Pulmonary Tuberculosis

Objectives: This study was carried out to compare and assess two vs. three sputum samples for the microscopic detection of acid fast bacilli in suspected cases of pulmonary tuberculosis. Materials and Methods: A retrospective review of register of TB laboratory, in which record of the sputum smears result were maintained throughout 2007. Results: Among 3593 suspects, 2.85% had positive finding for AFB on third smear which were reported negative in the first and second sample. 70.09% had positive finding for AFB on first smear and 27.06% had positive finding for AFB on second smear, in which first smear failed to report positive finding. Conclusion: At least three smear microscopy examinations are required for proper diagnosis. Without rapid diagnostic test facilities, the cost of the third specimen and loss of time should not be a matter of debate. The diagnostic yield of 2.85% in third smear is indicative of the importance of third smear.

Objectives: To assess the efficacy and diagnostic yield of third sputum smear among pulmonary TB patients. Materials and Methods: Patients presenting with respiratory symptoms, having abnormal chest X-rays and having a clinical suspicion of tuberculosis were asked to submit three sputum samples on two consecutive days (1 st spot, 2 nd early morning, 3 rd spot) for acid-fast bacilli smear microscopy. Smears were prepared and stained by Ziehl-Neelsen method. Results: A total of 7785 TB suspects submitted three sputum samples making a total of 23,355 slides for checking acid-fast bacilli using smear microcopy examinations. The smear positivity rate was 11.8%. About 12% suspects fulfilled the case definition of having one positive smear confirmed by a second smear, while, only 2.5% suspects fulfilled the case definition based on third smear in combination with first or second. A total 1164(15%) suspects had at least one positive smear; of these 896(77%) were positive in first smear, 190...

Objective: This study was planned to determine the prevalence of smear positive pulmonary TB among patients receiving care at a tertiary reference Hospital-National Hospital Abuja, Federal Capital Territory (FCT), Nigeria. Background: With an estimated 9.4 million new cases globally, tuberculosis (TB) continues to be a major public health concern 1. Eighty percent of all cases worldwide occur in 22 high-burdens, mainly resource-poor settings. This devastating impact of tuberculosis on vulnerable populations is also driven by its deadly synergy with HIV. Therefore, building capacity and enhancing universal access to rapid and accurate laboratory diagnostics are necessary to control TB and HIV-TB co-infections in resource-limited countries 2. In low income countries (Nigeria inclusive), Ziehl-Neelsen sputum smear microscopy is the only cost-effective tool for diagnosis and monitoring of patients on treatment 3. There is dearth of data on the prevalence of pulmonary tuberculosis (PTB) among patient attendees from individual Institutions and Health Care Facilities performing sputum smear microscopy in Nigeria. This retrospective study will analyze sputum smear microscopy results among pulmonary TB suspected patients presenting to National Hospital Abuja, Federal Capital Territory (FCT), Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2014 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed. Methods: This hospital based retrospective study analyzed sputum smear microscopy results among pulmonary TB suspected patients presenting to the National Hospital Abuja, Federal Capital Territory, Nigeria. Sputum smear microscopy for Acid Fast Bacilli (AFB) results of new suspected pulmonary TB (Diagnosis) patients and their demographic data comprising age and sex recorded from January 2010 to December 2013 were retrieved from the TB Laboratory Register of the Medical Microbiology department and analyzed. Data processing and statistical analysis were performed using SPSS software (Windows version 16.0). The results were expressed as percentage, with significance at 5%. Results: The overall prevalence of sputum smear positive cases were 17.3% (63 0f 364) and most of the positive patients were within the age range 15 – 44 years. The highest percentage of TB was seen in the age group of 15-24 years compared with the lowest percentages in the age group below 14 years and above 45 years. A total of 63 (17.3%) suspects were found to have at least one positive. Of these, 56 (88.9% of those with one or more positive smears and 92% of those who fulfilled the case definition) were detected from the first specimen and 7 (11.1%) were positive on the second specimen but not the first. The third specimen did not have any additional diagnostic value for the detection of AFB. Conclusion: The prevalence of sputum smear positive cases of 18.3% increases with age up to the age 44 years. Our result show that examining two sputa smears was sufficient for the detection of AFB in our laboratory. Further research involving different laboratories from all of the six geo-political groups in Nigeria is needed to reassess these findings.

INDIAN JOURNAL OF …, 2006

Objective: To study the smear and culture positivity rates in pulmonary tuberculosis patients declared as smear positive in the districts of North Arcot (Tamil Nadu), Raichur (Karnataka) and Wardha (Maharashtra) in India in order to evaluate the diagnosis of pulmonary tuberculosis at the field level under programme conditions. Methods: Two specimens of sputum from each of 320 patients in North Arcot, 314 patients in Raichur and 302 patients from Wardha district, all of whom had been reported as smear-positive at the field level, were examined by smear and culture. Findings: The proportion of specimens found to be smear-negative was 4.7% in North Arcot and 5.7% in Raichur as against 38.7% in Wardha. The proportions of culture negative specimens were 5.7% and 6.3% respectively in North Arcot and Raichur, while it was 35.6% at Wardha. The difference in the smear and culture negativity between Wardha and the other two districts was highly significant. The study revealed an unacceptably high level of false positives in sputum smear microscopy in the Wardha district. This could be attributed to the absence of systematic and intensive training in smear examination consequent to the non-implementation of the DOTS strategy in this district and a high standard of training offered in the RNTCP implemented districts.

