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Isolated pancreatic tuberculosis is an extremely rare clinical entity and is difficult to diagnose particularly in immunocompetent individuals. Clinical findings and symptomatology of brucellosis are often similar to tuberculosis thus making the differentiation amongst the two entities difficult. We report a case of pancreatic tuberculosis with systemic brucellosis in a 29 year old veterinarian who presented with epigastric pain and loss of appetite. Initial investigations revealed leukocytosis with moderately elevated transaminase, gamma glutamyl transferase, amylase and lipase levels. Imaging studies revealed an anechoic multiloculated cyst in the body and tail of the pancreas. Given the patient’s occupational risk coupled with the presence of a positive Brucella agglutination test (with a titer of 1:320); a diagnosis of pancreatitis secondary to brucellosis was given. In addition to standard pancreatitis therapy of bowel rest with intravenous fluid/electrolyte replacement, anti-brucellosis therapy was also administered. The patient’s initial response to therapy was positive however, 6 weeks into therapy, his abdominal pain recurred and repeat CT scan revealed the development of a pseudocyst in the pancreas. After failing a second attempt at conservative supportive therapy, the patient underwent an explorative laparotomy. Histological examination of the resected pancreatic specimen showed necrosis and was positive for tuberculosis by polymerase chain reaction. Herein, we describe the first case reported in the medical literature of the coexistence of systemic brucellosis with pancreatic tuberculosis. We suggest that the possibility of the coexistence of brucellosis with tuberculosis be kept in mind when assessing pancreatitis patients in endemic regions and in individuals with occupational risk hazards.
EN
Tuberculosis (TB) is an infectious disease that can involve any organ system of the body. Abdominal TB can be gastrointestinal, lymph-nodal, visceral or peritoneal. Gall bladder (GB) is rarely involved as a primary organ in abdominal TB. On extensive research, the literature on gall bladder TB is limited to case reports. There has been no review on this rare abdominal pathology. The GB tuberculosis is difficult to diagnose preoperatively. It is a rare differential among the more common gall bladder pathologies like cholelithiasis, or a gall bladder malignancy. Standard histopathology of a resected specimen helps in this rare diagnosis. Subjecting every specimen to histopathological examination followed by medical treatment offers a chance to cure. Through this review the authors have tried to provide an insight into this entity.
EN
Background: A low prevalence of TB and MDR-TB was indicated from the retrospective study conducted at Pandit Dindayal Upadhyay Government Medical Hospital (PDUGMH) in Gujarat between 2018 and 2022. Mycobacterium tuberculosis causes tuberculosis (TB), the most lethal infectious disease in the world that affects people of all ages. Material and methods: From its TB & Chest Department, a total of 5,624 TB notification records were reviewed for the study, of which 5207 were TB positive, with 3586 (68.87%) males and 1621 (31.13%) females. Results: Amongst positive patients, 215 were diabetic, and 454 were HIV positive. Of 5207 TB-positive patients, 2982 (57.27%) had pulmonary TB. Extra Pulmonary TB showed the maximum number of patients with an infected lymph node. Age between 15 to 29 years was the leading affected age group, with a high peak in 2019. Drug resistance of Shorter Multidrug Resistance (RR-TB) was observed with a maximum of 0.8% (n = 42) patients and of Oral longer MDR/FQ with a minimum of 0.1% (n = 3) patients. Conclusions: Findings indicate that in these five years, patients treated at PDUGMH exhibited a tuberculosis prevalence of 92.59%, with a corresponding rate of multidrug-resistant TB standing at 1.48%. A comprehensive assessment is required to depict the burden and guide initiatives for eradication.
EN
Tuberculosis (TB) is an infectious disease that can affect any organ system of the body. Abdominal TB can be gastrointestinal, lymph nodal, visceral or peritoneal. The gallbladder (GB) is rarely involved in abdominal TB as a primary organ. Extensive research literature on gallbladder TB is limited to case reports. There has been no review on this rare abdominal pathology. GB tuberculosis is a difficult diagnosis preoperatively. It is a rare differential among the more common gallbladder pathologies such as cholelithiasis, or a gallbladder malignancy. Typical histopathology of the resected specimen helps to establish this rare diagnosis. Subjecting every specimen to histopathological examination followed by medical treatment offers the chance of cure. Through this review, the authors attempt to provide an insight into this disease entity.
EN
A quantitative structure-activity relationship (QSAR) study on a set of 66 structurally-similar 6-fluoroquinolones was performed using a large pool of theoretical molecular descriptors. Ab initio geometry optimizations were carried out to reproduce the geometrical and electronic structure parameters. The resulting molecular structures were confirmed to be minima via harmonic frequency calculations. Obtained atomic charges, HOMO and LUMO energies, orbital electron densities, dipole moment, energy and many other properties served as quantum-chemical descriptors. A multiple linear regression (MLR) technique was applied to generate a linear model for predicting the biological activity, Minimal Inhibitory Concentration (MIC), treated as negative decade logarithm, (pMIC). The heuristic method was used to optimize the model parameters and select the most significant descriptors. The model was tested internally using the CV LOO procedure on the training set and validated against the external validation set. The result (Q 2 ext = 0.7393), which was obtained on an external, previously excluded validation data set, shows the predictive performances of this model (R 2tr = 0.7416, Q 2 tr = 0.6613) in establishing (Q)SAR of 6-fluoroquinolones. This validated model could be proficiently used to design new 6-fluoroquinolones with possible higher activity. [...]
EN
Extrapulmonary tuberculosis (EPTB) involves 10-15% of all tuberculosis (TB) cases. Recent statistical report showed that EPTB accounts for more than 50% of all cases of TB in HIV-positive patients. In spite of existing anti-tubercular drugs based treatment of EPTB, the ideal regimen and duration of treatment have not yet been established. In general, EPTB is a kind of TB infecting diversified tissues and organs of body other than lungs. In fact, people suffering from TB and co-infected with HIV are prone to develop EPTB much more frequently. The present chapter discusses on the general overviews of EPTB infecting distinct body sites other than lungs. Currently, the treatment of EPTB completely relies on existing anti-tubercular drugs. In addition, significant efforts, particularly close clinical monitoring would be an imperative step towards its therapeutic strategy.
EN
Tuberculosis (TB) is a disease particularly affecting the poorest socioeconomic groups. One such group in Central Europe are the homeless. We developed a prevention programme that targets, among others, homeless individuals in Warmia and Mazury Province (in the northeast of Poland). We investigated 121 homeless persons. We performed surveys, X-rays and microbiological tests of the sputum for TB. Five cases of pulmonary TB were found. The prevalence of TB in this community was estimated at 4132 per 100,000 (4.13%). Efficient TB control justifies continued prevention programmes aimed at the systematic monitoring of the homeless population.
EN
Children bear a substantial part of the tuberculosis (TB) epidemic worldwide, and it is estimated that there were ≅ 500.000 childhood TB cases globally in 2010, although accurate data are problematic to obtain given the many difficulties associated with TB diagnosis in children and the weaknesses of surveillance systems in countries where TB is endemic. The World Health Organization is working hard in order to reduce the TB prevalence rates and deaths by half by 2015. In this challenge, general practitioners and pediatricians play a key role in detecting early cases of suspected TB and sending them to experts in infectious diseases. This will reduce delayed diagnosis and the spread of disease, which is especially important now that the prevalence of multidrug resistant TB is increasing. For this reason, the purpose of this report was to delineate the characteristic clinical features of the most common forms of pediatric TB and to suggest a rational and practical approach to the disease underlining the role of patients and parents personal and clinical history.
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