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Intestinal tuberculosis [keywords]
- Abdominal cocoon in a young man. [Journal Article]
- World J Emerg Med 2014; 5(3):234-6.
Intestinal obstruction remains a common problem encountered in the surgical emergency, and usually occurs secondary to adhesions, obstructed herniae or tubercular strictures. However, at times, rare causes of obstruction can also be encountered.A 24-year-old male patient presented with recurrent episodes of intestinal obstruction that was found to be secondary to an abdominal cocoon on laparotomy.The patient underwent adhesiolysis of the cocoon, and remains well on a follow-up. Histopathological report of the cocoon wall revealed fibrocollagenic tissues with a mixed inflammatory infiltrate, without any evidence of tuberculosis.Abdominal cocoon can be a rare cause of intestinal obstruction in male patients. Adhesiolysis of the cocoon membrane releases the obstruction and gives good results.
- Efficacy and safety of Stephania glabra: an alkaloid-rich traditional medicinal plant. [JOURNAL ARTICLE]
- Nat Prod Res 2014 Sep 4.:1-15.
Stephania glabra (Roxb.) Miers (Menispermaceae) has long been used for the treatment of asthma, tuberculosis, dysentery, hyperglycaemia, cancer, fever, intestinal complaints, sleep disturbances and inflammation in many Asian countries. It mainly contains alkaloids and, until now, over 30 alkaloids such as bisbenzylisoquinolines, hasubanalactams, berberines and aporphines have been isolated from its tuber. Most of its traditional medicinal activities are scientifically approved by various in vitro and in vivo studies. It shows remarkable anti-psychotic, anti-diabetic, antipyretic, analgesic, antimicrobial and anti-hypertensive activities. This work includes comprehensive information on the ethnobotany, chemistry and pharmacology of S. glabra. This review also focuses on the future perspectives with main emphasis on the establishment of therapeutic index and safety index of the plant. This review concludes that S. glabra has a great potential to treat various diseases, and could be used as a source for novel healthcare products in the near future, which needs further studies.
- Abdominal tuberculosis with an acute abdomen: our clinical experience. [Journal Article]
- J Clin Diagn Res 2014 Jul; 8(7):NC07-9.
Tuberculosis is an important cause of morbidity in India. Abdominal Tuberculosis is a great mimicker and is difficult to diagnose. This prospective observational study is based on those patients who were diagnosed to be suffering from Abdominal Tuberculosis only after they presented with an acute abdomen. This study aims to document the nature of different types of acute presentation in Abdominal Tuberculosis according to involved sites and surgical pathology. The study also discusses the indications and extent of surgical intervention.Seventy new cases of Abdominal Tuberculosis (out of 718 cases of acute abdomen) were diagnosed and treated over a period of three years in the surgical ward of Calcutta National Medical College. Macroscopic appearance of abdominal tissues during surgery suggested the diagnosis of tuberculosis. The diagnosis was confirmed by histopathology and tissue culture. All patients were subsequently treated with a full course of antitubercular drugs (ATD).The clinical presentations of acute abdomen included acute intestinal obstruction, perforative peritonitis and acute appendicitis etc. Terminal ileum and ileocaecal region were predominantly involved. The most common pathology was intestinal stricture with or without perforation. Most of the patients (approx 78.5%) required emergency surgery as a therapeutic intervention. A two-stage procedure was preferred in peritonitis and sepsis. Most of the remaining patients (12.8%) required surgery after initial conservative treatment for the first few days. Undiagnosed Abdominal Tuberculosis represents a notable percentage (10%) of patients who present with an acute abdomen as a surgical emergency.Abdominal Tuberculosis is very difficult to diagnose and diagnosis is often delayed till an acute abdomen is presented with. Almost all patients needed surgical intervention. Irrespective of surgery, all patients of abdominal tuberculosis require a full ATD.
- [Crohn's disease or intestinal tuberculosis: A diagnostic challenge.] [JOURNAL ARTICLE]
- Arch Pediatr 2014 Aug 25.
