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Biomedical subjects

Rupak Singla

Publications and source records attributed to Rupak Singla.

5 recordsLinked to original sources
PubMed2003

Does diabetes alter the radiological presentation of pulmonary tuberculosis.

OBJECTIVE: The aim of this study is to determine whether diabetes mellitus (DM) alters the radiological manifestations of pulmonary tuberculosis (TB). METHODS: A retrospective review of the medical records and skiagrams of 692 consecutive smear positive pulmonary TB patients admitted in the Sahary Chest Hospital, Riyadh, Kingdom of Saudi Arabia, from January 1998 to December 1999, was performed. One hundred and eighty-seven (27%) patients had an associated DM. The radiographic findings of pulmonary TB patients with DM (PTB DM group) were compared to those without DM (PTB group). RESULTS: The PTB DM group of patients had increased frequency of lung lesions confined to lower lung field compared to PTB group (23.5% versus 2.4%, p<10(-4)). The PTB DM group of patients had significantly higher frequency of cavitary lung lesions compared to PTB group (50.8% versus 39.0%, p=0.005). Also cavitary lesions were more frequently confined to lower lung field in PTB DM group compared to PTB group (28.9% versus 2.5%, p<10(-4)). Logistic regression analysis showed that diabetes was the only independent significant risk factor associated with lung lesions or cavities in the lower lung fields (lung lesions [odds ratio [OD]=12.63, 95% confidence interval [CI]=6.50-24.56]; cavitary lesions [OD=15.66, 95% CI = 5.82-42.16]). CONCLUSION: The PTB DM group are more likely to present with atypical radiological images. Among diabetic patients presenting with lower lung field lesions or cavities possibility of TB should always be considered for prompt diagnosis and management.

Adult↗
PubMedDate not supplied

Prevalence of resistance to antituberculosis drugs in Riyadh and a review of previous reports.

BACKGROUND: Resistance to antituberculosis drugs is an important cause of treatment failure. We evaluated the prevalence and pattern of antituberculosis drug resistance in the central region of Saudi Arabia, and reviewed previous reports from Saudi Arabia. MATERIALS AND METHODS: We retrospectively examined the records of sputum smear and culture-positive pulmonary tuberculosis patients admitted consecutively from 1998 through 1999 in a main referral hospital in Riyadh, and analyzed drug sensitivity reports. We also reviewed previous reports on antituberculosis drug resistance in Saudi Arabia. RESULTS: Of 515 patients with pulmonary tuberculosis, 80 (15.5%) had resistance to at least one antituberculosis drug. Resistance to streptomycin was most frequent (9.7% ), followed by rifampicin (9.5%), isoniazid (4.3%), and ethambutol (0.2%). Resistance to one antituberculosis drug was found in 8.9%, resistance to two drugs in 5.2%, resistance to three drugs in 1.2%, and resistance to four drugs in 0.2%. Multidrug resistance (defined as resistance to at least isoniazid and rifampicin) was found in 1.9% of patients. A literature review including 6114 patients in Saudi Arabia showed that resistance against streptomycin was most common (8.8%), followed by rifampicin (8%), and isoniazid (7.2%). Of the 6114 patients, 6.8% patients were resistant to only one drug, 3.6% were resistant to two drugs, and 3.7% to three drugs. CONCLUSION: The high prevalence of rifampicin resistance and resistance to multiple drugs in the Riyadh region and in other parts of Saudi Arabia is a major challenge to the control of tuberculosis in this country. Efforts should be made to prevent the emergence of further antituberculosis drug resistance.

Journal Article↗
PubMedDate not supplied

Influence of pre-treatment bacillary load on treatment outcome of pulmonary tuberculosis patients receiving DOTS under revised national tuberculosis control programme.

OBJECTIVE: To study the influence of initial bacillary load on sputum conversion rates and treatment outcome of new smear positive pulmonary tuberculosis patients. METHODS: A retrospective study was done among 2938 new smear positive pulmonary tuberculosis patients, registered at the peripheral centres, covering a population of 1.6 million in Delhi, India. The patients pre-treatment sputum smears were graded as 1+, 2+ or 3+ based on three samples. Patients were given intermittent short-course chemotherapy under supervision and the treatment outcome was analysed. RESULTS: Sputum conversion rates among patients graded as sputum 3+ and rest of the patients (combined graded sputum 1+ and 2+) at the end of two months were 62.2% and 76.8% respectively (p<0.001), and at the end of three months were 81.3% and 89.5% respectively (p<0.001). Cure rates among same group of patients were 76.6% and 85.1% respectively (p<0.001), and failure rates were 7.7% and 4.5% respectively (p<0.001). CONCLUSIONS: Under field conditions even with directly observed treatment (DOT) new smear positive patients with heavy bacillary load showed statistically significant poor sputum conversion rates at two and three months and higher failure rates as compared to patients with lesser bacillary load. To investigate possible reasons for this poor response and possible solutions further studies are needed.

Adolescent↗