Indian Journal of Public Health Research & Development

Abhishek Chauhan ¹, Jai Kishan ², Sameer Singhal ³, Achchhar Singh ⁴, Aditi Gupta ⁵, Pankaj Saini ¹

Affiliations
1 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Prof and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
5 Assistant Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Tuberculosis is an infectious disease. It is caused by bacteria Mycobacterium Tuberculosis. It can be diagnosed by demonstrating AFB by either phenotypic method like sputum smear microscopy, culture or by genotypic method like NAAT or LPA. For better results there should be a good quality sputum sample. Induction of sputum is a method for improving the quality of sample. The most commonly used method is induction using 3% saline. It has been seen that during taking throat swab specimen patients usually produce cough. This induced cough can produce better quality of sputum. The following study was done to know about the role of throat swab as a method of sputum induction.

Keywords

AFB, CBNAAT, LPA, Mycobacterium Tuberculosis.

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Achchhar Singh ¹, Jai Kishan ², Sameer Singhal ³, Vishvdeep Saini ⁴, Abhishek Chauhan ⁴

Affiliations
1 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Professor and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

The aim was to evaluate the inhalation technique among COPD patients using pressurized metered dose inhaler and determinants of incorrect inhalation technique. In this hospital based cross-sectional study, total 92 COPD patients were enrolled. Basic socio-demographic information was collected. The inhalation technique was visually observed and scored on checklist. Statistical Analysis Used: Chi-square test and Fisher exact test. Among the 92 patients observed, 69 (75.0%) were males. The mean age of the patients was 45.8 ± 1.4 years. Correct technique was observed in only 22 (23.9%) patients step at which maximum number of patients committed mistake was exhalation 65.2% followed by breath holding 45.7% and multiple actuations were seen in 44.5%. It was found that substantial errors were made in the inhalation technique hence proper training and follow-up of the patients is required to achieve the desired effects of the inhaled medications.

Keywords

COPD, pMDI, Inhalation technique.

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Pankaj Saini ¹, Varsha A. Singh ², Kunal Sharma ³, Gunjeet Singh ³, Abhishek Chauhan ⁴, Shailja Sharma ⁵

Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN

Abstract

Non-tuberculous mycobacterium (NTM) has been identified in human pulmonary and extra pulmonary diseases and is of great concern for clinicians and microbiologists because of their increasing global incidence. They are now increasingly recognized as important pathogens in both immunocompromised and immunocompetent population. They should be identified rapidly and should be carefully differentiated as contamination, colonization ordisease. Cultures were made on conventional LJ and LJ with PNB media. Growth was confirmed as AFB (acid fast bacilli) by ZN staining. NTM were identified by growth on LJ with PNB media, colony morphology, rate of growth, pigmentation, catalase activity and confirmed by MPT 64 antigen rapid test (using SD Bioline TB Ag MPT 64 test kit) . Data was analysed statistically using SPSS software. Out of total 500 processed samples (250 pulmonary & 250 extrapulmonary), 12(21.05%) and 7(21.8%) NTM were isolated from pulmonary and extrapulmonary samples respectively. Maximum pulmonary NTM (41.7%) were isolated from > 60 years age of patients in contrast to extrapulmonary NTM isolates which were more in 20-40 years of age group. There was 16.7% previously treated patients in pulmonary while 100% were newly diagnosed patients in extrapulmonary TB cases. This study highlights the importance of early diagnosis and differentiation among Mycobacterium tuberculosisand NTM so that these NTM are not underestimated in routine diagnostic procedures merely as environmental or laboratory contaminants.

Keywords

Non-tuberculous mycobacterium, p-nitrobenzoic acid, Pulmonary TB, extrapulmonary TB, MPT64 antigen.

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Abhishek Chauhan ¹, Jai Kishan ², Sameer Singhal ³, Achhar Singh ⁴, Aditi Gupta ⁵

Affiliations
1 Resident, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
2 Prof. and Head, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
3 Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
4 Associate Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN
5 Assistant Professor, Department of Respiratory Medicine, M.M. (Deemed to be) University, Mullana, Ambala, IN

Abstract

Sputum examination is the most widely used test for diagnosis of TB. Under RNTCP two samples of sputum are required for examinations which are preferably 1st spot and early morning sample or two spot samples collected on the same day. Patients usually come from far off places at the tertiary care centre and frequent visits are usually not possible. Giving an early morning sample is usually defaulted by the patient due to various reasons. The present study was aimed at studying the delay in giving the early morning sample and barriers in accessing the sputum smear microscopy services at a tertiary care hospital. In this study 300 presumptive TB patients were studied. Patients were asked to give a 1st spot sample for sputum smear examination and asked to bring early morning sputum sample. Patients who refused to give early morning sample were asked to give 2nd spot sample and the reason for not coming early morning were noted. The patients who did not come despite agreeing to come were noted. If they came after a delay of few days, then also the reason of delay were noted. It was found that nearly one third (31%) of the patients agreed and came on the next day to give early morning sample. A large number of patients (16%) did not come at all to give the early morning sample.

Keywords

Pulmonary tuberculosis, presumptive TB patient, sputum microscopy, spot sample, early morning sample, RNTCP.

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Achchhar Singh ¹, Jai Kishan ², Sameer Singhal ³, Vishvdeep Saini ⁴, Abhishek Chauhan ⁴

Affiliations
1 Associate Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
2 Professor and Head, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
3 Professor, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, MMIMSR, M.M. Deemed to be University, Mullana, Ambala, Haryana, IN

Abstract

Aim: study the prevalence of various risk factors and co-morbidities in patients with acute exacerbation of chronic obstructive pulmonary disease. Material and Method: 73 patients admitted with AE-COPD data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management were obtained. Results: Eighty-eight percent of the admitted patients had current or past smoking habit of ‘Bidi’ and 9% were cigarette smokers. of admitted patients, 46% had at least one co-morbid condition. Mean FEV1 was 42.5%. Conclusion: Study concluded that the hospitalized patient with AE-COPD suggests spirometric impairments because majority of the patients had current or past smoking habits. Diabetes and cardiovascular diseases were found to be the major co-morbidities.

Keywords

AE-COD, Co-morbidities, FEV1.

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