Jurnal Dr Riko TB Dan DM

7/24/2019 Jurnal Dr Riko TB Dan DM

1/17

Impact of diabetes on the

presenting features of

tuberculosis in hospitalizedpatients

Pulmunology Subdivision

Internal Medicine DepartmentMedical Faculty Of Andalas UniversityDr. M. Djamil ospital Padang

!"#$

Dr. Riko Jumatullah


2/17

Introduction

Tuberculosis (TB) incidence has declined in some

developed countries, but has risen in countries with high

rates of HIV.

Man studies

TB increased among diabetics patients,especiall with poor glcemic control.

!M causes dsfunction of the immune sstem, which can

increase the susceptibilit to TB

at the same time, TB ma increase the blood glucoselevels and trigger a ""latent diabetes##interleu$in % and

T&' alpha increasestimulate anti insulin hormone


3/17

ifampicin, as an inducer of the hepatic microsomal

enme sstem

increases metabolism ofsulphonlureas and biguanides

Hperglcemia on !M can lowers the bioavailabilit

of rifampicin

Introduction


4/17

Material and methods

Study conducted at theRespiratory Department ofCentro Hospitalar Lisboa NorteHospital Pulido Valente.

Review medical record patient!!!"!!#$ %& patient with '(and D)$ also %& patient 'bwithout D) * control +roup,

Patient with H-Vecluded

No patient withimmunosuppresive therapy


5/17

Review parameters

a+e$ +ender$ immi+ration$ lun+ lesionslocation$ cavitary lesions$ etra"pulmonary'( manifestations$ multidru+"resistant '(*)DR"'(,$ adverse effects of anti"'(dru+s$ len+th of hospital stay and in"hospital mortality.


6/17

Radiographic interpretation

isolated lowerlun+ /eld *LL0,

involvement

isolated upperlun+ /eld *1L0,

involvement

)ultilobarinvolvement


7/17

Analysis

usin+ SPSS*Statistical Pac2a+e

for the Social

Sciences, version %3.!

'"test$ Chi"s4uareand binary lo+istic

re+ression*si+ni/cance level

p5!.!3,.


8/17

R!"#$


9/17

66 patients *#!.37, prior dia+nosis D)89 ural and 3

+ot insulin$ and in 9 *%6.37, cases the dia+nosis was

con/rmed durin+ the admission

'he mean a+e of patients in the diabetic +roup was

36.:%9.9 years$ while in the nondiabetic +roup it was

9%.9:%&.# years

'here were #8 males *8!.87, in the diabetic +roup and #;

*;6.67, in the nondiabetic +roup.

'he nondiabetic +roup had immi+rants *&!.67, while

the diabetic +roup had %6 *%3.37,


10/17


11/17


12/17

'he dia+nosis of )DR"'(3 patients *9.%7, of the

diabetic +roup and cases were etensively dru+"resistant'( *


13/17

DI!%"!!I&'


14/17

!M affected

presenting features of TBa higher fre*uenc of e+tra

pulmonar TB

isolated --' involvement.

. !iabetic patients alsoshowed a higher inhospital

mortalit rate

maor strengths of this studwere the signi/cant sie of

the sample, the good *ualitof data collection and the

inclusion of a control group

Maor limitationthecontrol group was not

perfectl matched with thediabetic group


15/17

'hese study showed hi+her rate of LL0 involvement in the diabetic+roup than in nondiabetic

?2to+uetal. found a hi+her rate of LL0 '( amon+ diabetics ascompared withnondiabetics*%%7and3.&7$respectively,

P@reA"BuAmnetallhi+her rate of LL0 lesions in '( D)comparison with the '( +roup *%67 vs 87,

-n fact$ the clinical and radiolo+ical presentation of '( in diabetic

patients has some similarities to that seen in H-V infected patients

Dooley et al.showed that patients with D) had .! times hi+her odds ofdeath than patients without D)


16/17

%&'%#"!I&'

!M affected some

clinical andradiologicalpresenting featuresin hospitalied TBpatients.

LL0

involvementand etra"

pulmonary '(

manifestationswere morefre4uent indiabetic

patients


17/17

$(A')!

Documents

Jurnal Dr Riko TB Dan DM