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Article
13- HEPATIC TUBERCULOSIS: A REPORT OF TWO CASES

Authors: Mohammed H Saeed --- Hashim S Khayat
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 62-65
Publisher: Basrah University جامعة البصرة

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Abstract

During the second half of the 20th century, as a result of improved nutrition, reduced crowding,public health measures, and effective chemotherapy, a dramatic decrease in the incidence oftuberculosis was seen in the world. But in recent years, increased incidence of tuberculosis hasbeen attributed to several causes, including AIDS epidemic, intravenous drug abuse andincrease in the number of immunocompromised. Hepatic tuberculosis is the most commonmanifestation of upper abdominal parenchymatous organ tuberculosis and its incidence hasbeen increasing. Lack of familiarity with this condition was apparently responsible for thediagnosis of hepatic tuberculosis being made at autopsy or surgery in the past. Sincetuberculosis remains a potentially curable disease, an awareness of its protean manifestationsis essential.

Keywords

HEPATIC --- TUBERCULOSIS


Article
Characteristics of Extra Pulmonary TB Cases in the Specialized Center for Chest and Respiratory Disease

Authors: Mohammad Yahya Abdulrazaq*, --- Abdulla Janger Al-Farttoosi --- Hayder H.Ali Al-Sikafi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 593-599
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Tuberculosis (TB) is a serious global problem. It remains the number one killer infectious disease in developing countries. The clinical manifestations of TB could be either Pulmonary or Extra pulmonary (EPTB).Extrapulmonary tuberculosis involves relatively inaccessible sites, and often, because of the vulnerability of the areas involved, much greater damage can be caused by fewer bacilli..In 2007 in the United States, 20% of newly reported cases of tuberculosis involved extrapulmonary sites only In order of frequency, the extrapulmonary sites most commonly involved in TB are the lymph nodes, pleura, genitourinary tract, bones and joints, meninges, peritoneum, and pericardium. However, virtually all organ systems may be affected.OBJECTIVE:This study was done to identify the Characteristics of extra pulmonary TB cases.METHODS :A cross sectional study was done in the specialized center for chest and respiratory disease in Baghdad and respiratory department in the early cancer detection center during the period 9th of January 2011 – 9th of June 2011.Any patient attending the specialized center for chest and respiratory disease in Baghdad during the study period diagnosed as a new case of extrapulmonary TB was enrolled in this study, also Any patient attending respiratory department in the early cancer detection center during the study period diagnosed as a new case of extrapulmonary TB was enrolled in this study.A total number of 70 TB patients were enrolled in this study. 35 male TB cases and 35 female TB casesRESULTS:In the male group 20 cases (57%) with pleural TB, 2 cases (5.7%) with uveitis-eye TB, 2 cases (5.7%) with pericarditis TB , 2 cases (5.7%) with orchitis TB , 2 cases (5.7%) with meningitis TB , 2 cases (5.7%) with miliray TB , 2 cases (5.7%) with skin TB , 2 cases (5.7%) with LN TB , and 1 case (2.85%) had osteoarticular TB.In the female group 17 cases (48.5%) had pleural TB , 7 cases (20%) with LN TB , 4 cases (11.4%) with osteoarticular TB , 4 cases (11.4%) had peritonitis TB , 1 case (2.85%) had thyroid TB , 1 case (2.85%) had salpingitis TB , and 1 case (2.85%) with breast TB.CONCLUSION:Pleural TB cases consist of more than half the extrapulmonary TB cases , and LN , osteoarticular and peritoneal TB cases consist of about quarter of the extrapulmonary TB cases , while all other cases form the remnant quarter


Article
The roles of radiology and ESR in the diagnosis of tuberculosis in young military males in Iraq
التدرن لدى الشباب من العسكريين الذكور في العراق

Author: Hussein M. Jumaah حسين محمد جمعة
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 2 Pages: 182-185
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjective: To describe the radiological findings of active pulmonary tuberculosis (PTB) and /or tuberculous pleural effusion (TPE) in adult males, to determine the site and extent of lesions and test the significance of the erythrocyte sedimentation rate (ESR) in these patients.Patients and methods: A retrospective observational study of two hundred and sixty two military male patients with PTB and /or TPE with their age ranging from 25 to 40 years. Data were collected from the medical records at the Mosul General Hospital (which was a military hospital prior to 2003), during the period from July1995 to June 2002. Results: The radiologic lesions of PTB were most commonly seen in the upper zones, (74% P-value 0.0001). TPE was more commonly involving the right side (64%). ESR value was found to be elevated in most of the patients (84%).Conclusion: PTB was seen mostly in the upper zones, TPE has more predilections to the right side. The ESR is still a useful test in the diagnosis of tuberculosis.