Distinguishing intestinal tuberculosis from Crohn disease is difficult and can result in misdiagnosis, especially when active pulmonary infection is absent. A 13-year-old girl was admitted to our hospital with a 2-month history of watery diarrhea, abdominal pain, and 12-kg weight loss. Based on clinical, radiological, endoscopic, and histological findings, she was initially misdiagnosed as having Crohn disease and treated with glucocorticosteroids, with a poor response after 4 weeks. Intestinal tuberculosis was then suspected. Improvement was observed during the 1st week of antituberculous treatment. The differentiation of intestinal tuberculosis from Crohn disease may be very difficult in some patients. A positive response to antituberculous treatment associated with clinical, endoscopic, and histological features argue in favor of the diagnosis of intestinal tuberculosis.
- Infectious diseases in Poland in 2012. [Journal Article]
- Przegl Epidemiol 2014; 68(2):177-85.
The aim of the study is to assess the epidemiological situation for infectious and parasitic diseases in Poland in 2012.The main source of data for this study are statistical overviews contained in the annual bulletins "Infectious Diseases in Poland in 2012" and "Immunizations in Poland in 2012" (NIPH-NIH, Warsaw 2013) and data contained in the articles presented in this issue of Przegląd Epidemiologiczny. Information on deaths due to infectious and parasitic diseases registered in Poland in 2012 and earlier years is based on the data of the Department for Demographic Research of Central Statistical Office.Upper respiratory tract infection classified as "influenza and influenza-like illness" were reported in 2012 in a total number of 1 460 037 cases. In comparison with 2011, it was an 26.2% increase of incidence, and as compared to the median of 2006-2010 of 286.1%. In 2012, with still the clear predominance of salmonellosis among intestinal bacterial infections, downward trend in the incidence of intestinal infections of this etiology persisted. In 2012 reported number of intestinal infections caused by Salmonella was, 8 267 (21.5/100 000), which represents incidence decrease of 4.5%. Foodborne infections of viral etiology were reported in 39462 cases (102.4/100 000). Most frequent were caused by rotaviruses - 23 692 (61.5/100 000). In 2012, there were 4 684 reported cases of pertussis (12.2/100 000), which means an increased incidence compared with the previous year by 180%. In 2012, there was an increase in the number of cases of mumps by 7.5% (from 2 585 to 2 779 cases), and of rubella by 46.0%, but compared to the median of the years 2006 to 2010 it was a decrease of 52.9%. In 2012, there was not any case of congenital rubella. Number of measles cases was 70 (0.18/100 000). In 2012, there was an increase in the number of cases of invasive disease caused by H. influenzae from 31 in 2011 to 36 in 2012. Number of infections caused by Streptococcus pneumoniae remained in 2012 as compared to 2011, on almost the same level: 436 in 2012 and 430 in 2011. However, there was a 36% increase in the number of sepsis cases caused by this organism. The incidence of tuberculosis in total (all forms of TB) in 2012 decreased compared to the previous year from 22.0 to 19.6 /100000, and pulmonary tuberculosis from 20.5 to 18.2. In 2012, were reported 1 093 cases of HIV infections (2.84/100 000), compared with the previous year, it was a fall in incidence of 2.4%. 21 cases of malaria occurred in people, who infection acquired abroad in malaria endemic areas. In 2012, there were no cases of diphtheria, poliomyelitis, rabies and viral haemorrhagic fevers outside of dengue, of which 5 cases of infections acquired in endemic areas were reported to National Sanitary Inspection. Total number of people who died in Poland in 2012 due to infectious and parasitic diseases, was 2 774. The share of deaths from these causes in the total number of deaths was 0.72%, and the mortality rate - 7.2/100 000. Out of all those deaths 41.1% were due to sepsis.
- Clinical problem-solving. A gut instinct. [Case Reports, Clinical Conference, Journal Article]
- N Engl J Med 2014 Aug 7; 371(6):560-4.
