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தொகுதி 8, பிரச்சினை 6 (2022)

மினி விமர்சனம்

The Importance of Post-Bronchoscopy Sputum Examination in the Diagnosis of Active Tuberculosis

Joanne Goravey

Beforehand opinion is a abecedarian element of global tuberculosis control. The ideal of this study was to estimate the individual yield ofpostbronchoscopy foam (PBS) testing as part of a tuberculosis individual work- up. All new residers in the State of Qatar suffer a tuberculosis (TB) webbing program. Those with abnormal casket radiology, negative foam acid-fast bacilli (AFB) smears and nucleic acid modification testing (NAAT) for M. tuberculosis, suffer an fresh bronchoscopic evaluation for TB. We prospectively enrolled individualities who were going to suffer bronchoscopy to give two PBS samples for AFB smears and mycobacterial societies between 18 September 2018 and 12 March 2021. A aggregate of 495 individualities, with a median age of 31 times, were included. The maturity of the cases were males. The most frequent country of origin was India followed by the Philippines. The addition of PBS to bronchoalveolar lavage (BAL) testing allowed microbiological evidence of tuberculosis in an fresh 13 cases, performing in bettered perceptivity, negative prophetic value and negative liability rate. Where coffers are available, the objectification of routine PBS examination as part of tuberculosis individual work- up can enhance the individual yield.

மினி விமர்சனம்

Inhaled Drug Particle Dissolution and Absorption in the Lungs

Basanth Bastola

Dry powder inhalation therapy has been shown to be effective in treating localised lung diseases such as asthma, COPD, cystic fibrosis, and lung infections. The physicochemical nature and aerosol performance of powder particles are determined in vitro for dry powder formulations. There is a well-established relationship between particle properties (size, shape, surface morphology, porosity, solid state nature, and surface hydrophobicity) and aerosol performance of an inhalable dry powder formulation. In contrast to oral formulations, there is no standard dissolution method for assessing the dissolution behaviour of inhalable dry powder particles in the lungs. This review focuses on different dissolution systems and absorption models used to evaluate dry powder formulations. It includes an overview of airway epithelium as well as barriers to development. an in vitro dissolution method for inhaled dry powder particles, fine particle dose collection methods, various in vitro dissolution testing methods developed for dry powder particles, and models commonly used to study inhaled drug absorption.

வழக்கு அறிக்கை

Co-Existence of Extensively Drug Resistant Tuberculosis (XDR-TB) and Sarcoidosis in a Patient: A Case Report

P Prasanth*, N C Kajal, K T Nithin, Vikas Kumar and Ritu Dadra

Tuberculosis (TB) and sarcoidosis are multisystem diseases having different etiology and management; however, they have similar clinical and histological characteristics, that may rarely coexist. The emergence of Extensively Drug-Resistant Tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide. The treatment is further compounded with unique management difficulties. Treatment of XDR-TB requires prolonged chemotherapy with second-line anti-TB drugs, which offer lesser potency and increased risk of drug related side effects. Sarcoidosis is a multisystem granulomatous disorder characterized pathologically by the presence of non-caseating granulomas in involved tissues. Depressed cellular immunity predisposes patients to infections with certain intracellular organisms, mostly fungi, Mycobacterium tuberculosis and Nocardia. As these infections are mainly insidious and difficult to differentiate from the underlying disease, a possible misdiagnosis may lead to fatal complications. This case highlights the high index of suspicion required in order to identify any possible infection in a case of sarcoidosis. A case of a 66-year-old female with 3-months history of fever, exertional dyspnea and dry cough, in whom extensively drug resistant tuberculosis was documented with co-existence of sarcoidosis. This case highlights the high index of suspicion required in order to identify any possible infection in a case of sarcoidosis.

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