PLoS ONE, 2013

Background: From long instances, it is debatable whether three sputum specimens are required for the diagnosis of pulmonary tuberculosis (TB) or TB can be diagnosed effectively using two consecutive sputum specimens. This study was set out to evaluate the significance of examining multiple sputum specimens in diagnosis of TB.

African Journal of Clinical and Experimental Microbiology, 2010

The microbial diagnosis of Pulmonary Tuberculosis plays a key role in routine treatment and Tuberculosis control Programmes in developing countries. Many patients have presented with signs and symptoms of pulmonary tuberculosis, of which consecutive direct sputum smear microscopy have given negative results for Acid-Fast Bacilli (AFB). Microscopy of smears made directly from sputum has a low sensitivity and there is an urgent need for improved methods. This study was carried out at the Yaoundé University Teaching Hospital and is aimed at evaluating the sputum smear concentration technique in the laboratory diagnosis of pulmonary TB. Sputum samples were collected in screw-cap tight containers and evaluated by both the direct and concentrated methods. Microscopy of direct smears of sputum after liquefaction with 5% sodium hypochlorite (NaOCl) solution; and concentration of the organisms by centrifugation were compared and evaluated. Results showed an increase in sensitivity from 18.27% to 25% with a specificity of 90.95%. The tuberculosis prevalence was 25%. 13.33% belongs to the age range 20-40 years and 11.67% to the age range >40 years. The positive predictive value was 73%. We concluded that the use of sodium hypochlorite (NaOCl) in the concentration of acid-fast bacilli (AFB) in sputum significantly improves the laboratory diagnosis of pulmonary tuberculosis

Revista arheologică, 2024

The group of Dubăsari burial mounds was studied by an expedition led by N.A. Chetraru (1931-2011) over seven field seasons between 1980-1983 and 1985-1987. This group comprised two large clusters: the southwestern cluster (I), situated between Pohrebea and Dubăsari, and the northeastern cluster (II), located between Goianul Nou and Crasnîi Vinogradari, as well as four isolated mounds. In total, 38 mounds containing 139 burials were excavated during the 1980s, with the largest number of burials (18) attributed to the Scythian period, dating from the late 6th to the 4th centuries BC. The Dubăsari mounds gained widespread attention due to the Scythian complexes unearthed, which included not only gold jewelry but also Greek amphorae, Attic pottery, a Scythian stone sculpture, and a bronze cauldron. Barrow 5 was particularly notable; alongside the 814-gram gold torque of Greek origin, other significant finds included a silver horse harness ornament of Thracian origin, an Attic black-glazed kantharos, and fragments of a red- figure krater. Based on amphora fragments associated with the funeral feast, Barrow 5 can be dated to the early second quarter of the 4th century BC. At least two distinct phases can be identified in the development of the Dubăsari burial ground, with a significant gap between them. The earliest mounds (43 and 46), located in the northeast, date back to the first third of the 5th century BC, or possibly even the second half of the 6th century BC. The second phase of the burial ground, dating to the first quarter of the 4th century BC, includes barrows 45, 20, and possibly 47. The largest number of Scythian mounds and burials is linked to the second quarter of the 4th century BC, concentrated in the southwestern part of the burial ground. This phase includes barrows 13, 18, 21, and 5. According to planigraphy, seven simultaneous mounds (12-16, 51, and 52) were found surrounding Barrow 5. These mounds had no documented burials but showed evidence of burned wooden structures, suggesting that they may have served a memorial rather than a funerary purpose, likely in connection with Barrow 5, which was the dominant feature in the landscape.

R. Woodard, ed. Divination and Prophecy in the Ancient Greek World. Cambridge. CUP, 93-115., 2023

What happened when oracular consultations “failed”? Modern scholarship tends to emphasize how ancient Greek oracular consultation provided clarity and a sense of control for its clients. In contrast, myriad tales about oracles from across ancient literature tell of hopes raised and dashed, mortals who misunderstand, and oracles that mislead. This essay suggests that we might productively explore these stories as responses to an important aspect of ancient lived experience: specifically, when the events that an oracle had foretold did not occur. Focusing on oracles concerned with the foundations of settlements, this essay begins by examining how scholars have previously explained such apparent oracular failures by appealing to a combination of “structural blocks to falsifiability” (e.g., mortal misunderstanding) and ancient piety. Drawing on psychological theories and anthropological studies of failed prophecy, this essay offers an alternative account of the ways in which failed oracular pronouncements were explored, explained, and managed by those who received them. Stories of oracular failure reveal how creatively cultural resources – from storytelling to cult foundation – were employed to preserve the core concepts of communities and their cultures.

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2016

So many people helped make this project possible. My family and friends endlessly encouraged and supported my efforts. My parents, especially, instilled in me the values that laid the foundations for my path. Teachers along the way made an enormous