الخلاصةالأهداف: لوصف العلامات الشعاعية للتدرن الرئوي الفعال وإنصباب الجنب التدرني عند الذكور البالغين، ولتحديد مدى وموقع هذه الآفات، وفحص أهمية قيمة نسبة ترسيب الكريات الحمراء لدى هولاء المرضى. الطرق: دراسة إسترجاعية ملاحظاتية، أجريت على 262 مريضا من الذكور المصابين بالتدرن الرئوي الفعال و/ أو إنصباب الجنب التدرني. تراوحت أعمارهم بين 25-40 سنة. جمعت المعلومات من الوثائق الطبية في مستشفى الموصل العام (والتي كانت تدعى مستشفى الموصل العسكري قبل 2003) وذلك للفترة بين تموز1995- حزيران 2002. النتائج: كانت الآفات الشعاعية للتدرن الرئوي أكثر شيوعاً في الأجزاء العليا من الرئتين (74% من الحالات)= P-value 0,0001. إنصباب الجنب أصاب الجانب الأيمن في 64% من الحالات، وكانت نسبة ترسيب الكريات مرتفعة في أكثر المرضى (84%).الإستنتاج: كانت أكثر حالات التدرن الرئوي تصيب الفصوص العليا من الرئتين. وإنصباب الجنب كان أكثر حدوثاً في الجانب الأيمن. وكانت نسبة ترسيب الكريات مفيدة في تشخيص التدرن الفعال وإنصباب الجنب التدرني .

Keywords

ESR --- tuberculosis


Article
An Epidemiological Study of Urinary Tuberculosis in Iraq

Author: Riyadh M. A. Al-Saegh
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1901-1911
Publisher: Kerbala University جامعة كربلاء

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Abstract

Genitourinary tuberculosis is almost always secondary to symptomatic or asymptomatic primary lesion in the lung. After lymphadenopathy, the most common form of nonpulmonary tuberculosis is genitourinary disease. Most patients are between 20 to 40 years of age with a male to female ratio of 2:1. 4. However, a negative test does not exclude clinical disease. This is a cross sectional double centered study of patients with recurrent urinary tract infections attends the private and public outpatient's clinics in Basra teaching hospital and Imam Husain medical city-AlZahra teaching hospital in Kerbala holy. Patients who full fill two out of the following three diagnostic criteria were considered to have urinary tuberculosis..Thesecriteria were: demonstration of mycobacterium tuberculosis in urine by microbiological ,histopathological methods ,and intravenous urography.We exclude patients who prove to have genital tuberculosis ,and those who had only positive findings in intravenous urography. Statistical analyses were performed using IBM-SPSS version 20. Among our 1500 patients enrolled in this study,35(2%) full fill the diagnostic criteria of urinary tuberculosis. The mean age was 50.7 ± 14.9 SD.The urine for acid fast bacili was positive in 1patient(4%) and urine culture for mycobacterium was positive in only 2patients(16%).The tuberculin skin test was positive in 26 patients(74%).The intravenous urography showed abnormalities in 29patients(84%).40% of patients had a positive findings in histopathology of kidney tissue. At a cut off value of 0.6 the sensitivity was 82% and specificity was 50% for the tuberculin skin test in the diagnosis of urinary tuberculosis. The low prevalence rate 2% of urinary tuberculosis in our study is because our diagnosis was hypothesized in the setting of non-specific bacterial cystitis associated with a therapeutic failure or a urinalysis with a persistent leukocyturia and absence of bacteriuria.The clinical characteristics of urinary tuberculosis in older adults can be unusual and may be confused with age-related illnesses. Generally in Iraq like many other Middle East countries, Women spent more time at home and are more likely to be infected within the home than outside it, with a corresponding higher infectious dose. Our patients were less likely to offered histological diagnoses, a situation that points to late diagnosis. In such instance,urinary tuberculosis is consequently more severe, with a higher frequency of renal failure. When kidney and bladder tuberculosis are concerned ,the kidneys are mute and the bladder plays the role of vocal cords. In the context of immunosuppression, urinary tuberculosis behaves as a severe bacterial infection, with bacteremia and visceral metastatic foci. Sterile pyuria was found in 80 % in this study. This could be explained by more liberal use of antibiotics that has anti-mycobacterial effects in our country which render the urine sterile even in the presence of secondary bacterial infection. A high index of suspicion should be made in cases of sterile pyuria who resist antibiotic therapy that have no antituberculous effects. We recommend further studies to detect the prevalence of urinary tuberculosis among immunocompramised patients including those on chronic dialysis program.