- The detergent fraction is effective in the detection of IgG anti-Strongyloides stercoralis in serum samples from immunocompromised individuals. [JOURNAL ARTICLE]
- Parasitol Int 2014 Aug 2.
Human strongyloidiasis is an intestinal helminthiasis that can be fatal particularly in cases of immunosuppression. The aim of this study is to assess the diagnostic accuracy of the detergent fraction (D), purified from total saline extract (SE) of Strongyloides venezuelensis, in the detection of anti-Strongyloides stercoralis IgG antibodies in serum samples from individuals coming from endemic areas for strongyloidiasis and presenting immunocompromised conditions: human immunodeficiency virus (HIV(+)), diabetes mellitus type 2, cancer, tuberculosis and alcoholism. Serum samples from 93 individuals were analyzed by ELISA, as follows: Group 1: 30 immunocompromised individuals with strongyloidiasis; Group 2: 33 immunocompromised individuals without strongyloidiasis and Group 3: 30 healthy individuals. The total saline extract (SE) and detergent fraction (D) showed a sensitivity of 73.33 and 83.33%, and specificity of 82.15 and 86.36%, respectively. The detergent fraction was effective to detect anti-S. stercoralis IgG antibodies in immunocompromised individuals with strongyloidiasis and may be applied as an important tool in the immunodiagnosis of human strongyloidiasis related to immunosuppression.
- Intestinal Co-infection of Tuberculosis and CMV can Cause Massive Lower GI Bleeding in a Patient with HIV. [JOURNAL ARTICLE]
- J Surg Sci 2013 Dec 1; 1(1):12-15.
Tuberculosis (TB) and HIV are considered pandemic by the World Health Organization (WHO). It has been reported that HIV infection is one of the major risk factors for the development of TB, increasing the incidence by up to 1,000 times, but it often has an atypical presentation. The incidence of extrapulmonary TB is increasing, largely among HIV patients. The diagnosis of intestinal TB is a challenge because of its chronic and nonspecific presentation which often mimics other diseases, and requires a high clinical suspicion to timely diagnose. Massive lower gastrointestinal bleeding due to intestinal TB was once an uncommon complication of TB, but recent reports indicate an increased incidence especially in developing countries. We suspect that co-infection with cytomegalovirus colitis contributes to the massive hemorrhage from intestinal TB. Surgical intervention is the recommended management for intestinal TB complicated by lower gastrointestinal bleeding. Accordingly, it is important for HIV patients to be screened and treated for TB to prevent this complication. Although the diagnosis is a challenge, it is important to consider intestinal TB as a cause of gastrointestinal bleeding in the HIV positive patients.
- Mycobacterium marinum Infection in Japanese Forest Green Tree Frogs (Rhacophorus arboreus). [JOURNAL ARTICLE]
- J Comp Pathol 2014 Jul 18.
Four Japanese forest green tree frogs (Rhacophorus arboreus) were presented with emaciation, abdominal distention and ulcerative and nodular cutaneous lesions affecting the brisket, limbs, digits and ventral abdomen. Another three frogs had been found dead in the same tank 1 year previously. Necropsy examination of these seven frogs revealed splenomegaly and hepatomegaly, with multiple tan-yellow nodular foci present in the liver, spleen, heart, lungs, ovaries and kidneys. Microscopically, five frogs had necrosis and surrounding granulomatous inflammation in the liver, spleen, kidneys, lungs, intestine and ovaries, with numerous acid-fast bacilli in the areas of necrosis. Two frogs had granulomatous lesions in the lungs, liver, spleen, heart, coelomic membrane, stomach and intestinal wall. These lesions had no or minimal necrosis and few acid-fast bacilli. Mycobacterium spp. was cultured from three frogs and identified as Mycobacterium marinum by colony growth rate and photochromogenicity and DNA sequencing. This is the first report of M. marinum infection in Japanese forest green tree frogs.
- Abdominal tuberculosis masquerading as intestinal lymphangiectasia. [Case Reports, Journal Article]
- Trop Gastroenterol 2013 Oct-Dec; 34(4):285-6.