Clinical presentation of abdominal tuberculosis in HIV seronegative adults

BACKGROUND: The accurate diagnosis of abdominal tuberculosis usually takes a long time and requires a high index of suspicion in clinic practice. Eighty-eight immune-competent patients with abdominal tuberculosis were grouped according to symptoms at presentation and followed prospectively in order to investigate the effect of symptomatic presentation on clinical diagnosis and prognosis. METHODS: Based upon the clinical presentation, the patients were divided into groups such as non-specific abdominal pain & less prominent in bowel habit, ascites, alteration in bowel habit, acute abdomen and others. Demographic, clinical and laboratory features, coexistence of pulmonary tuberculosis, diagnostic procedures, definitive diagnostic tests, need for surgical therapy, and response to treatment were assessed in each group. RESULTS: According to clinical presentation, five groups were constituted as non-specific abdominal pain (n = 24), ascites (n = 24), bowel habit alteration (n = 22), acute abdomen (n = 9) and others (n = 9). Patients presenting with acute abdomen had significantly higher white blood cell counts (p = 0.002) and abnormalities in abdominal plain radiographs (p = 0.014). Patients presenting with alteration in bowel habit were younger (p = 0.048). The frequency of colonoscopic abnormalities (7.5%), and need for therapeutic surgery (12.5%) were lower in patients with ascites, (p = 0.04) and (p = 0.001), respectively. There was no difference in gender, disease duration, diagnostic modalities, response to treatment, period to initial response, and mortality between groups (p > 0.05). Gastrointestinal tract alone was the most frequently involved part (38.5%), and this was associated with acid-fast bacteria in the sputum (p = 0.003). CONCLUSION: Gastrointestinal tract involvement is frequent in patients with active pulmonary tuberculosis. Although different clinical presentations of patients with abdominal tuberculosis determine diagnostic work up and need for therapeutic surgery, evidence based diagnosis and consequences of the disease does not change

Tools for conviviality: Transcribing design

This paper presents the outcomes and findings of a semester long trans-disciplinary design studio recently taught at RMIT University, involving students from the disciplines of architecture, industrial design and landscape design. The focus of the studio was to investigate the creation and appropriation of tools for innovative design processes. Drawing on craft theory and theories of design and computation, this paper illustrates how tools can transgress disciplinary boundaries and investigates how an understanding of the intricate relationship between tools, techniques, the media they operate in and the design outcome is the premise of a more informed design approach

A cholinergic poisoning case shaded with foreign body aspiration story [Yabanci Cisim Aspirasyonu Öyküsüyle Gölgelenmiş Bir Kolinerjik Zehirlenme Olgusu]

Organophosphates and carbamates are often seen in rural areas and vitally important. Here is presented a case referred to our hospital with the diagnosis of foreign body aspiration, however revealed the signs of cholinergic poisoning in physical examination. The aim in this case is the questioning approach related with clinical suspicion contributes substantially to diagnosis is emphasized. Copyright © 2016 by Türki ye Klinikleri