Pigeon fancier’s lung – An under-diagnosed cause of severely debilitating and chronic breathlessness

AbstractPigeon fanciers lung or Bird fanciers lung (BFL) is one of the common and preventable causes of hypersensitivity pneumonitis. It is an under diagnosed cause of severe incapacitating breathlessness and can be acute, sub-acute or chronic. We report a case of 53year old female who presented with severe chronic breathlessness due to regular exposure to pigeons for last 35years. Clinicians should take a detailed history of exposure in patients with unexplained breathlessness as the avoidance of exposure to the antigens can reverse the disease preventing the morbidity and mortality of the patient

Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis

Background: To determine the prevalence of primary drug resistance to either rifampicin or isoniazid alone or both in newly diagnosed sputum smear positive pulmonary tuberculosis patients.Method: A prospective study 100 newly diagnosed sputum smear positive pulmonary TB patients was conducted. The patients with an age of ≥15 years and who had either not taken anti TB treatment or who had taken ATT for less than 1 month were enrolled in this study. Two sputum samples (5ml each), including one early morning sample as per the RNTCP guidelines were collected and subjected to line probe assay (LPA).Results: Out of 100 cases 6 were having resistance to both rifampicin and isoniazid, 9 has resistance to INH alone and 1 had resistance to rifampicin alone.Conclusion: The prevalence of primary drug resistance is high. For early and rapid detection of DR-TB newer modality should be used  for the detection of primary drug resistance in sputum smear positive TB patients

Reducing the burden of Tuberculosis: an emphasis on improving awareness among caregivers

Background: Tuberculosis (TB) is one of the common communicable disease affecting human beings since ancient times. Though effective chemotherapy emerged during 20th century had raised hope towards eliminating TB burden, it still remains as a distant goal. Awareness about TB among close contacts of active disease is of paramount importance in preventing its spread and promoting early diagnosis and treatment. This study aimed to assess the knowledge about tuberculosis among caregivers of tuberculosis patients.Methods: This was a cross sectional study that enrolled 300 subjects who were then caregivers of tuberculosis patients admitted in the Department of Pulmonary Medicine. Subjects were interviewed according to a predesigned panel of questions meant to assess their basic knowledge and perceptions about tuberculosis symptomatology, diagnostic modalities, treatment and prevention.Results: About 90.3% (n=271) of subjects had heard about TB previously and about 37.7% (n=113) considered themselves to be well aware of it. Most of them believed TB to be communicable (90.3%, n=271). Majority believed that TB affects lungs only (n=206, 68.7%), with most commonly perceived symptom being cough (n=285, 95%). Knowledge regarding disposal of sputum was poor (n=110, 36.7%). About 168 (56%) subjects considered usage of face mask by the patient as an effective tool for TB prevention.Conclusions: Caregivers of tuberculosis patients lack proper knowledge about major aspects of the disease. Public awareness and care giver education programs needs to be implemented along with standard TB care to reduce transmission of TB among close contacts