Abstract

A RETROSPECTIVE ANALYSIS OF THE INVESTIGATION DONE IN PATIENTS OF TUBERCULOSIS, FOLLOW-UP AND OUTCOME OF THE TREATED PATIENTS REPORTING AT ANANTA INSTITUE OF MEDICAL SCIENCES AND RESEARCH CENTRE, RAJSAMAND, RAJASTHAN

Sherin Mary Rajan*, Harshita Kalal, Swapnil Panchal, Pushprajsinh Vaghela, Dr. Komal Sharma

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Abstract

Acid-Fast Bacillus Mycobacterium tuberculosis is the primary cause of TB, a chronic granulomatous infectious disease. Although TB can affect any organ or tissue, the most common form is pulmonary tuberculosis. Extra-pulmonary TB may affect the intestines, meninges, bones and joints, lymph nodes, skin, eyes, the reproductive system, and other organs. Low socioeconomic status, dirty living conditions, illiteracy, and a casual attitude are the main contributors to the prevalence of TB in developing countries. Defaulters to treatment are one of the negative outcomes for patients on the DOTS programme, and they continue to be a substantial hurdle for control initiatives. Sputum analysis, X-rays, CBNAAT, bronchoscopy, sonography, CT scans, and other procedures are frequently used to diagnose TB. Treatment of TB in immune compromised persons requires more drugs and longer durations, especially in HIV positive patients where it may be an opportunistic infection. The RNTCP (Revised National Tuberculosis Control Programme) incorporates both the Directly Observed Treatment Short-Course (DOTS) concept and the WHO's global TB control plan. The NTEP, which stands for the elimination of tuberculosis (TB), has created the "NIKSHAY" website. The WHO South-East Asia (SEA) Area is home to 26% of the world's population and has 43% more TB cases than the worldwide average (WHO worldwide TB Report 2021). In 2020, it is anticipated that 4.3 million people would become sick and 700,000 people will die from it (excluding HIV+TB mortality). This amounts to more than half of the 1.3 million TB deaths anticipated globally for the year. In the 2019 cohort, 85% of patients with both new and recurrent TB responded to therapy. Over 1,400 Indians die from TB every day and over 480,000 every year. The following five elements make up a thorough medical examination for TB disease: Health history, physical exam, M. tuberculosis infection test, chest radiograph, and bacteriologic analysis of clinical specimens. The Cartridge Based Nucleic Amplification Test (CBNAAT, GeneXpert) is an automated Cartridge-based molecular technique that has been approved by the World Health Organisation as an initial diagnostic test in patients with suspected tuberculosis, both in the pulmonary and specific forms of the disease TB outside the lungs. Fine Needle Aspiration Cytology (FNAC) is a rapid, easy, and affordable technique that is typically employed in outpatient clinics to sample superficial masses like those seen in the neck. It almost poses no risk of problems and provides very little damage to the patient. Using this method, it is simple to identify masses in the head and neck area, including lesions of the thyroid gland and salivary gland. AIDS or acquired immunodeficiency syndrome is brought on by HIV. The three primary types of HIV testing are antibody tests, RNA (viral load) tests, and an amalgam test termed p24 (antibody-antigen test, or HIV Ab-Ag test), which can detect both antibodies and viral protein. HIV testing include antibody, RNA, and antibody-antigen (Ab-Ag) tests. Most nations and settings should do routine diabetic mellitus (DM) screenings on adult patients with active tuberculosis (TB) illness. A single Random Blood Glucose (RBG) test is done first, and any patient whose plasma glucose is 6.1 mmol/l (110 mg/dl) requires a second test since they are at risk for diabetes. Mycobacterial stain and culture, biopsies, body fluid analyses, nucleic acid amplification tests, and immunological tests are used to diagnose extrapulmonary TB. A treatment default occurs when TB therapy is stopped for two or more months in a row within the planned treatment cycle. Controlling TB locally and globally is hampered significantly by de-faulting on TB medicines. Additionally, defaulting prolongs the risk of mortality, relapse, and medication resistance, as well as infectiousness.

Keywords: Tuberculosis, DOTS, CBNNAT, X-ray, FNAC, HIV, Relapse, Defaulter, RNTCP and.