A study of nutritional assessment of newly diagnosed tuberculosis patients in a tertiary care hospital of Tripura, India

Background: Tuberculosis kills more than any infection in India. TB is a serious public health problem in India. Tuberculosis causes immense morbidity. The mortality rate of this disease is also very high. Tuberculosis causes a great distress to the patients. To control this infection is a challenge to the health care facility of India. A lot of steps are being taken at various levels to end this disease. Still a huge number of patients are dying everyday from these deadly diseases. Out of so many recognised risk factors, malnutrition is considered to be as one of the most important among them. The immunity of a malnourished patient is suppressed. When the patient’s immunity is ineffective, the conversion of latent tuberculosis to diseases happens. Malnutrition invites tuberculosis and tuberculosis again causes morbidity, so there is a complex relation between this two. Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world.Methods: In this cross sectional hospital based study involving 400 newly diagnosed Tuberculosis cases were taken. Their nutritional status was measured by BMI.Results: It was found that 66% of the study population is having malnutrition (BMI <18.5kg/m2). Malnutrition was more in females (71%). Mean BMI is 17.9Kg/m2. Mean height of the population is 1.53 meters.Conclusions: Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world. This study has demonstrated that half of newly diagnosed adult TB patients were malnourished at the time of starting treatment, with more than a quarter having moderate to severe malnutrition

Giant pulmonary hamartoma: A rare entity

Hamartoma is one of the common benign tumor of lung. These lesions represent an abnormal proliferation and mixing of the normal components of the lung tissue. Most hamartomas are asymptomatic. We report a rare case of giant pulmonary hamartoma (12 cm in diameter) occupied almost whole of left hemithorax. Computed tomography guided fine-needle aspiration cytology revealed a benign cartilaginous neoplasm, suggestive of chondroid hamartoma. Tru-cut biopsy of the tumor confirmed the diagnosis. Complete resection of the tumor was performed. Patient was on a regular follow-up postoperatively for 6 months without any clinical and radiological relapse

A rare case of pleural lymphoma

We present a case report of a 20 years old male who had low grade fever, weight loss of about 10 kg and left-sided chest pain increasing in intensity over a year. Clinically, it mimicked left sided pleural effusion with a tender, soft, parietal swelling in left in-fraaxillary area. Chest x-ray and Computerized Tomography-scan of thorax showed pleura based mass in left hemi thorax. Computerized Tomography guided Fine Needle Aspiration Cytology confirmed the diagnosis of non Hodgkin Lymphoma, diffuse large B cell type, high-grade

A RARE CASE OF PLEURAL LYMPHOMA

We present a case report of a 20 years old male who had low grade fever, weight loss of about 10 kg and left-sided chest pain increasing in intensity over a year. Clinically, it mimicked left sided pleural effusion with a tender, soft, parietal swelling in left in-fraaxillary area. Chest x-ray and Computerized Tomography-scan of thorax showed pleura based mass in left hemi thorax. Computerized Tomography guided Fine Needle Aspiration Cytology confirmed the diagnosis of non Hodgkin Lymphoma, diffuse large B cell type, high-grade

Chronic arsenicosis with varied pulmonary involvement – A case series

Arsenic is an element which occurs naturally in the earth’s crust and in small quantities in rock, soil, water and air. Chronic arsenic toxicity produces various dermal and systemic manifestations including cancer. It may also cause different pulmonary diseases. Here, we have described a case series of three chronic arsenicosis patients having varied pulmonary involvements ranging from bronchiectasis to chronic obstructive pulmonary diseases. They all had classic raindrop pigmentations with one patient developing squamous cell carcinoma. Pulmonary manifestations were severe with more cutaneous manifestations as well as more arsenic levels in hair and nail samples of patients. Manifestations also seemed severe with increased duration of exposure and more amount of arsenic in their drinking water

Tonsillar tuberculosis: a forgotten clinical entity

Tuberculosis of tonsils is an extremely rare variety of extra-pulmonary tuberculosis which frequently simulates the tonsillar malignancy, especially in elderly individuals. Secondary form is more common than primary one, and in present day, contact with the infected sputum or saliva in a case of sputum smear positive pulmonary tuberculosis is the main source of the disease. Chronic or recurrent tonsillitis with enlarged tonsils and sore throat is the main clinical presentation. As it is very difficult to differentiate it from tonsillar malignancy on clinical ground, histopathological examination of the tissue is must for the diagnosis of tonsillar TB. Antitubercular therapy is adequate for its successful resolution. Here, we report a primary form of tonsillar tuberculosis in a 76-year-old male, in whom, no pulmonary tuberculosis was documented

Cough-induced Diaphragmatic and Abdominal Hernia in an Asthma Patient – A Case Report

The list of complications of coughing is very long. Chronic cough as in asthma can affect every system in our body such as cardiovascular, gastrointestinal, neurological, musculoskeletal, and diaphragm. We report a case of 46-year-old male patient who was suffering from asthma for the past 15 years with occasional violent coughing. The X-ray of that patient was suggestive of pleural effusion which was misleading. A computed tomography scan of the thorax and the abdomen revealed the presence of diaphragmatic and abdominal hernia. The patient had no other history which can contribute to diaphragmatic injury except chronic cough. We found a chronic uncontrolled cough complicated with diaphragmatic and abdominal wall hernia

An Osteolytic Metastasis of Humerus from an Asymptomatic Squamous Cell Carcinoma of Lung: A Rare Clinical Entity

Advanced lung cancer is complicated by skeletal metastases either due to direct extension from adjacent primaries or, more commonly, due to haematogenous dissemination of neoplastic cells. Lumber spine is the most common site for bony metastases in bronchogenic carcinoma. Proximal lone bones, especially humerus, are unusual sites for metastases from lung primaries. Small cell and large cell varieties of lung cancer are most commonly associated with skeletal dissemination. It is also unusual that an asymptomatic squamous cell carcinoma of lung presents with painful, soft tissue swelling with osteolytic metastasis of humerus which is reported in our case. Systemic cytotoxic chemotherapy, local palliative radiotherapy, adequate analgesia, and internal fixation of the affected long bone are different modalities of treatment in this advanced stage of disease. But the prognosis is definitely poor in this stage IV disease