Study of respiratory symptoms among sputum positive
Study of respiratory symptoms among sputum positive Study of respiratory symptoms among sputum positive
"'Sever or massive = coughing up 150 cc more at once, 400 mIl or more of .. - blood within 3 home or 600 ml of blood within 24 hours .J r-- (c) Past history: Past history of medical importance were asked for stressing the importance ofpredisposing factor for TB e.g D.M. and past history oftreatment ofcorticosteriod and other immunosuppressive therapy (ATS, 1990). Past history suggestive of TB diseases e.g. : acquired hip joint disease leading to limping, sinus, recurrent ischiorectal abscesses, port's of spine, contact to known TB-case and pervious thoracithesis or lymphadenopathy (Mobasher, 1993). (2) Full clinical examination: - General and local examination with special concern about facial appearance toxic face or pallor and body built and scar ofBCG. Local chest signs as post-tussive rales and bronchial breathing as these are the principle finding oftuberculosis specially in the apeces of the lungs (Rossman and Mayock, 1995). (3) Radiological examination: A)Plain CXR: Postero-anterior view offull-sized ordinary CXR were done to show the radiographic features suggestive ofpulmonary T B, opacities mainly in the upper zones, patchy or nodular opacities, presence ofcavity or cavities, presence of calcification, bilateral opacities especially if in upper zone(s) and opacities that persist after several weeks (and thus are less likely due to 70
acute pneumonia (Leitch, 2000). The National TB Association of the USA (1961), classified radiographic features into three groups: (1) Minimal: Lesions of slight to moderate density, with no demonstrable cavitation. They may involve a small port of one or both lungs, but the total extent, regard less ofdistribution, should not exceed the volume of lung on one side that occupies the space above the second chondrosternal junction and the spine of the fourth or the body ofthe fifth thoracic vertebra. (2) Moderately advanced: Lesions may be present III one or both lungs, but the total extent should not exceed the following limits disseminated lesion of slight to moderate density that may extend throughout the total volume ofone lung or the equivalent in both lungs; dense and confluent lesions limited in extent to one-third the volume of one lung; total diameter of cavitation, if present, must be less than 4 em. (3) Far advanced: B) CT. Lesions more extensive than moderately advanced. C.T. was done to exclude other possible associating agents e.g tumour, 15 patient did C.T to exclusion of malignancy and after microbiological examination, there were 12 active TB. smear +ve and 3 cases were smear -ve. 71
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acute pneumonia (Leitch, 2000). The National TB Association <strong>of</strong> the<br />
USA (1961), classified radiographic features into three groups:<br />
(1) Minimal:<br />
Lesions <strong>of</strong> slight to moderate density, with no demonstrable<br />
cavitation. They may involve a small port <strong>of</strong> one or both lungs, but the total<br />
extent, regard less <strong>of</strong>distribution, should not exceed the volume <strong>of</strong> lung on<br />
one side that occupies the space above the second chondrosternal junction<br />
and the spine <strong>of</strong> the fourth or the body <strong>of</strong>the fifth thoracic vertebra.<br />
(2) Moderately advanced:<br />
Lesions may be present III one or both lungs, but the total extent<br />
should not exceed the following limits disseminated lesion <strong>of</strong> slight to<br />
moderate density that may extend throughout the total volume <strong>of</strong>one lung<br />
or the equivalent in both lungs; dense and confluent lesions limited in<br />
extent to one-third the volume <strong>of</strong> one lung; total diameter <strong>of</strong> cavitation, if<br />
present, must be less than 4 em.<br />
(3) Far advanced:<br />
B) CT.<br />
Lesions more extensive than moderately advanced.<br />
C.T. was done to exclude other possible associating agents e.g<br />
tumour, 15 patient did C.T to exclusion <strong>of</strong> malignancy and after<br />
microbiological examination, there were 12 active TB. smear +ve and 3<br />
cases were smear -ve.<br />
71
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