Keywords

Tuberculosis --- urinary.


Article
Detection of mycobacterium tuberculosis in the saliva of patients having pulmonary tuberculosis

Author: Gassan Y. Hamed
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2011 Volume: 11 Issue: SpIss Pages: S290-S295
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: The purpose of this study was to determine the efficacy of saliva as a sample for diagnosing pulmonary tuberculosis(T.B.) by looking for acid fast bacilli in a direct smear and comparing it with sputum and to determine whether the isolation of M. tuberculosis is from the lung or disseminated through blood. Material and Methods : The study sample consisted of 25 patients of both sexes. Age range was (17 - 65) years . Approximately 2 ml of unstimulated mixed saliva from each subject and parotid saliva were collected for direct smear for acid fast bacilli by Ziehl-Nelson acid fast stain. Five samples were inoculated on Lowenstein Jensen media and storenbrink media .Results: About 60% of unstimulated mixed saliva revealed positive acid fast bacilli, while all samples of parotid saliva showed negative acid fast bacilli. The five samples of saliva which were inoculated on Lowenstein Jensen media and stonebrink media showed positive culture. To our knowledge, we did not find any study performed on saliva as a sample for diagnosis of pulmonary tuberculosis to compare our finding with these studies, so the comparison was made between the sensitivity of saliva and the sensitivity of sputum . In this study, the sensitivity of direct smear of saliva for A.F.B was equal to 60% of the sensitivity of sputum. The sensitivity of direct smear of sputum for A.F.B. ranged from (2280%). There were no clinical manifestations like gummas; granulomas; ulcer; alveolar abscess and osteitis. CONCLUSION: This clinical and laboratory study revealed that M Tuberculosis which was present in the mixed saliva resulted from contact of oral tissue with infected sputum; Mixed saliva was less efficient than sputum in diagnosis of T.B. disease . Saliva can be inoculated on different media and that newly diagnosed patients with T.B disease don't have any clinical manifestations in the oral cavity


Article
Resistance of anti-tuberculosis drugs among pulmonary tuberculosis patients in Yemen
مقاومة الأدوية المضادة للسل بين مرضى السل الرئوي في اليمن

Author: Ahmed M. Al-Haddad أحمد محمد الحداد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2013 Volume: 55 Issue: 3 Pages: 250-253
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Tuberculosis (TB) is still a major global public health problem worldwide. The global prevalence of Mycobacterium (M tuberculosis) infection has been estimated in 32% of the world population with more than 8 million new cases diagnosed each year.Objective: To estimate drug resistance among previously treated tuberculosis patients, focusing on multi-drug resistant strains at two time intervals (2002 and 2009) in Yemen.Materials and Methods: A total of 192 M tuberculosis complex isolates were collected from patients with positive sputum smear who had been treated previously with the four main anti- tuberculosis drugs for more than two months. The isolates were identified by their colonial morphology, pigmentation, shapes on Ziehl-Neelsen smears, growth on Löwenstein-Jenson medium and biochemical tests as niacin and nitrate tests. A proportional method was used for the in vitro drug susceptibility testing.Results: Of the 192 M tuberculosis complex tested isolates, 55 (28.7%) were resistant to one or more drug; 20 (10.4%) were resistant to one drug, 13 (6.8%) to two drugs, 13 (6.8%) to three drugs and 9 (4.7%) to four drugs. Regarding the resistance to an individual drug, out of 192 tested isolates, 36 (18.7%) were resistant to rifampicin, 34 (17.7%) to isoniazid, 33 (17.2%) to ethambutol and 18 (9.4%) to streptomycin and these results were without a statistical significance. The incidence of multidrug resistance against rifampicin and isoniazid with or without other drugs was 13.5% among the tested M tuberculosis complex strains and this result was also without a statistical significance. Conclusion: The results of this study revealed nearly similar drug resistance patterns for the tested isolates in comparison with previous findings of 2002 and the emergence of more multi-drug resistance M tuberculosis complex strains after a time interval in Yemen.Key words: Tuberculosis, resistance, anti-tuberculosis drugs, MDR, Yemen.

