Clinical profile of 103 patients with abdominal tuberculosis in Nepal
Journal Title: Journal of Advances in Internal Medicine - Year 2015, Vol 4, Issue 2
Abstract
Background and aims: The nonspecific clinical features of abdominal tuberculosis (TB) have made its diagnosis difficult, which can lead to the poor outcome in patients who are not able to receive early treatment. Hence, the aim of our study was to determine the clinical profile of abdominal TB in the patients of Nepal. Methods: This is a prospective observational study in which 103 patients with abdominal TB were analyzed for clinical profiles from May 2010 to April 2015. All diagnosed patients received anti-tubercular treatment (ATT) and were followed up at 1 and 6 months of ATT. Results: Among 103 patients of abdominal TB [males 48 (46.6%), females 55 (53.4%); mean age 33.1 years (±12.9)], 47.6% had histopathological examination (HPE) confirmation, 27.2% had high ascitic adenosine deaminase (ADA) value and another 25.2% had suggestive imaging findings. The common symptoms were abdominal pain (84.5%), weight loss (75.7%), anorexia (63.1%), chronic diarrhea (56.3%) and fever (52.4%). The mean weight was <50 Kg, hemoglobin <11 gm/dl and Erythrocyte Sedimentation Rate >40 mm/first hour. The sites involved were ileo-cecal (35.9%), peritoneal (27.2%), ileal (15.5%), colonic (15.5%), lymph nodal (3.9%) and gastroduodenal (1.9%). The sensitivity of HPE for diagnosis of abdominal TB was 47.6% (95% confidence interval 37.6% to 57.6%). All patients of abdominal TB had a good clinical response after ATT. Conclusion: The common symptoms of abdominal TB were abdominal pain, weight loss, anorexia, chronic diarrhea and fever. Since the diagnosis of abdominal TB by HPE may not always be positive, other parameters such as ascitic ADA value, imaging findings and associated supportive clinical features have to be considered, and a therapeutic trial of ATT may be indicated so that all patients of abdominal TB can be treated early in the course of disease.
Authors and Affiliations
Umid Kumar Shrestha*| Manipal College of Medical Sciences, Pokhara, Nepal, Dinesh Shrestha| Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, Ramila Shrestha| Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal, Arnab Ghosh| Manipal College of Medical Sciences, Pokhara, Nepal
Keywords
Related Articles
- EP ID EP4798
- DOI http://dx.doi.org/10.3126/jaim.v4i2.16896
- Views 488
- Downloads 21
Clinical profile of Spondarthritis in females as compared to male patients with reference to HLAB27: A single center study from Nepal
Background and Aims-To study the differences in clinical parameters between male and female patients with spondarthritis (SpA) in Nepalese population; to study the prevalence of HLA B27 phenotype in Nepalese patients wit...
ECONOMIC ANALYSIS OF GROUNDNUT ENTERPRISE IN RAFI LOCAL GOVERNMENT AREA OF NIGER STATE, NIGERIA
This investigation assessed the economic analysis of groundnut business in Rafi local Government Area of Niger State. 120 closed structural questionnaires were randomly distributed to 120 groundnut traders in six selecte...
Skin Lesions and Lower Extremity Edema in a newly diagnosed HIV patient
The differential diagnosis of skin lesions in human immunodeficiency virus patients is diverse and includes both infectious and non infectious causes. In this case presentation, a 37 year old male newly diagnosed with HI...
Tuberculosis status among patients visiting antiretroviral therapy centers of Seti Zonal Hospital and Mahakali Zonal Hospital of far western Nepal
Background and aims: Tuberculosis is still a major public health problem in Nepal. The situation is further worsened by the widespread epidemic of HIV. Knowledge of TB/HIV co-infection is essential for effective dual cas...
Effect of a yoga intervention on hypertensive diabetic patients
Background - The concept of psychosomatic medicine has gained popularity, with yoga racing ahead in the field. The present study was conducted to assess the effectiveness of yoga as an intervention in the management of p...