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Biomedical subjects

Salil Mehta

Publications and source records attributed to Salil Mehta.

11 recordsLinked to original sources
PubMed2006

Choroidal tubercles in neurotuberculosis: prevalence and significance.

PURPOSE: Neurotuberculosis is a relatively common form of tuberculosis and may be seen in 1-10% of patients of systemic tuberculosis and may present in several forms. Ocular lesions are frequently seen, most commonly optic nerve lesions. Limited data are available for choroidal tubercles. We conducted a prospective study 1) to determine the prevalence of choroidal tubercles in a cohort of patients of neurotuberculosis as well as its relative prevalence in the various morphological manifestations and 2) to study the role of co-existent systemic tuberculous infection. METHODS: IRB-approved prospective cross-sectional observational study. A hospital-based cohort of patients underwent a detailed physical, laboratory and ocular evaluation. RESULTS: A total of 52 (20 male, 32 female) patients were evaluated with tubercles being seen in 23 eyes (18 patients, 34.6%). Twenty four patients (46.12%, 16 female, 8 male) presented with intracranial granulomas and 28 (53.8%, 16 female, 12 male) presented with tuberculous meningitis. Tubercles were seen in 10 eyes of 8 (28.5%) patients with tuberculous meningitis and in 13 eyes of 10 patients (41.6%) with intracranial granulomas. This result is not statistically significant. Twenty seven patients (51.9%) had neurotuberculosis without systemic infection, whereas 25 (48.1%) patients had systemic foci. Tubercles were seen in 18 eyes (13 patients) with systemic foci and in 5 eyes (5 patients) of neurotuberculosis alone. The odds ratio for the presence of systemic tuberculosis when choroidal tubercles are present is 5.6 (95% confidence interval: 1.39-24.49, statistically significant [p = 0.005]). CONCLUSIONS: Tubercles were equally likely to occur in either manifestation of neurotuberculosis, and their presence was related to the presence of systemic focus of tuberculous infection. The presence of choroidal tubercles may serve as a diagnostic marker for the presence of an underlying systemic infection.

Adolescent↗
PubMed2006

Fundus fluorescein angiography of choroidal tubercles: case reports and review of literature.

The aim of this communication was to report the fundus fluorescein angiography findings in three patients with choroidal tubercles. In all cases, there was a marked peritubercular inflammation. The tubercles themselves showed an initial hypofluorescence or minimal hyperfluorescence that increased in the late phases. Clinicians need to be familiar with these new findings as they may help in the diagnosis of ocular tuberculosis.

Adult↗
PubMed2006

The treatment of ocular tuberculosis: a survey of published literature.

With an expanding awareness of ocular tuberculosis, ophthalmologists are increasingly required to participate in the care of these patients. We conducted a survey of published ophthalmic literature to identify whether the regimens of antitubercular medications prescribed conform to current guidelines. A Medline search for publications (1995-2005) was done and the data were systematically analyzed with respect to demographic features, clinical findings and the antitubercular therapy prescribed. Of the 34 papers (82 patients) available, 33 papers described the prescribed antitubercular therapy. Eighteen papers (54.5%, 46 patients) conformed to guidelines versus 15 papers (45.4%, 32 patients) did not, suggesting that a large proportion of papers do not conform to current guidelines. Wider dissemination of therapeutic guidelines is necessary to encourage rational therapy and minimize therapeutic failures, drug resistance or relapse.

Antitubercular Agents↗
PubMed2005

Ocular tuberculosis in acquired immune deficiency syndrome (AIDS).

AIM: To determine the prevalence and clinical features of ocular tuberculosis in patients with the acquired immune deficiency syndrome (AIDS). DESIGN: Prospective cross-sectional study. METHODS: Detailed history and ocular examination of 46 patients (92 eyes) in the outpatient department of an AIDS clinic. RESULTS: Seventeen of 46 (36.9%) patients had clinical and radiological evidence of pulmonary tuberculosis. Of these, four (23.5%) showed findings consistent with ocular tuberculosis. Lesions included tubercles (1 eye of 3 patients) and chorioretinitis (1 eye of 1 patient). Commonly, these patients had evidence of abdominal tuberculosis. Hemorrhages, cotton-wool spots, herpes zoster ophthalmicus (HZO), cytomegalovirus retinitis (CMVR), and disc edema were other non-tubercular AIDS-related lesions and were seen in seven of the remaining 42 patients (16.2%). CONCLUSION: Ocular tuberculosis was a common finding in this study and was found in profoundly immunocompromised patients with disseminated tuberculosis. Diagnosis of ocular tuberculosis may help reduce HIV/tuberculosis co-infection mortality.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Ocular lesions in acute disseminated tuberculosis.

PURPOSE: To determine the prevalence of ocular involvement in patients with acute disseminated tuberculosis and to assess the findings associated with ocular involvement. METHODS: Assessment of all intensive care (ICU) admissions with a differential diagnosis of mycobacterial sepsis during a period of one year, with a detailed systemic and ophthalmic evaluation. RESULTS: Of 342 admissions, 24 patients were suspected to have mycobacterial infection. Of these 24 cases, 10 were proven to have mycobacterial sepsis, six of which (60%) showed evidence of ocular involvement. Five (83%) of the six patients had choroidal tubercles and one (16%) had retinal vasculitis. Detection of the lesions allowed a lead time of 12-72 hours in which to start earlier targeted therapy. CONCLUSIONS: Ocular involvement in acute disseminated tuberculosis is often seen, with the most common manifestation being choroidal tubercles. Early detection of these lesions may be important in treatment.

Acute Disease↗
PubMed2002

Role of computed chest tomography (CT scan) in tuberculous retinal vasculitis.

AIM: To compare computed chest tomography (chest CT) and routine chest X-rays for the detection of pulmonary tuberculosis in patients with presumed tuberculous retinal vasculitis. MATERIALS AND METHODS: Case reports. RESULTS: Three patients underwent a detailed workup for uveitis. Routine chest X-rays showed normal lung fields in all cases with abnormal hilar shadows in one case. Chest CT revealed the presence of active tuberculous mediastinitis in all three patients. CONCLUSIONS: Chest CT revealed the presence, dimensions, and activity of tuberculous mediastinal lymphadenopathy which routine chest X-rays were unable to detect. Thus, chest CT may be the preferred modality for pulmonary evaluation in these patients.

Adult↗