لا يزال خمج السل الرئوي يشكل مشكلة صحية رئيسية على مستوى العالم، حيث تم تحديد مدى انتشاره بين سكان العالم بنسبة 32% مع زيادة 8 مليون من الحالات المشخصة الجديدة كل عام. هدف الدراسة: تحديد مدى مقاومة الأدوية المضادة للسل الرئوي بين مرضى معالجين سابقا وكذا التركيز على ذريات المتفطرة السلية المعندة على عديد من الأدوية في فترتين زمنيتين (2002 و 2009) باليمن .طريقة الدراسة: شملت هذه الدراسة على 192 عزلة للمتفطرة السلية أخذت من مرضى كان فحص القشع لديهم إيجابيا، و ذلك بعد فترة علاج تزيد عن شهرين بالأدوية الأربعة المضادة للسل (أيزونياسيد, ريفامبيسين, ستربتوميسين, ايثامبوتول). بعد تعريف هذه العزلات بواسطة الفحوصات التأكيدية من حيث الشكل المميز للمتفطرة واللون والنمو على الوسط الزراعي والتفاعلات الحيوية، تم اجراء فحص الحساسية في الزجاج للأدوية الأربعة المذكورة أعلاه مع كل عزلة على حده.النتائج: تم تحديد 55 عزلة (28.7%) من اجمالي العزلات 192 المدروسة وكان توزيع العزلات المقاومة لدواء واحد أو أكثر كالتالي: 20 عزلة مقاومة لدواء واحد و13 لدوائين و13 لثلاثة أدوية وأخيرا 9 لأربعة أدوية. نتيجة مقاومة هذه العزلات لدواء واحد أو أكثر لم تكن ذات أهمية إحصائية. ما يخص مقاومة العزلات لكل دواء على حده فكانت النتيجة كالتالي: 36 عزلة مقاومة لدواء ريفامبيسين و34 عزلة لدواء أيزونياسيد و33 عزلة لدواء ستربتوميسين و18 عزلة لدواء ايثامبوتول من اجمالي 192 عزلة. و لم تكن أيضا هذه النتائج ذات أهمية إحصائية. أما ما يخص مقاومة هذه العزلات على عديد من الأدوية فكانت هناك 26 عزلة مقاومة من اجمالي العزلات 192 المدروسة بنسبة 13.5% ولم تكن أيضا هذه النتيجة ذات أهمية إحصائية.الاستنتاج : اظهرت هذه الدراسة عن وجود نسبة أقل قليلا من العزلات المعندة للأدوية المضادة للسل سواء كان لدواء واحد أو أكثر وظهور ذريات أكثر من المتفطرة السلية المعندة على عديد من الأدوية بعد فترة من الزمن في اليمن عند مقارنة نتائج الدراسة الحالية بنتائج دراسة العام 2002.


Article
Abdominal Tuberculosis: Clinical Presentation, Diagnosis, Outcome and Experience with 11 Cases

Author: Ibrahim Falih Noori
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 3 Pages: 581-591
Publisher: Babylon University جامعة بابل

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Abstract

Tuberculosis is a common health problem. Abdominal tuberculosis constitutes about 2% of all tubercular cases and it’s the sixth most common extrapulmonary tuberculosis. The aim of this study was to evaluate the clinical presentation, diagnosis and effective treatment of abdominal tuberculosis. This is a retrospective study including 11 patients (4males and 7 females), with clinical features of abdominal tuberculosis. They were divided according to the clinical presentation into two groups. The first group included patients presented as acute abdominal pain mainly due to bowel obstruction or as peritonitis and were prepared and treated by explorative laparotomy and definitive diagnosis of abdominal TB was made by tissue biopsy. The second group included patients with chronic symptoms. The results observed in this study were that abdominal pain was the commonest symptom followed by abdominal distention, anorexia, weight loss and fever. Tender right lower abdominal quadrant was found in 7 patients(63.6%) and right iliac fossa mass was found in 3 patients (27.3%). Explorative laparotomy was needed for 5 patients (45.5%) who presented as acute abdomen. Strictures were found in 3 patients (27.3%), adhesion in one patient (9.1%) and peritonitis caused by perforation in the terminal ileum was recorded in one patient. Ascitic fluid analysis for AFB stain and culture confirm the diagnosis of abdominal tuberculosis in patients who presented with chronic symptoms of tuberculosis. All patients showed good response to ATT therapy. No mortality or recurrence was recorded during ATT treatment or during follow up period. We concluded that abdominal tuberculosis is difficult to diagnose due to vague and non specific symptoms and signs such as abdominal pain, anorexia, weight loss and fever. High index of suspicion and clinical awareness is needed for definite diagnosis which depends on PCR or histopathology or AFB stain.


