDNA presence in sputum samples. The aim of the study was the development of a direct NCR method using mpt64specific primers for rapid diagnosis of MTBinfection.

To development of study, eight positive and negative sputum specimens obtainedfrom Masih Daneshvari hospitalpulmonary TB center, were studied. After smear preparation genomic DNA was extracted and mpt64was amplified using NCR method. While doing work we paying attention to PCR standardization and precautions to avoid sample contamination.

After evaluation gained appropriate results from purified genomic DNA by AGE and biophotometer, the standardized NCR products were evaluated by Agarose Gel Electrophoresis. Five of 7 positive samples were positive, and one of the negative samples was negative using our NCR assay.

Based on the results of this study, we could be successful in the NCR technique’s optimization to our system for disese detection,while it can be apply as a more rapid, accurate, inexpensive, and specific diagnostic assay for direct detection of MTBDNA.

 Since December 2019, a new type of pneumonia named coronavirus disease 2019 (COVID-19) has been reported in Wuhan, Hubei province, China. At present, there are no relevant reports on cases of COVID-19 and comorbid pulmonary tuberculosis. We herein report a case of a patient with COVID-19 and comorbid pulmonary tuberculosis.

 A 47-year-old female patient with COVID-19 positive pharyngeal swabs. She did not have fever, coughing or breathing difficulties. The patient diagnosed as COVID-19, and pulmonary tuberculosis based on the patient's epidemiological history, routine blood test, imaging findings, and COVID-19 nucleic acid test results. Contact and droplet precautions were implemented. Antiviral treatment, anti-tuberculosis treatment, and liver protection treatment were given. The patient has not complained of discomfort, and her condition is stable.

 COVID-19 and comorbid tuberculosis is suspected, epidemiological history, clinical presentation, laboratory tests, and imaging examinations must be combined to make a comprehensive diagnosis and prompt quarantine and treatment measures should be implemented.

 Tuberculosis (TB) affects various aspects of quality of life (QoL), and self-care is the most important form of primary care and one of the main factors involved in the process of treating chronic diseases and improving the patients’ QoL.

 This study aimed to investigate the effect of self-care education on the QoL of TB patients.

 In this quasi-experimental study, 110 TB patients referred to the TB coordinating Center in Zahedan, Southeastern Iran, in 2018, are studied. Participants were selected using convenience sampling and were randomly assigned to the intervention (n = 55) and control (n = 55) groups. Data were collected using the tuberculosis quality of life-version 2 (TBQol-v2). For the intervention group, first, patients and their caregivers were divided into groups compromising of 4 to 6 members, and then three sessions of self-care education, including lectures and questions and answers meetings, each lasted for 30 minutes (in total 90 minutes) were provided to each group. Data were analyzed in SPSS version 21 using descriptive statistical tests, independent t-test, paired t-test, and chi-squared test.

 Mean of the total QoL score of the two groups before the intervention was 67.56 ± 5.99 and 67.09 ± 5.03, respectively, indicating no significant difference (P = 0.65). But after providing the intervention, the mean score of patients QoL in the intervention group (74.84 ± 4.90) was significantly higher than the control group (67.98 ± 0.68) (P = 0.001).

 Since self-care education can effectively enhance the QoL of TB patients, it is recommended to provide such educations for both treatment and follow-up of these patients along with directly observed treatment, short-course (DOTS).
 

To investigate the expression levels of miRNA-29a (miR-29a), tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) in peripheral blood of pulmonary tuberculosis patients and their correlation with clinical and pathological features.

A prospective analysis was performed on 192 pulmonary tuberculosis patients (pulmonary tuberculosis group) and 186 healthy patients (control group) who were admitted to Beijing Chest Hospital, Capital Medical University, Beijing, China from Jun 2015 to Jun 2019. Real-time quantitative PCR was used to detect the expression levels of miR-29a, and ELISA to detect the concentrations of TNF-α and VEGF in serum. The diagnostic value of miR-29a, TNF-α and VEGF in tuberculosis was analyzed using receiver operating characteristic curve (ROC). The correlation of the expression levels of miR-29a, TNF-α and VEGF with gender, age, low-grade fever, expectoration, hemoptysis and pulmonary tuberculosis classification was analyzed.

The expression levels of miR-29a, TNF-α and VEGF in pulmonary tuberculosis group were significantly higher than those in control group (P<0.001). The area under curves of miR-29a, TNF-α, and VEGF were 0.818, 0.743, and 0.805, respectively. miR-29a was closely correlated with low-grade fever, expectoration, hemoptysis and pulmonary tuberculosis classification (P<0.050). TNF-α and VEGF were closely correlated with patient age, low-grade fever, expectoration, hemoptysis and pulmonary tuberculosis classification (P<0.050).

Highly expressed in pulmonary tuberculosis patients, TNF-α and VEGF are closely correlated with the disease progression of patients, expected to become targets for the diagnosis and treatment of pulmonary tuberculosis in the future.