Article
Anti-bacterial Properties of Melatonin against Mycobacterium Tuberculosis in Vitro

Authors: Suhad F. Hatem Almuqdadi --- Mustafa G.Alabbassi --- Thamer M. Jasim
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2010 Volume: 19 Issue: 2 Pages: 59-63
Publisher: Baghdad University جامعة بغداد

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Abstract

57 isolates of Mycobacterium tuberculosis and Mycobacterium bovis were identified; they were isolated from different clinical sources which included sputum, bronchial wash, abscess, pleural fluid, gastric fluid, eye fluid, and CSF, also urine and ear swab. This investigation was carried out on 198 patient attended National Reference Laboratory for T.B during September 2009. Also the study declared that the ratio of separation of this bacterium from male was (67.6%) and it’s higher than the ratio of separation this bacterium from females which was (32.3%). The susceptibility of Mycobacterium tuberculosis to melatonin was evaluated. Many concentrations of melatonin were prepared to investigate it as antibacterial drug against multidrug resistant Mycobacterium tuberculosis and Mycobacterium bovis. Suspension bacteria (10-1, 10-3 and 10-5) were cultured on Lowenstein-Jensen media (LJ) contains melatonin, while control media without this drug. Six isolates were chosen according to their susceptibility patterns; they were resisting to Rifampicin, Streptomycin, Isonicotinic –hydrazide and sensitive to Ethambutol. In conclusion, these in vitro studies clearly demonstrate anti-bacterial effects of melatonin. Among possible mechanisms, it is concluded that melatonin showed antibacterial effects against multidrug resistant T.B by reducing intracellular substrates. Identifying the mode of action could be of great help in developing and researching new anti-bacterial drugs.
Key words: Antibacterial, Melatonin, Mycobacterium tuberculosis.

تم تشخيص 57 عزلة موجبة من العصيات الدرنية الفطرية والعصيات الدرنية البقرية من المصادر السريرية المختلفة والتي تضمنت القشع ، الغسل القصبي، الخراج، سائل الجنب والمعدة والعين والنخاعي كذللك الادرار ومسحة الأذن. نفذت هذه الدراسة على 198 مريض راجع المختبر الوطني المرجعي للتدرن خلال شهر ايلول 2009. أوضحت الدراسة ان نسبة اصابة الذكور(67.6%) هي اعلى من نسبة اصابة الأناث (32.3%) تم تقييم حساسية العصيات التدرنية لعقار الميلاتونين. تم استخدام عدة تراكيز من الميلاتونين كمضاد للبكتريا ضد عصيات التدرنM. Tuberculosis و M. bovis ذات المقاومة المتعددة للمضادات. زرعت عدة تخافيف للعالق البكتيري ( 10 -5,10 -3,10 -1) على وسط (LJ)والذي يحتوي على عقار الميلاتونين بينما وسط السيطرة لايحوي هذا العقار. اختيرت ستة عزلات بالأعتماد على الأنماط التحسسية حيث كانت هذه العزلات مقاومة للريفامبسين، الستربتومايسين، ايزونيكوتنك هايدرازايدINH، وحساسة للايثامبيتول. نستنتج من هذه الدراسة التاثيرالتثبيطي للميلاتونين على البكتريا مختبرياوالميكانيكية المحتملة بواسطة تأثيره على داخل الخلية للبكتريا وبذللك يفتح الآفاق لمضاد بكتيري جديد.


Article
Gastrointestinal Tuberculosis: Retrospective Review of 86 Cases

Author: Zuhair R Al-Bahrani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 3 Pages: 169-183
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The aim of this study is to present our experience in the management of gastrointestinal tuberculosis in Iraq.PATIENTS&METHODS:86 cases with intestinal tuberculosis were histologically proven by endoscopy or surgery, during the period 1965-2004 at the Medical City Teaching Hospital, & two private hospitals (Alousi & Mustansiria), Baghdad.RESULTS:54(62.8%) were female and 32(37.2%) were male. Age ranged from 6-82 years (mean 33yrs), peak 30-39 years. Clinical presentation were; intestinal obstruction 44(51.2%), abdominal mass 20(23.3%), malabsorption 13(13%), massive gastrointestinal bleeding 3(3.5%), peritonitis 3(3.5%), pyloric obstruction 2(2.3%) and dysphagia 1(1.2%) patients. Chest X-ray reported; normal in 62(72.1%), active pulmonary tuberculosis in 3(3.5%), and healed lesion in 21(24.4%) patients. Barium study revealed dilated bowel loops in 31(45.6%); other less frequent findings were strictures, filling defect, shortening and bowel irregularity. OGD showed a significant pathology in 7 out of 11 patients examined. Ultrasound showed helpful imaging modality in 15/21 patients; ascitis, masses, enlarged lymph nodes, and thick bowel loops in some cases. Site of lesions were; ileocecal 42(48.8%), small bowel 33(38.4%), colorectal 8(9.3%) and stomach 3(3.5%) patients. Gross appearance were hyperplastic 33(38.4%), ulcerative 20(13.9%), strictures 21(24.4), and mixed 12 (13.9%) patients. Surgical procedures were; right hemicolectomy 38(44.2%), resection of small bowel 23(26.7%), colectomy 4(4.7%), by-pass 4(4.7%), stricturoplasty 2(2.3%), and subtotal gastrectomy 1(1.2%) and biopsy only 14(16.3%) patients. One patient died post-operatively from pulmonary embolism, 6 lost to follow, 4 had relapse after stopped treatment within 3-5 months (one of them died from intestinal obstruction) while the result in those followed 74 (including 3 who relapsed and re-treated) patients whom received chemotherapy for over one year were very satisfactory.CONCLUSION:Gastrointestinal tuberculosis affects females more than males. No age is immune, peak in 3rd decade. Symptomatology is non-specific, it should be suspected in patients having abdominal pain, weight loss, anorexia, fever, ascites and abdominal mass. Sub-acute or acute intestinal obstruction is the most common presentation followed by abdominal mass or malabsorption in our study. Normal chest radiograph does not exclude the presence of abdominal tuberculosis, but it should be suspected in high ESR patients. Surgical interventions is not alternative to standard anti-tuberculous therapy


Article
The Effect of Age on Clinical and Radiological Presentation in Patients with Pulmonary Tuberculosis in Baghdad

Authors: Hashim M.Al-Kadhimi --- Haider Noori Dawood
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 1 Pages: 125-129
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Mycobacterium tuberculosis causes the most common type of human tuberculosis worldwide .The most common mode of transmission is by inhalation of droplet nuclei from expectorated respiratory secretions.Active infection is diagnosed by documenting the presence of M tuberculosis in respiratory secretions or other body fluids or tissues.Age is an important determinant of the risk for the disease .The risk may increase in the elderlyOBJECTIVE:To compare the effect of age between elderly and younger on clinical and radiological presentation in patients with pulmonary tuberculosis in Iraq.PATIENTS AND METHODS:A prospective study was done for 251 patients with smear positive pulmonary tuberculosis in outpatient's clinic in the Chest and Respiratory Disease Specialized Center in Baghdad.Collected from January to May 2009.The following parameters were assessed:Age, gender, symptoms, risk factors, radiological findings, and incidence of recurrent .The relation of these parameters between elderly and younger was evaluatedRESULTS:There were 174 young adult patients and 77 elderly patients .The elderly group age was between 60-80years ,and younger adult age was between 17-59 years. There was no significant difference in the symptoms between the two groups .Family history of pulmonary tuberculosis (p=0.009) was more common in young adult, while DM (p=0.001) was more common in elderly .Comparison of radiological findings in young adults vs. elderly patients shown a typical findings (p=0.036) which is more in elderly .There was no significant difference in the incidence of recurrence between the two groups.CONCLUSION:There was no significant difference in the symptoms between elderly and younger age groups .Family history of PTB was more common in young adults, while DM was more common in elderly.A typical radiological findings were more in elderly.There was no significant difference in the incidence of recurrence between the two groups

Keywords

tuberculosis --- age --- radiology

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